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NRSG370 Assessment Task 3: Case Study – Medical/Surgical #1
Bianca Lane, 20 years of age, Peritonitis following ruptured appendix
Ms. Bianca Lane presented to the Emergency department with a history of 2-3 days of severe Right Lower Quadrant abdominal pain, lack of appetite, nausea and fever.
She has a past medical history of asthma and depression, with her current prescribed and compliant medications list which includes:
• Salbutamol
• Seretide
• Sertraline
Physical examination of the abdomen and an ultra-sound diagnosed a perforated appendix, which required emergency laparoscopic surgery. Bianca is now 36 hours post-operative and her observations are as follows:
• BP 94/45mmHg
• HR 136
• Temp 38.5°Celcius
• RR 24/min and shallow
• SpO2 95% on room air
She has been complaining of increasing nausea, feeling ‘bloated’ and increasing centralised abdominal pain, that is worse with any movement and respiration, giving it a score of 7/10.
Physical examination identifies a distended rigid abdomen, with generalised abdominal guarding and no bowel sounds.
To investigate her condition further, a FBC, electrolytes, blood cultures and an abdominal X-ray were organised. Pathology results reveal a raised white blood cell (WBC) count and CRP, blood cultures are pending. Abdominal X-ray identifies oedematous and gaseous distention of the small and large bowel.
You are the RN caring for Melody post-operatively on the surgical ward.

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