Kristy Parkes is a 35-year-old woman who owns and runs a large cattle farm with her husband in outback central Queenslan
Posted: Thu Mar 31, 2022 8:02 am
Kristy Parkes is a 35-year-old woman who owns and runs a large
cattle farm with her husband in outback central Queensland.
Together she and her husband have a 3-year-old son, Sam. Yesterday
Kristy was thrown from her horse whilst mustering cattle. She
landed on her right side and hit her head. She was not wearing a
helmet. Her husband witnessed the event and rang for help and
Kristy was air lifted to Brisbane Hospital, 2 hours away by the
care flight rescue team. On arrival to hospital her X-rays showed
she has fractured her pelvis in 2 places on the right side, and her
head CT scan shows some right sided cerebral contusions. Kristy is
intermittently confused. She remembers her horse bucking and her
falling off but does not remember the events after her fall. She
remains sometimes confused to place and time. Her spine and neck
have been radiologically cleared and she has no neck pain. Kristy
has no other medical history. She has been administered intravenous
(IV) morphine for her pain and is waiting for surgery which is
scheduled for tomorrow to repair her fractured but stable pelvis.
Her husband has had to remain at home to care for their son and to
continue to manage the family property. It is now the following
day. Kristy has been transferred from theatre recovery to the ward
post operatively following a 3-hoursurgery to repair her fractured
pelvis. The recovery nurse hands over to you that Kristy’s surgery
went well. There was a small amount of blood loss of approximately
400mls intraoperatively. She received 500mls of fluids
intraoperatively and has been commenced on IV normal saline (NaCl
0.9%) fluids in recovery, of which the first bag is currently
running. She had fentanyl, propofol and midazolam during the
procedure and a dose of IV fentanyl was also administered in
recovery for her pain. Upon arrival to the ward, you conduct an
assessment of Kristy and find the following: • Kristy is a little
drowsy but easy to rouse,she is orientated to person, however
confused to time and place. • Kristy is moaning that she “feels
sick”. • Her vital signs are as follows: pain score is 7/10; BP
105/74mmHg; PR 95bpm, regular; RR 15bpm; SpO2 97% on 4L O2 via
nasal prongs (NP); T 35.8°C • BGL is 6.5mmol/L. Her lower limb
assessment reveals the following: bilaterally cool feet, slightly
pale skin colour, and cap refill to both feet are 3 seconds. She is
able to move both feet and can slightly bend her knees on the bed.
She denies any numbness or pins and needles to both lower
limbs/feet. • Kristy has a honeycomb long Opsite dressing to her
right hip. The dressing is clean, dry and intact. Kristy is to
remain on strict bed rest until the physiotherapist reviews her
tomorrow. Identify three (3) abnormal cues in Kristy’s
post-operative nursing assessment. For each of these cues, discuss
the pathophysiological or pharmacological factors that has resulted
in these abnormal findings. (800 words)
cattle farm with her husband in outback central Queensland.
Together she and her husband have a 3-year-old son, Sam. Yesterday
Kristy was thrown from her horse whilst mustering cattle. She
landed on her right side and hit her head. She was not wearing a
helmet. Her husband witnessed the event and rang for help and
Kristy was air lifted to Brisbane Hospital, 2 hours away by the
care flight rescue team. On arrival to hospital her X-rays showed
she has fractured her pelvis in 2 places on the right side, and her
head CT scan shows some right sided cerebral contusions. Kristy is
intermittently confused. She remembers her horse bucking and her
falling off but does not remember the events after her fall. She
remains sometimes confused to place and time. Her spine and neck
have been radiologically cleared and she has no neck pain. Kristy
has no other medical history. She has been administered intravenous
(IV) morphine for her pain and is waiting for surgery which is
scheduled for tomorrow to repair her fractured but stable pelvis.
Her husband has had to remain at home to care for their son and to
continue to manage the family property. It is now the following
day. Kristy has been transferred from theatre recovery to the ward
post operatively following a 3-hoursurgery to repair her fractured
pelvis. The recovery nurse hands over to you that Kristy’s surgery
went well. There was a small amount of blood loss of approximately
400mls intraoperatively. She received 500mls of fluids
intraoperatively and has been commenced on IV normal saline (NaCl
0.9%) fluids in recovery, of which the first bag is currently
running. She had fentanyl, propofol and midazolam during the
procedure and a dose of IV fentanyl was also administered in
recovery for her pain. Upon arrival to the ward, you conduct an
assessment of Kristy and find the following: • Kristy is a little
drowsy but easy to rouse,she is orientated to person, however
confused to time and place. • Kristy is moaning that she “feels
sick”. • Her vital signs are as follows: pain score is 7/10; BP
105/74mmHg; PR 95bpm, regular; RR 15bpm; SpO2 97% on 4L O2 via
nasal prongs (NP); T 35.8°C • BGL is 6.5mmol/L. Her lower limb
assessment reveals the following: bilaterally cool feet, slightly
pale skin colour, and cap refill to both feet are 3 seconds. She is
able to move both feet and can slightly bend her knees on the bed.
She denies any numbness or pins and needles to both lower
limbs/feet. • Kristy has a honeycomb long Opsite dressing to her
right hip. The dressing is clean, dry and intact. Kristy is to
remain on strict bed rest until the physiotherapist reviews her
tomorrow. Identify three (3) abnormal cues in Kristy’s
post-operative nursing assessment. For each of these cues, discuss
the pathophysiological or pharmacological factors that has resulted
in these abnormal findings. (800 words)