Clinical Reasoning Cycle and Patient Scenario - Nursing Assignment

Internal Code: MAHOZ10

Nursing Assignment

You a third-year nursing student working on a surgical ward allocated to the high dependency area. It is 7:30 am and you have just received the following handover from the night staff. Your buddy nurse asks you to care for Lisa today. Lisa a 38-year-old mother of two who competes in triathlons. Lisa presented to the emergency department 48 hours ago with an acute abdomen and was diagnosed with perforated bowel secondary to suspected diverticulitis. Lisa underwent emergency midline laparotomy with the division of adhesions and resection of 10 centimeters of bowel. Since returning to the ward she has suffered intractable pain that is not well controlled with a PCA and intrawound catheters. Her pain is reduced to a 2/10 for about 2 hours after the local anesthetic via the intra-wound catheters and then increases to 7-8/10. Lisa attempted to sit out of bed yesterday but was unable to sit due to the pain and discomfort while sitting. She had a CT scan which was NAD. Overnight Lisa had a 10 minute period of AF which altered blood pressure. She was given IV potassium and magnesium by MET Call Team.