Essay Mary had Haematemesis, Melena and was Unresponsive – Medical Science Assignment Help

Assignment Task:

Task:

I am the RN looking after Mary Gavin DOB: 2/04/1977 URN: 258963 under Dr. Coffey 
Mary has not passed urine overnight and has just complained of abdomen pain. She had a bladder scan and there is 800mIs residual of urine in her bladder. I have just notified the resident Dr Smith and he would like an IDC inserted and a CSU sent for C&S. It has been noticed that when she sleeps that sometimes he has periods of sleep apnea, due to her size. he was reviewed by the respiratory consultant and she has recommended a CPAP machine .t night time when she is discharged during the week. Mary will be followed up in the respiratory OPD 4 weeks post discharge. 
Mary was admitted to hospital 30 days ago after an Oesophageal Variceal Bleed at home due to Alcoholic Hepatitis, after a 3-week history of heavy drinking. She was brought in by ambulance and was transferred to ED after her brother Peter found her unconscious on the kitchen floor surrounded by hematemesis, melena and unconscious.

department (ED) by ambulance after her brother found her unconscious lying on the kitchen floor, after she didn’t answer her phone. Mary had haematemesis, melena and was unresponsive. The brother immediately rang for an ambulance. When the paramedics arrived at the house her GCS was 3 and they had to intubated her at the scene with a Laryngeal Mask Airway (LMA). On arrival to the emergency department a Sengstaken tube was inserted via the nose to stem the bleeding from her oesophagus. She had mass transfusions to stabilise her and was rushed to theatre. Mary had 6 units of PRCC, 4 units of FFP and 4 units of Platelets in ED. The mass transfusion protocol was initiated in ED. 
• In theatre they completed a gastroscopy and found multiple large Oesophageal Varices. They were tied off using endoscopic band Ligation to stop the bleeding. Mary had a further 4 units of PRCC and 2 units of Platelets in theatre due to hypotension.

• She was transferred to ICU post-operative where she remained for the next 16 days. She was newly diagnosed with Hepatitis due to Alcoholism. Mary has an acquired coagulopathy due to her liver function. She had a tracheostomy inserted due to slow weaning from the ventilator and large amounts of secretions 7 days ago. She has a left thigh wound on admission with a dressing in place.