Patient Care in a Hospital | Case Study

Running Head: CASE STUDY
CASE STUDY
Name of the Student
Name of the University
Author’s Note

CASE STUDY1
Bullet point list your main concerns for this patient
 Mrs Cherry is a 72 year old woman who has currently gone through surgical procedure
for her small bowel obstruction. The concern here is that she is an old lady, which can be
a reason for delayed treatment and limitations in medical interventions.
 She has issues with her bowel movement, which is evident from her symptoms of nausea,
vomiting and abdominal pain. It is a major concern as she is in her old age and it can
increase her dependency on others.
 Her vital signs indicated that she has low blood pressure of 100/75 mmHg. This is not
preferable for her health condition as low blood pressure can lead to severe issues.
 She has a wound drain and it might contaminate if it is not handled properly.
 She has IDC in situ that means indwelling catheter, which is a catheter used for urination.
It is used to remove urine from the bladder as the bag collects. This can be complicated
for Mrs. Cherry as she is in her old age and it can lead to pain and further infection if the
catheter is not sanitized properly.
Provide a rationale/reason for this concern
 People in their old age are vulnerable to more number of diseases and complications
especially when they are going through any surgical procedures. Mrs. Cherry is in a post-
operative stage as she was operated for her small bowel obstruction. Anaesthesia is a
common sedation that is used during surgery as it helps in the prevention of pain and
losing consciousness. She is conscious and alert after her operation but she is vulnerable
to post-operative complications such as postpartum cognitive dysfunction. It is a matter

CASE STUDY2
of concern as she is an old lady and she is already suffering from small bowel
obstruction, which was diagnosed when she got admitted.
 She was diagnosed with small bowel obstruction (SBO) and later she was gone through a
surgical procedure that relieved her from her obstruction. SBO is the blockage in the
small intestine that is caused due to several reasons such as cancer, hernia or scar tissue.
She was admitted for nausea and vomiting, which is a matter of concern for older people
as they are weak and they need to be assisted and guided during these time (Loftus et al.,
2015). People with small bowel obstruction especially older people have a high morbidity
and mortality rate. Their quality of life and functioning is affected by the complications
due to bowel obstruction. They need acute and emergency medical care due to the
increasing issues in their bodily functions and daily tasks. Small bowel obstruction is the
reason for 51% of emergency laparotomies. There is an 80% of morbidity rate in people
with small bowel resection that includes death related to emergency surgery (Paulson &
Thompson, 2015). Some of the methods of diagnosis for small bowel obstruction is
abdominal X-ray, computerized tomography (CT), standard X-rays, ultrasound and air or
barium enema. These diagnosis methods are used when the patient starts showing
symptoms such as cramp including abdominal pain, constipation, vomiting, and inability
to pass gas or bowel movement or swelling of the abdomen (Catena et al., 2016).
 Low blood pressure could be a life threatening medical condition because it indicates that
the blood is not able to travel to all parts of the body such as heart and the brain. People
in old age are more susceptible to low blood pressure as they are weak and are sometimes
deprived of nutrition. If the blood pressure is lower than 90/60 mmHg then it is diagnosed
as hypotension, which means that Mrs. Cherry needs to keep a check on her blood

CASE STUDY3
pressure because it can later turn into hypotension (Elgendy et al., 2015). She has just
been operated for her small bowel obstruction, which makes it more dangerous for
someone with hypotension. She was admitted for her tendencies that suggested that she
had obstructions in her bowel movement or the small intestine. Having a low blood
pressure can limit her medications and further surgical interventions, which is not safe for
her health. A low blood pressure could be signs of cardiovascular disease, which shows
signs of future complications.
 The concerns related to indwelling catheter is several in old age because the material used
for catheter could cause irritation and allergic reactions. When an IDC treatment is done
for a long time then it can cause kidney damage as well including injury to urethra
causing blood in urine. It can also lead to urinary tract infection, kidney or blood
infection if the catheter is not cleaned properly (Nicolle, 2014). Patients with long term
catheters have a tendency of suffering from hematuria, which is a symptom of kidney
stones or cancer in the bladder. Bladder spasm is also a common complication found in
patients who use indwelling catheter.
 Surgical draining is done in wounds to reduce the infection by removing the fluid in the
wounds. These are implants that help in the removal of fluid or gas from the wound or
any body cavity. It also helps in increasing the rate of the healing process that is
necessary for patients with surgical wounds. It reduces inflammation, foreign material,
bacteria and necrotic tissue from the wounds. The issue with wound drainage is the fact
that it becomes contaminated if the management is not handled properly. There are
certain measure that needs to be followed before handling a wound drainage such as
sanitizing the hand before using any instrument, checking room for additional