Louise Young, a mid-aged woman of 30 years

Louise Young, a mid-aged woman of 30 years has gone through a laparoscopic surgery because of a ruptured appendix and have been returned to the ward. Later her readings were observed and the denominations were BP 140/75, respiration 28, pulse-112 and the temperature- 38.96°C. Louise has underground four incisions in the abdominal area which is being concealed with transparent occlusive bandages. The wounds are still intact and each of the surgical sutures is discharging fluid.

The Abdomen area of the patient is swelling and she is having the ache of 8/10 in the pain scale. The patient is having a line in the intravenous region inside the elbow i.e. the left cubital fossa. The patient is being provided with the saline fluids and maintenance dextrose at the rate of 125ml/hr. Louise is not taking any medication orally hence she is mounted with a nasogastric tube which is facilitating the free drainage. The patient was provided with the dose of intravenous fentanyl in the convalescent stage and an additional order of intravenous morphine is done for the patient.

After the befalling of half hours in the ward, the condition of the patient worsened and deteriorated. Her medical readings after the worsening of the situation are pulse 160, temperature 40.1 °C, BP100/55 and respiration 36. The abdominal area of the patient is now more bloated and stretched. The patient has lost her consciousness and regains the awareness only after she is shaken.

  1. Explain what should have been the priorities for care when the patient was returned to the ward while considering the factors like her dressing, observations, analgesia, etc.
  2. What should have been the actions and the interventions taken when the patient’s health deteriorated?
  3. What is occurring to Louise?
  4. Explain the precautions and other interventions to be done when the condition of Louis worsens.

Answer: When the patient was returned to the ward after surgery, her dressing, medical observation, and analgesia should have given more importance. After the half hour of the entry of patient the pulse, temperature and the respiration rate of the patient increased to an abnormal level. Making the situation worse her blood pressure fell to a dangerous level. Read More

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