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(Solved): cenario:T.C. is a 49-year-old woman who 3 weeks ago underwent a vaginal hysterectomy and right salpi ...



cenario:T.C. is a 49-year-old woman who 3 weeks ago underwent a vaginal hysterectomy and right salpingooophorectomy for abdominal pain and endometriosis. Postoperatively, she experienced an intraabdominal haemorrhage, requiring transfusion with 3 units of packed red blood cells (RBCs). After discharge, she continued to have abdominal pain, chills, and fever. She was readmitted twice: first for treatment of postoperative infection and second for evacuation of a pelvic hematoma. Despite treatment, T.C. continued to hav abdominal pain, hills, fever, and nausea and vomiting.T.C. has now been admitted to your unit from the postanesthesia care unit (PACU) after an exploratory laparotomy. Vital signs (VS) are 130/70, 94, 16, 99.7 F. Respirations are shallow and her Spo2 is 93% with oxygen at 2 L by nasal cannula. She is easily aroused and oriented to place and person. She dozes between verbal requests. She has a low-midline abdominal dressing that is dry and intact and a Jackson-Pratt drain that is fully compressed and contains a scant amount of bright red blood. Her Foley to down drain has clear yellow urine. She is receiving an IV of 1000 mL D5.45NS at 100 mL/hr in her left forearm, with no swelling or redness. T.C. is receiving IV morphine sulfate for pain control through a patient-controlled analgesia (PCA) pump. The settings are dose 2 mg, lock-out interval 20 minutes, 4-hour maximum dose of 30 mg. When aroused she states that her pain is an 8 on a scale of 1 to 10. 1.What concerns you most right now about T.C. and why? 2.Identify factors that are affecting T.Cs respiratory status. 3.What interventions do you need to implement to promote T.C.s respiratory status?



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