Case Study 1: Cynthia Jones
Cynthia Jones is a 49 year old woman who lives on a rural property with her 13yr old son. She is now widowed following a farm accident where her husband was killed. Cynthia has two other children who both live some distance away. She has been experiencing symptoms of dysmenorrhea which has led to a diagnosis of uterine fibroids (leiomyomas). Cynthia has a history mild depression.
Cynthia was admitted to hospital for a Total Abdominal Hysterectomy via general anaesthesia.
After 1 hour in the post-anaesthetic recovery room (PARU) and an uneventful recovery, she was transferred to the ward, where you have been allocated to her care.
PRESENTATION TO THE WARD:
On return to the ward Cynthia’s observations are as follows:
• Respiration rate 30 per minute
• BP 90/50mmHg
• Pulse 130bpm
• Temperature 36.5oC
• Pain 0/10
• Patient controlled analgesia with Morphine 1 mg bolus with a 5 minute lock out.
• Indwelling urinary catheter insitu with 10mls of urine output for the last hour
• Abdominal wound staples which are covered with transparent dressing. moderate haemoserous ooze noted.
It is planned for Cynthia to be discharged after three days on the ward.
QUESTIONS TO BE ADDRESSED:
In relation to Cynthia Jones:
• Discuss the aetiology and pathophysiology of the patient’s presenting condition (LO3).
• Critically discuss the underlying pathophysiology of the patient’s post-operative deterioration. Prioritize, outline and justify the appropriate nursing management of the patient during this time (LO1; LO2; LO3; LO5: LO6)
• Identify three (3) members of the interdisciplinary healthcare team, apart from the primary medical and nursing team, who you would involve in the care of the patient before their discharge and provide justification for their involvement. (LO1; LO4: LO5; LO6)
ACU_NRSG258_Sem2_2018