Kelly Malone is a 49 year old female who has a history of ‘not being able to breathe well through her nose’, and this disrupts her sleep. Kelly also states that if she exercises or exerts herself, she ‘cannot get enough air in’ and has to mouth-breathe, using breathing techniques to take deep, slow breaths to stabilise her breathing pattern, so that she does not go dizzy.

 

kelly Malone is a 49 year old female who has a history of ‘not being able to breathe well through her nose’, and this disrupts her sleep. Kelly also states that if she exercises or exerts herself, she ‘cannot get enough air in’ and has to mouth-breathe, using breathing techniques to take deep, slow breaths to stabilise her breathing pattern, so that she does not go dizzy. Kelly has a history of sensitivity to codeine (which causes nausea, dizziness, temperature flushes and malaise), is not on any medication, and has no other medical problems. After review by the specialist ENT surgeon, it was arranged for Kelly to undergo surgery for a septoplasty and right ethmoidectomy. On arrival pre-operatively Kelly’s observations were: T-36.4, HR-69bpm, RR-18pm, BP-119/70mmHg, O2-94% RA. You are looking after Kelly on her return to the ward post-operatively at 11:30hrs. She is awake and alert, and has a nasal bolster under her nose, with moderate sanguineous ooze. Her current observations are: T-36.2, HR-68bpm, RR-18pm, BP-111/73mmHg, O2-93% RA, and pain score 2/10. IV compound Sodium Lactate 1L is running at 4/24 rate into Kelly’s left arm. Kelly’s anaesthetist has prescribed Paracetamol 1g 1V/PO 6 hourly, Celecoxib 200mg PO BD, and Tramadol SR 100mg PO BD. Assume nothing, if data is not stated, you should state that it is not known or information has not been provided, and advise what actions you would take. You are required to research and write an essay with headings, directly relating to the above scenario. Using the nursing process, outline the nursing management for Kelly post-surgery (using all headings in the assignment criteria), discussing all care in general, but focusing on three (3) priority nursing diagnosis/problems


 

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