Assignment Task:
Case Study – Medical/Surgical
Bianca Lane, 20 years of age, Peritonitis following ruptured appendix Ms. Bianca Lane presented to the Emergency department with a history of 2-3 days of severe
Right Lower Quadrant abdominal pain, lack of appetite, nausea and fever. She has a past medical history of asthma and depression, with her current prescribed and
compliant medications list which includes:
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- Seretide
- Sertraline
Physical examination of the abdomen and an ultra-sound diagnosed a perforated appendix, which required emergency laparoscopic surgery. Bianca is now 36 hours post-operative and her observations are as follows:
- BP 94/45mmHg
- HR 136
- Temp 38.5°Celcius
- RR 24/min and shallow
- SpO 2 95% on room air
She has been complaining of increasing nausea, feeling ‘bloated’ and increasing centralised abdominal pain, that is worse with any movement and respiration, giving it a score of 7/10. Physical examination identifies a distended rigid abdomen, with generalised abdominal guarding and no bowel sounds. To investigate her condition further, a FBC, electrolytes, blood cultures and an abdominal X-ray were organised. Pathology results reveal a raised white blood cell (WBC) count and CRP, blood
cultures are pending. Abdominal X-ray identifies oedematous and gaseous distention of the small and large bowel. You are the RN caring for Bianca post-operatively on the surgical ward.perforw
Identified issue
– Oedematous and gaseous distension of the small and large bowel
– Increasingcentralised abdominal pain
– Sepsis
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