Case Study

[2bnurse15]

I have this case study which is pretty complex, so im asking for some help please... :wtosts:

its about a 27 yr old male with a long diagnosis of Crohn's. who in the last 6 months has had many acute episodes resulting in a BMI (body mass index) of 15. he physician believes only option is surgery.

He is employed and his partner studies at tafe and they have a 4 yr old son.

due to his state his admitted to hosptial 10 days prior to the surgery for the insertion of a central venous catheter and administration of TPN, during this time his BMI increases to 17.

In theatre aprox. 1.5 m of his small & large bowel is removed in multiple sections. when he returns to the ward he is nil by mouth and has a temporary ileostomy. he has TPN, hydration via centrl venous catheter, nasogastric tube on free drainage, indwelling catheter, and an order for I.V antibiotics.

A full blood count reveals decreased Hb, reduced PVC and slight elevation of white cell count.

on day three post surgery, his Hb drops to 62g/l. thus three units of packed cells are ordered. he tolerates first unit well. however 15 mins into the second unit, he fells unwell and his vital signs are

temp 39'C, BP 126/80, HR 128, Resp 24, SpO2 92%.

i need to list the actual and potential issues related to his situation, but more importantly i need to identify the top three high priority acutal issues/complications.

obviously the blood reaction is first priority, then pain.

could somone help me with identifying possible complications and maybe the top three complications.

Kind regards.

[Daytonite, BSN, RN]

I posted websites for you yesterday to look at regarding the surgery this patient would have and the transfusion. This information had complications of the surgery, transfusion reaction and complications of anesthesia. All you need to do now is look up information about Crohn's Disease. I've given you most all the information you need to come up with a long list of the complications. It included the actual and potential issues related to his situation. You need to sit and do some reading about this. I suggest searching on the Internet to find more information and just reading.