ISBAR Assignment - Case Study Client Scenario Attending physician: Dr. Keating Ward: General Surgery - 5th floor Client - Mrs. Megan Webb Mrs. Webb has a documented allergy to cats; however, she has 2 of them in her home. Their names are Mickey and Mantle. She is a 40-year-old woman who lives with her husband, Chris (a carpenter), and their two small children. Her children are 7 and 10 years old, and their names are Richard and Harry. Richard's birthday is next week, and he wants a new remote-controlled car. Megan works as a teacher. She is in hospital because she had her appendix removed yesterday. The surgeon attempted to remove the appendix laparoscopically, but unfortunately the appendix ruptured so she now has an incision approximately 3 inches in length in the right lower quadrant. Megan's pain was controlled yesterday. This morning her temperature was 37.6C and she ate half of her breakfast tray. She did not consume the eggs because they were scrambled, and she prefers them hard boiled. Her heart rate is 90 beats per minute and her respiratory rate is 18 breaths per minute. Megan's son Harry has an allergy to peanuts. Megan's BP is 102/67 and her SPO2 is 97% on room air. Yesterday Megan's wound dressing contained minimal sanguinous drainage. She rested well through the night. Today her dressing is saturated with sanguinous fluid, and the blood is leaking under the dressing and is soaking the bed. Megan and Chris have plans to attend a professional hockey game in ten days so she would like to be fully healed to attend the game. Today Megan rang the call bell to notify nursing staff that she was bleeding around the dressing and her bed was wet with blood. When you took the dressing off you noticed active bleeding from the wound and two sutures appear to have been torn. Megan does not take medications. Megan has one sister named Elizabeth and has a family history of heart disease. Megan has a medical history of one vaginal and one C-section birth, and a tibia/fibula fracture with surgical repair 15 years ago related to a skiing accident. She has also had her wisdom teeth removed and has a permanent retainer behind her lower teeth. Her immunizations are up to date, with exceealth benefits through her employer that cover for a semi-private room during hospital admissions. Megan is awake and alert, GCS 15. After removing the dressing and observing the issue with the sutures, you applied a new dressing with an absorbent reinforcement but unfortunately you can now see sanguinous fluid on that dressing as well. She has IV NS infusing at 75cc/hr. Megan travelled to Mexico 5 weeks ago for vacation and enjoyed her time on the resort. Megan currently rates her pain as 2/10. You observe minimal erythema and swelling to the surgical site. She has purchased a St. Bernard puppy that she will pick up in 3 weeks. She plans on naming the puppy Bruno

organize the data from the case scenario into a verbal ISBAR report.