INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA

NURC 2411 FUNDAMENTAL MEDICAL – SURGICAL & SPECIAL SENSE NURSING

CASE STUDY (SR ROHAIDA ABD WAHAB)

SCENARIO:-

Mr Rizal, 24-year-old, came to Emergency Department with complaints of diarrhoea and vomiting
since two (2) days ago, loss of weight, lethargic, abdominal pain and having fresh blood during bowel
open. History taking done, patient had taking food for lunch from the stall outside his office two days
ago. Started vomiting and diarrhoea at early morning. Smoker with 10 cigarettes per day. Working as
a clerk.

Vital sign taken, blood pressure 91/42mmHg, temperature 37.8’C, pulse 110/minute, respiration
18/minute, SPO2 94%. Blood investigation done. After giving three (3) pint intravenous fluid to Mr
Rizal, his vital sign was checked and blood pressure 122/78, pulse 82/minute, respiration 18/minute.
Doctor was discharge him from Emergency Department and transfer to medical ward.

In the ward, he was reported going to the bathroom 5 times this morning and afternoon which he says
is very abnormal for him. You note his stool is completely liquid and having fresh blood.

Based on Mr Rizal condition: -

1. Explain pathophysiology changes for him.

2. Describe the investigation test would be done for him.
3. Describe type of intravenous solution would be giving to Mr Rizal at Emergency Department
and ward.
4. Discuss the treatment that will be required for him.
5. Discuss the nursing diagnosis, goal and nursing intervention based on his condition: -
a. Deficit fluid volume related to excessive output as evidence by patient diarrhoea and
vomiting.
b. Activity intolerance related to physical weakness as evidence by excessive output.
c. Risk for impaired skin integrity related to decreased skin turgor.