Essay On Iv ) Dexamethasone

Sometimes the anaesthetist may order that a patient’s normal everyday medications be withheld the day of surgery. This is to ensure that the effect of any sedatives, tranquillisers, anticholinergics or antihistamines for surgery aren’t affected by the patient’s usual medication (Berman, Kozier and Erb, 2012). These surgery medications must be given at the scheduled time or when notified by the operating room to do

According to surveys, up to 80% of patients reported moderate to severe post-surgical pain, which can sometimes be left undertreated (Sinatra et al., 2005). Postoperative pain is generally managed with opioids, which carry numerous side effects. Side effects can be bothersome and possibly cause a delay in the postoperative healing process (Beard, Leslie, & Nemeth, 2011). IV acetaminophen can possibly decrease opioid consumption, minimize side effects, increase patient satisfaction, and decrease costs (Wininger et al., 2010). The purpose of this paper is to dive further into the research to present data on the effectiveness of IV acetaminophen in decreasing opioid usage and whether it produces an additive effect causing more effective pain management in the postop patient.

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

Ward also touches on other groups of patients who may need to be treated postoperatively. These patients include, the elderly, patients who have a tolerance, patients with persistent pain, and patients with sleep apnea. The author is able to create an easy to follow model that guides a person who is dosing these patients. For instance, the model helps to see if a patient needs to have a decreased dose due to a limitation or if they may need a stronger dose due to a

Pre-operative data collection was obtained in the ambulatory minor surgery unit (AMSU). A communication sheet was filled out that collects patient data such as their diagnosis, the procedure they are having, drug allergies, vital signs, IV placement, and their current medications. This information is documented by the AMSU

According to the systematic review covered by Apfel, Turan, Souza, Pergolizzi & Hornuss, 2013 there is a significant reduction in postoperative nausea and vomiting and opioid use when using intravenous acetaminophen. The reviewers used Medline and Cochrane databases to conduct their search along with a hand search of abstracts to identify randomized-controlled trials using intravenous acetaminophen. The review was to determine if the acetaminophen was going to have a significant decline in nausea and vomiting following surgical procedures as

Postoperative surgical pain can often be moderate to severe leaving the client in a state of discomfort that requires the administration of opioid analgesic medications. Morphine intravenous (IV) patient-controlled analgesia (PCA) is commonly provided through a pump to treat postoperative surgical pain, but with advances in the medication administration field, a fentanyl iontophoretic transdermal system (ITS) has become another popular method (Lindley, Pestano, & Gargiulo, 2009). Morphine and fentanyl are similar medications in that they are both opioid analgesics and are both equally effective to reduce pain, but they offer differences through their administration techniques, comfort for the client, and providing care in a timely manner by the nurse. The nurse must take into consideration these differences to choose the proper medication for their specific client.

Ketamine may be used for postoperative pain management. Low doses of ketamine reduce morphine use and nausea and vomiting after surgery. High quality evidence in acute pain is insufficient to determine if ketamine is useful in this

He does not smoke or drink. He is married with two children. There is no cancer within the family. No known drug allergies. Current home medications are Omeprazole 20 mg 1 tablet daily, Ondansetron 4 mg 1 tablet daily, Oxycodone 5 mg 1 tablet p.r.n. for pain. He was recently started on FOLFOX with chemotherapy. Currently patient has been on Hydrocodone, morphine IV for pain, Ondansetron IV for nausea, and Lovenox SC for DVT prophylactic. Patient has been not taking any blood pressure or diabetes medication as per hospital record which may lead to raise in blood glucose level and blood pressure (due to pain) postoperatively. Close monitoring of vital signs, pain scale and CBG will be the important in patient’s care. Due to his extensive metastatic condition, obesity and being prediabetic makes his overall prognosis poor with high chance of having complications postop including fistulas, bowel injury, infection, slow wound healing and

One of the possible complications from surgery for Mrs Smith will be dehydration or electrolyte imbalance which would be why Mrs Smith was commenced on intravenous therapy (Farrell & Dempsey, 2014, p 321). Mrs Smith would be at a high risk of either dehydration or electrolyte imbalance due to the medications she is currently prescribed. Frusemide and Spank K have many side effects one of them for both medications is dehydration although Frusemide should have been ceased 7 days prior to surgery (Tiziani, 2013, p 700). Also contributing to possible dehydration and electrolyte balance would be the amount of time Mrs Smith would have fasted prior to the operation and the amount of time the operation procedure took.

Opioid-free anesthesia, as the name indicates, is the avoidance of opioids in pain treatment pre-operatively, intra-operatively, and post-operatively in an attempt to reduce opioid-induced respiratory complications without sacrificing patient comfort. Some of the reasons to avoid opioids, besides respiratory depression, include: “muscle weakness, excessive somnolence, post-operative nausea and vomiting, ileus and constipation, urinary retention, dizziness, obstructive breathing, negative inotropism, and the possibility of tolerance and addiction” (Mulier, 2012). Post-operatively, the patient’s respiratory system may be too depressed to pass extubation criteria. If able to extubate, early mobilization may be difficult if the patient is too

Post-Operative Nausea and Vomiting (PONV) is defined as any nausea, retching or vomiting occurring during the first 24 hours after surgery (Oxford Journals). It is an uncomfortable and unpleasant experience for the patient and can adversely affect the post recovery outcome by causing dehydration, electrolyte imbalance, aspiration, wound dehiscence, increasing length of stay (LOS), unanticipated admission, and increased healthcare costs, not to mention a top concern and great dissatisfier for the patient (JPN, Hodgens). Since approximately 30% of all post-operative patients

When discussing Dextromethorphan (DXM)there are psychoactive effects similar to that of marijuana, higher doses will produce dissociative effects, including sensory enhancement and hallucinations. Drivers (male) who have been detained due to driving while under the influence of Dextromethorphan exhibit poor psychomotor performance on standardized field sobriety tests, horizontal gaze nystagmus, vertical gaze nystagmus, and overall signs of central nervous system depression,” ( Cochems, & Harding, & Liddicoat, 2007). From my research on the effects and mirroring aspects of DXM, it is noted that young men are more apt to use DXM than females, although not mentioned it would appear that DXM also has an intoxicating effect similar to alcohol. I was shocked to see that studies were done on drivers, I tend to think how safe are we while on the road?

Perioperative hypothermia causes adverse effects in the recovery of a post-operative patient. These well known effects include delayed anaesthetic recovery, increased incidence and duration of postoperative ventilation, increased blood loss and transfusion requirements, increased cardiac events, increased surgical wound infection, pro-longed hospital length-of-stay (LOS) and higher hospital mortality.

Although post-operative nausea and vomiting (PONV) has been called the big “little problem” in anesthesia, it remains a major cause of patient dissatisfaction and increased perioperative costs from delayed discharge and unplanned hospital admission. (1-3) Postoperative vomiting occurs in 30% of adults, nausea in 50% and post-discharge nausea and vomiting in 37%, with rates as high as 80% for various subsets of adults. (2, 4) In pediatric patients, the incidence of PONV in children may be underestimated as many younger pediatric patients cannot report the sensation of nausea. (2, 5) In pediatric studies the rate of postoperative vomiting (POV) is therefore used as an endpoint and the incidence of POV is higher in children than adults.