Case Study Essay

2691 Words Jun 26th, 2012 11 Pages
Case study Essay
Length: – 1800 words

Sally with Talipes who has had TendoAchilles lengthening

Sally is a 4 month old baby girl with unilateral talipes equinovarus (TEV) and congenital hip dysplasia. Serial plasters in hospital began since day three of her birth and today she is admitted to the day surgery unit for left Tendo Achilles lengthening and plaster cast application. Following surgery Sally has returned to the ward with an intravenous cannula in her right hand and a plaster of paris cast encasing her left lower leg and foot. The focus of this essay is Sally’s two priority nursing problems, which are post surgery pain related to Tendo Achilles lengthening and the plaster cast application, and secondly peripheral tissue
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Opioid side effects to consider include respiratory depression, nausea and vomiting, and should be minimised by monitoring for symptoms such as RR, HR and appetite, to avoid compromising pain management and adverse effects such as constipation should be prevented or promptly treated (AAP & APS, 2001; ANZCA, 2010; Forster & Fraser, 2007; MIMS, 2012). For infants on continuous intravenous infusion of morphine, you should also consider availability of an opioid antagonist and equipment for artificial ventilation in case of overdose (Gahart, Nazareno, 2011; MIMS, 2012). The efficacy of Sally’s analgesia is evaluated by the nurse though criteria of examination techniques with normal findings at least 4hourly and/or before repeat medication (Wilson & Giddens, 2009). The nurse observes Sally’s posture and behaviour, facial expressions, sounds made, skin colour , skin temperature, measure blood pressure, pulse, respiratory rate and pupillary size (Wilson & Giddens, 2009). Analgesia frequency and strength is adjusted in accordance to normal findings (AAP & APS, 2001). The use of non-pharmacologicalmethods can help reduce opioid intake and potentially harmful physiological and psychologicalresponses to pain (DiGiulio, Jackson, Keogh, 2007; He, et al., 2010). Non-pharmacological methods for relieving children’s pain have been sustained by various evidence and testimony (DiGiulio, et al., 2007; He, et al., 2010; Polkki,

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