Essay Paper on Nursing Case Study: Jacob William

This case study is devoted to considering abdominal trauma, namely, penetrating abdominal trauma which is a stab. It is usual that patients with clear clinical signs such as shock, peritonitis or evisceration are supposed to undergo an operation immediately. (Norton, 2000) It is also necessary to define some facts concerning pathophysiology of the condition. It is defined by two important factors such as peritonitis and hemodynamic instability. Thus, at the examination these two factors should be paid special attention to. Also, it is important to mention that abdominal stab wounds are considered low-velocity and thus less likely to cause morbidity and mortality when compared to gunshot or shotgun wounds.  It is also important to mention that some asymptomatic patients with abdominal stab wounds can be discharged from the hospital in 12 hours after the examination if there were no missed injuries defined as is stated by Alzamel, et al in the article in the Journal of Trauma-Injury Infection & Critical Care. (Alzamel, et al, 2005) But unfortunately, it is not the case in the situation under discussion.When we get down to contemplating our case study, it is necessary to characterize the patient Jacob William, a 25-year-old football player who was admitted after the pub brawl. He was stabbed in the abdomen and sustained a fractured jaw. In two days after the admission Jacob underwent the surgery to repair an abdominal stab wound, which perforated his large bowel. As well, his jaw was fractured and had to be wired. At the moment of rehabilitation Jacob has temporary colostomy. He has now returned to the ward requiring various nursing interventions in the management of his acute injuries.

As for Jacob’s initial observations, his heart rate is 98 bpm, and his respiration  rate is 22 bpm. Jacob’s blood pressure is 100/90, his SpO2 is 95%, and his temperature is 37.5 degrees Celsius. Jacob is thirsty and has not passed urine since admission. His postoperative pathology results are as follows. Hematology: Hemoglobin; 105 (normal 130 -180) Hematocrit, Red Cell Count 3.5 (4.5 – 6.5) White Cells 32 (4.0 – 11. 0). Biochemistry: Sodium 145 (Normal 136 – 146) Potassium 5.7 (3.4 – 5.5) Chloride 107 (94 – 107) Urea 6.5 (2.5 – 6.5) Creatinine 143 (60 – 125). These exact indexes are supposed to be considered while deciding on postoperative treatment and care.

It is the caring nurse’s duty to follow the prescribed postoperative intervention in order to avoid complications which can be a result of the injury and the surgery. It is understandable that the intervention is supposed to be based on the pathophysiology of the condition. As for hemodynamic concerns there are no grounds for them. The patient displays almost normal blood pressure. But as for peritonitis, this issue should be addressed and prevented with a greater concern.

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