Case study scenario Ms Betty Smith is

Case study scenario Ms Betty Smith is a 50-year-old female who is transferred to the ICU2 (High Dependency Unit) from the general surgical ward. She was admitted to hospital 2 days ago following a fall off a ladder. She has multiple abrasions to her body and was diagnosed with 2 rib fractures and concussion. Over the past 4 hours, she has been deteriorating on the ward and her observations on arrival to you are as follows: Spo2 93% on 3L oxygen via Nasal Prongs Pulse 106 beats/min Blood Pressure 105/ 50 Respiratory Rate 30 breaths/min Tympanic Temperature 37.90C Betty has a history of, hypertension, high cholesterol and has been a one pack a day smoker for over 30 years. You realise she has not had any of her daily medications today including Lisinopril. On arrival to the department you note she has an Indwelling Urinary Catheter (IDUC) and her urine look concentrated. She has not had an accurately maintained fluid balance chart on the ward prior to her arrival. Betty has a central venous catheter (CVC) inserted into her subclavian vein due to difficult intravenous access on arrival in ED and the need for intravenous fluids. She is transferred to your department on a cardiac monitor. While assessing her it is obvious that Betty seems confused about her location and asks you why are in her house. 1: Prioritise nursing assessments and subsequent interventions in light of this patient’s current state. 2: What are the potential complications Betty Smith is at risk of developing?

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