The patient is a 29 year old woman admitted 20 hours ago for an acute exacerbation of Crohn’s disease with intense abdominal pain.

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The patient is a 29 year old woman admitted 20 hours ago for an acute exacerbation of Crohn’s disease with intense abdominal pain. She is NPO and receiving normal saline intravenously at 175 mL per minute. She was last given hydromorphone (Dilaudid) 4 mg IV 30 minutes ago. Because she did have an episode of hypotension earlier after Dilaudid, you now take her vital signs. On inflating the blood pressure cuff, she develops palmar flexion. The flexion remains after the cuff is deflated. What is most likely the cause of this problem? What electrolytes are most likely to be out of balance and why? What is your best first action? Should the Rapid Response Team be called? Why or why not? What additional assessment data are most important to collect? Explain your answer.

 
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