NRSG258: Cynthia Campbell Experiencing Dysmenorragia & Peter Harris Experiencing Urinary Symptoms – Nursing Case Study Assessment Answers
Case Study 1: Cynthia Campbell
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 dysmenorragia 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 hours 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)
Case Study 2: Peter Harris
Peter Harris is 72 year old man who was admitted to hospital for surgery following urinary symptoms that led to a diagnosis of benign prostatic hyperplasia (BPH). He has a history of COPD and Type 2 diabetes. Alan lives alone but his adult son is with him on admission and reports that his father likes his beer and can drink up to six stubbies per night and doesn’t eat well. Peter currently weighs 70kgs.
Alan was taken to surgery and underwent a transurethral resection of the prostate (TURP) under spinal anaesthesia.
After 1 hour in the post-anaesthetic recovery room (PARU) and an uneventful recovery, he was transferred to the ward, where you have been allocated to his care.
PRESENTATION TO THE WARD:
On return to the ward Alan’s observations are as follows:
Respirations 30 breaths per minute
BP 100/90mmHg
Pulse 128bpm
Temperature 35.0oC.
Pain score 0/10
He has a continuous bladder irrigation via a three lumen urethral catheter. His urine contains large blood clots.
Peter has IV therapy via peripheral line running at an 8 hrly rate.
It is planned for Peter to be discharged after two days on the ward.
QUESTIONS TO BE ADDRESSED
In relation to Peter Harris:
Discuss the aetiology and pathophysiology of the patient’s presenting condition (LO1; 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)
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