Acute Operative Surgery And Surgical Stress Responses

The mineralocorticoid (aldosterone) is normally released by the adrenal cortex in response to decreased sodium and increased pottasium levels; the hormonally acts to promote the retention of Na and the excretion of K. It isn't working; hence the abnormal serum levels.

On 01/27/2016, I observed about 22 patients in Postanesthesia Care Unit. Some of the patients were observed after surgeries while others were observed after endoscopy. During my shift, I observed patients awaiting recovery for removal of kidney stones, malignant melanoma (removal of moles), Endometrial Biopsy (EBX), superficial femoral artery (SFA), Hernia repair, Oophorectomy (ovary removal surgery), Cardiorrhaphy (Ventricular repair), Cystolithalopaxy (bladder stone removal), gall stone removal, Ectopic pregnancy surgery, and leg surgery.

The day after the surgery was just as bad as the day of the surgery. I was wheel chaired out of the hospital, and I felt tired, groggy, exhausted, and overall just terrible. On the car ride home my heart was hurting a lot and I was having a lot of irregular issues with my heart. I was having more panic and anxiety attacks. The incision wounds partly reopened so that was really scary. This experience changed me quite a bit and not in a good way. It was one of the worst experiences in my life. It has made me constantly worry about my heart and health. I have really bad anxiety when it comes to my heart. Or anything for that matter. I am always worrying about my heart. This experience changed the way I felt about surgery and what people go through. I dislike surgery so

The appropriate assessment of patients prior to surgery to identify coexisting medical problems and to plan peri-operative care is of increasing importance. The goals of peri-operative assessment are to identify important medical issues in order to optimise their treatment, inform the patient of the risks associated with surgery, and ensure care is provided in an appropriate environment secondly to identify important social issues which may have a bearing on the planned procedure and the recovery period and to familiarise the patient with the planned procedure and the hospital processes.(American Society of Anaesthesiologists)

The pre-operative stage is an important phase in patient’s surgery process. This is the time where the patients is experiencing a lot of anxiety issues and have questions regarding the impending procedure. To help ensure good patient outcomes, it is imperative to provide complete preoperative instructions and discharge instructions (Allison & George, 2014). It is the nurses’ duty to safe guard and protects the patient’s welfare during the surgical experience. Effective preoperative preparation is known to enhance postoperative pain management and recovery. Health professionals need to be cognizant of the contextual factors that influence patients’ preoperative experiences and give context appropriate care (Aziato & Adejumo, 2014).

This study will adopt a literature review methodology, for critical and analytical assessment of the recent studies carried with a relevant outcomes to this study and particularly, studies that determine the effective methods of three intervention (parental presence, Sedative premedication and distraction) to alleviate preoperative anxiety of children. Siu and Comerasamy (2013) stated that literature review methodology is documented as essential methodological process to resolve research problems. Furthermore, contributing to improvement of knowledge in area of practice (Aveyard and 2014).

Hi Gregory, great information on glucose level before and after surgery. Moreover, I work in the pre and post surgery unit, blood chemistry are checked on each surgical patient. Blood glucose over 200 are treated, became this increase the chances of non- healing wound or infection, and moreover can cause other complications. Education in these patients before and after surgery are important, "the better control of your diabetes, the better your chances of an excellent surgical outcome. Keeping your blood glucose within the parameters your doctor recommends is key. Top-notch nutrition, including high-quality protein, is also essential. Protein is an important component in the healing process and can help contribute to faster wound healing, stronger

shortness of breath. Pain improved with sublingual Nitroglycerine and Aspirin given by EMS. On arrival to ED his blood pressure was 154/94, HR 70 bpm, RR 19 and SpO2 98% in room air. Heart, lung, abdominal and neurological examinations were unremarkable.

