Subject Case study:
Mrs. White is a 55 yo female with a PMHx significant for HTN, and DM type 1. She was admitted for abdominal pain. A CT scan revealed appendicitis. Her home medications include: Metoprolol, Lisinopril, and regular insulin. You received her from the PACU following a lap appendectomy.
PACU Report: AOx4, VS RR 24, HR 90, BP 125/90, T 99.8, SpO2 95% of 2LNC. Lungs clear. No bowel sounds, Has a foley catheter to bedside drainage with light yellow urine. Est. blood loss in the OR was 500cc. Pain currently at 4/10 with a PCA pump with morphine sulfate. The PCA settings are as follows: Basal rate of 3ml/hr, pt dose of 0.5ml Q15min with a 1 hour limit of 5ml/hr. IV fluids of D5 ½ NS @ 125ml/hr. #20 RAC. H/H pre-op 13.5/40, post-op 10.5/32.5
- List 3 priority nursing diagnoses.
- Discuss the initial/priority interventions for this client. Include dependent and independent actions.
- What lab values are you going to need to focus on and why?
- She is on both a beta-blocker and an ACE inhibitor, why, what is the rationale?
- Her pain is being managed via a PCA pump. What is the route for this type of pain management?
- The client has been NPO for the past 18 hours. Her blood glucose is 250mg/dl. Provide an explanation for the elevation in blood sugar.
- Determine the nursing priorities for this finding.
- Discuss the priority assessments related to this treatment protocol.
