NUR5703 - Mrs. Koehlert Case Study - Clinical Manifestations - Nursing Assignment Help

Assignment Task

Mrs. Koehlert 60 year old presented to GP two years ago  with swallowing difficulty and CT scan of the head and neck and MRI permformed and it was showing Right Acoustic Neuroma with 18mm in size.Same time she was also diagnosed with Goitre. At that time she did not have any symptoms so that she delayed surgery. Over  time she describes long standing  intermittent tinnitus associated with intermittent  dizziness,unsteady gait and vertigo. Pt had repeat MRI  and the Right Acoustic Neuroma gown from 18mm to 27mm .There significant brainstem compression with displacement but no hydrocephalus.The GP referred to the neurosurgeon with MRI report. Mrs Koehlert had ENT review and noticed R)hearing is less however,she did not feel any hearing imapairment. Usually ambulates normally. 

Surgery performed : Right retrosigmoid Craniotomy and resection of acoustic neuroma and cranioplasty.

Operation Findings  : please see  in the attached document

Current medication-
Ondansetran 4mg 8 hourly
Metoclorpromide 10 mg four times a day
Dexamethasone 4mg three times a day
Oxycodone 5mg 3hrly PRN
Tramadol 50 mg 6 hrly PRN 

IVFluids-CSL,Normal Saline 0.9%

Post operative complication which Mrs Koehlert had -reduced R)hearing ,L)facial droop from moderate  damage of the facial nerve which are expected risk in her surgery.

Nil allergies

PmHx 
Migraine  from 2017
Goitre-2018
GORD
Osteoarthritis
Haemorrhoids 
R)breast Cancer  and had Lumpectomy -2013
Inguinal Hernia repair
Ex Smoker

Medication
Pariet -20 mg

Social-Active
Family relationship-lives with husband in a single house

On Discharge Pt's condition
HB4 facial weakness
Complete loss hearing
ambulate with 4wf  independently

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