The Tracey Baxter Case Study - Nursing Assignment Help

Assignment Task:

A six-year-old child, Tracey Baxter, was admitted to hospital for a routine tonsillectomy. 

The operation was performed at the commencement of the afternoon list at 1300 hrs and the child was in the recovery room at approximately 1400 hrs. Just prior to the surgery, an intravenous (IV) line was inserted and the child received 300mL of normal saline during the surgery. 

At the conclusion of the operation, the surgeon wrote on the IV order chart that the child was to continue to receive 60mL per hour of the saline solution. The registered nurse in the recovery room commenced an observation chart on the child, but did not commence a fluid balance chart, which was later commenced in the children’s ward. The nurse working in the recovery room made some record of Tracey’s pulse rate and wrote that the child was to have ‘as much fluid as possible in the ward’. 

Tracey returned to the ward at approximately 1500 hrs, the fluid balance chart was commenced and observations continued. At 1630 hrs a further litre of IV dextrose/saline fluid was commenced, which was completed by 0200 hrs the following morning. A further litre was commenced by the registered nurse on night duty. By 0900 hrs the same morning, Tracey had received 700mL of that litre (this figure is not evident from the fluid balance chart, but this fact was established at the Coroner’s inquest). The IV fluid intake from the time of the surgery until 0900 hrs the morning after the surgery was three (3) litres. 

The observation chart reveals that Tracey’s observations continued ad hoc. A critical examination of her pulse rate demonstrates a slow but steady decline and one section of the nurse’s notes reveals that the child’s pulse rate went as low as 48 b/min.

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