This is a mix of qualitative and quantitative research that uses descriptive and cross-sectional survey design methods to evaluate the patient’s anxiety level and discomfort preoperatively and postoperatively. The level of evidence in this study is III, with controlled trial without randomization (LoBiondo-Wood, 2013). Methods used to collect data are logical, as it corresponds to the phenomenon of interest in this research as listed in the critiquing guideline table in appendix A. This study was conducted in the general surgery unit of a university hospital in 2011 with a sample size of ninety-nine patients. Definitive features, visual analogue scale (VAS) and State and Trait Anxiety Inventory (STAI) tools were used to collect data, refer to appendix A for details. The fasting protocol reported by the nurses in the surgical unit was no solid food on the day before surgery after 10:00 p.m. and no liquid after 12:00 a.m. In the meantime, the patients were on isotonic sodium chloride from beginning of anaesthesia until the 24th hour postoperatively. The result shows that patients who fasted for more than twelve hours has significant increase in anxiety level according to the STAI score, and higher hunger, thirst, nausea, and pain as shown in VAS scores compared to the patients whom fasted for less than twelve

An attending physician statement completed by Dr. Peter Chweyah (Internal Medicine), dated 06/16/2016, indicated that the claimant presented with complaints of lower extremity weakness, neuropathy, weight loss, acute renal failure, and gout, as well as anemia. Objective findings showed an extreme weakness of the legs and pain in the feet. He also had diabetes mellitus type 2, chronic kidney disease, and hypertension. It was noted that the claimant was totally disabled from 05/30/2017 through 06/15/2017 and 05/23/2017 - 05/26/2017 secondary to gout.

Patients with chronic conditions such as cancer, diabetes, or multiple surgeries may experience higher levels of stress; especially if they are parents or have a spouse that they normally take care of. My patients normally exhibit some level of stress that is hard to determine sometimes with just simple conversation.

Hypovolemia can be due to many predisposing factors such as fracture and surgery. The patient experienced a type of open fracture which is categorize by a wound in combination with the fracture (Whiteing, N., 2008, p. 50). Open Reduction Internal Fixation (ORIF) is the most common surgical technique for patients with open fracture which also includes tibia and fibula (William, L & Hopper, P., 2011, p. 1071). Since it was a major surgery massive blood loss or hypovolemia can be experience by a patient who will undergo this procedure. Craft, J., Gordon C., & Tiziani, A. (2011, p. 895) states that hypovolemia is a decrease in extracellular fluid volume and decrease in blood volume. In addition, Buttaro, T., (2013, p. 982) implies that there is approximately two (2)

The management of postoperative pain has received much interest nowadays. The intensity of postoperative pain depends on many factors such as type and duration of the surgery, type of anesthesia and analgesia used, and the patient’s mental and emotional status (11).

In a critically ill patient trauma to the body will cause a response of increased metabolism and hyperglycemia. This response involves the endocrine, immunological, and hematological systems. The main cause of the hyperglycemia is the pituitary hormone secretions in conjunction with an activation of the sympathetic system. This is referred to Stress Induced Hyperglycemia, or SIH. In these cases, the stress comes from the trauma and can cause an adrenal cortisol and catecholamine surge that is said to cause the SIH and correlate to how severe the injury is. There is an over abundance of gluconeogenesis, glycogenolysis and insulin resistance that happens in response to the neuroendocrine system. The cause of stress hyperglycemia is from an increased

A systematic review undertaken by Smetana (2009) identifies postoperative respiratory failure as an example of cascade iatrogenesis i.e. serial development of multiple medical complications that can be set in motion by a seemingly innocuous first event. In this case, Mrs Hilton’s open cholecystectomy is that first event. Smetana (2009) points out that: when an older patient with postoperative pain is over-sedated, a decline in respiratory function occurs, that if not recognized, can result in respiratory failure that requires mechanical ventilation, that again, if not managed properly can culminate in ventilator-associated pneumonia and even sepsis and death (p.1529). After her upper abdominal surgery Mrs Hilton may have difficulty with deep breathing and coughing due to pain however both are essential interventions for prevention and treatment of respiratory infections and complications. Brown et al. (2008) recommend that when Mrs Hilton is awake, turning, coughing and deep breathing should be encouraged every one to two hours as this aids in the removal of secretions and prevents mucous plugs. They also encourage mobility when possible to increase respiratory excursion. Moreover, as Mrs Hilton