Focus: Cardiac Assessment
Shift to shift Handover
Introduction Kaylene McCallum is a 64-year-old female admitted under Dr. Tracy Taylor
Situation Kaylene presented as an inpatient to surgical Ward 5 days ago for a right
knee replacement. Discharge has been delayed due to constipation and an
asthma attack that are now controlled.
Background Kaylene has a history of hypertension, asthma and osteoporosis. She lives
alone with her dog Sam. Nil known allergies. Kaylene receives an annual
zoledronic acid infusion for her osteoporosis and she takes irbesartan for
blood pressure control. She uses a Seretide inhaler daily and salbutamol PRN
to manage her asthma. Appendectomy at 12 years of age.
Assessment Vital Observations
Respiratory rate – 16 breaths per minute
Oxygen saturation – 96% on room air
Pulse – 89 bpm, thready and regular
Blood pressure – 105/65 mmHg
Temperature – 37.5°C
Dressing to right knee remains dry and intact.
Pain to right knee – 2/10 at rest increasing to 5/10 on
Recommendations Prepare for discharge tomorrow assuming Kaylene remains stable.
You are halfway through your busy AM shift when you undertake a set of vital observations on
Kaylene. You discover her blood pressure is 92/55 mmHg and she tells you that she feels a little
Differentiate normal from abnormal assessment
Using a symptom assessment framework, state
5 (five) questions you would ask to assess the
hypotensive episode. Other than blood
pressure, describe 3 (three) specific
assessments you would undertake and using
anatomy and physiology explain why these
assessments are relevant.