Question 1: Describe the Hartmann’s Procedure including definition, indications, and complications. Ensure you apply this discussion to Mr Kahil. (400 words)
You are handed over that the procedure went well with no complications. Mr Kahil was stable throughout the recovery period. His observations pretransfer to the ward are:
• Alert and coherent
• Temperature: 35.9 and warm on palpation
• Pulse: 72 bpm and regular
• Blood Pressure: 110/72mmHg (MAP 65mmHg)
• Respiration: 16 bpm
• SpO2: 99% on 1lt intranasal delivery
• Pain: 1/10 (localised to abdomen, dull in characteristics)
Mr Kahil is transported back to your ward for ongoing management. When you arrive on the ward you notice that Mr Kahil appears to be diaphoretic and cool to touch. You immediately complete a set of vital signs:
• • Drowsy
• • Temperature: 35.1 and cool on palpation
• • Pulse: 102 bpm and regular
• • Blood Pressure: 91/58mmHg (MAP 60mmHg)
• • Respiration: 14 bpm
• • SpO2: 92% on 1lt intranasal delivery
• • Pain: 1/10 (localised to abdomen, dull in characteristics)
Question 2: Review the above vital signs of Mr Kahil. Using your knowledge of the common causes of clinical deterioration in the postoperative patient; state which likely reversible cause (one of the 4H’s & 4T’s) Mr Kahil is experiencing and describe its pathophysiological cause resulting in Mr Kahil’s deterioration. Ensure you include a discussion of the pathophysiology of the reversible cause and link to the above vital signs. (600 words)
Question 3: Discuss THREE specific nursing assessments that would be prioritised for Mr Kahil’s deterioration (excluding vital signs).
For EACH nursing assessment, ensure your discussion includes a description of these assessments in the context of Mr Kahil’s condition AND clear rationale as to why these assessments would be priority. (450 words).
Question 4: Discuss THREE specific nursing interventions that YOU as a Registered Nurse could initiate to manage Mr Kahil’s deterioration.
For EACH intervention, ensure your discussion includes link to evidence-based practice AND provides rationale as to how it would improve the physiological outcomes of Mr Kahil’s condition. (450 words)
*Nursing interventions would include nursing activities or actions that the nurse could initiate in response to nursing assessment findings. Note: please be aware of the difference between an assessment and an intervention.
Questions 5: Mr Kahil is prescribed a bolus of intravenous isotonic crystalloid fluids. Describe the indication for and physiological effect of administration of bolus fluids. Ensure you link to the pathophysiology occurring in Mr Kahil’s deterioration and how intravenous fluids may assist. (450 words)
Question 6: Describe THREE nursing evaluations that you would complete in response to the assessments and interventions you have completed. For EACH evaluation, provide a brief rationale as to how these evaluations will assist in preventing the further clinical deterioration of Mr Kahil. (150 words).
