Name: Sue Warral
Ethnicity: Aboriginal Torres Strait Islander
Marital Status: Divorced from children’s father. Currently in a defacto relationship with James Michaels (55)
Medical history: Chronic Asthma, hypertension, hypothryroidism, hiatus hernia, osteo arthritis knee’s, smokes – 1 pack per week, alcohol – social
weight 95kg, height 160cm, BMI 37
Previous history of deep venous thrombosis
Occupation: Part-time reception duties at local primary school
Next of Kin: James Michaels Defacto husband
Dependents: 2 children (Rebecca 12yrs & Nathan 10yrs)
Family: Children visit their father every other weekend. Beryl’s mum and a sister live nearby. The whole family gets together on a regular basis.
Interests: Socializing, gardening, reading
Ms. Sue Warral presents in your gynecological surgical unit for an abdominal hysterectomy tomorrow. Ms. Warral has had three consecutive abnormal PAP smears in the past four months.
The patient states she has noticed an unusual vaginal discharge over the past six months. On further investigation Sue was found to have stage II carcinoma of the cervix
She reveals to you she is anxious about the cancer and having young children to look after. She also confides that she is worried that her partner will still love her. Sue’s surgeon Dr Turner stated that they would make a decision following the findings of the surgery regarding radiation therapy.
On admission to your ward, the day of surgery, you take Ms Warral vital signs;
BP 155/85, Pulse 88 bpm, temperature 36.6 ,respirations 18 , weight 95kgs
O2 sa 97%
Allergic to Penicillin”
“The patient gives you a list of her current medications.
Serevent – one puff twice daily
Salbutamol 1-2 puffs every 3 hours as needed
Metoprolol- 50mgs daily am
Thyroxine – 50mcgs daily am
Omeprazole 20mg daily am
Panadol osteo – two tablets TDS”
You have been asked to prepare Ms Warral for theatre. Discuss the following procedures in relation to the patient’s history.
The patient has been fasting from 2400. Sue states she was not sure whether to take her morning medications. State the reason why some of her medications may be given and some withheld on the day of surgery.
Ms Warral requires blood taken for a Urea & electrolytes (U & E) before surgery.
Discuss the rationale for this investigation & type of consent required.
Discuss how you will perform a venepuncture on Ms Warral using the vacutainer system, including any infection control precautions you would take. Include rationale for actions. (procedure may be written in list form
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