Importance Of Perioperative Glycemic Control : A Report From The Surgical Care And Outcomes Assessment Program

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 reporting party (RP) received call from Diego Baca with Kings County CPS, 1400 W. Lacey Blvd., Hanford, CA 93230 (559) 852-2345 who reported that on 12/21/16 at approximately 3PM while conducting a placement visit for youth Andrew Yanez DOB: 12/18/01 the youth and the social worker took a walk. During the walk Andrew disclosed that he and a staff member named Shawn Wilcox were involved in an altercation. According to Andrew at approximately 2:45PM he was in the office of the ground home with 2 other staff members named James Boston and Nicole Juarez. Andrew was requesting the staff members to take him to the store to use is Christmas gift cards, when staff member Shawn arrived and asked Andrew to exit the office. Andrew said no because

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

On placement, there were a lot of residents who had high blood pressure and diabetes, their diet was watched carefully as they needed to keep their cholesterol and blood pressure low to prevent pressure to the organs and they could eat too many sugars as the glucose would have built up in their kidneys which may have caused kidney disease.

Labeling issues-The lack of labeling as well as pre-labeling can put the patient at risk. The unit sited for this is the Operating Room.

According to the Department of Health and Human Services (2011), 18.5 % of the United States population is over the age of 60 years. Of these, 10.9 million (26.9%) are diagnosed with diabetes mellitus (ADA, 2011.) In Lewis and associates’ text book on Medical- Surgical nursing, Lewis states that the incidence of diabetes mellitus (DM) increases with age (Lewis, Dirksen, Heitkemper, Bucher, and Camera, 2011.) The purpose of this paper is to explore the disease process of diabetes mellitus in the geriatric population.

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)

In this paper I will be discussing preoperative fasting time for patients undergoing elective surgery with general anaesthesia. In clinical setting, nothing by mouth (NPO) after midnight is required on the day before scheduled surgery to prevent vomiting and aspiration of gastric content into the lungs. There are different preoperative fasting guidelines established by anaesthesiologist associations, for example the Canadian Anaesthesiologist’s Society (CAS) and American Society of Anaesthesiologists (ASA) (Tosun, B., Yava, A., & Açıkel, C. 2015). With these guidelines, fasting intervention is not just as simple as NPO after midnight. There was no evidence that showed shortened fast period increased patient’s risk for aspiration or

American Diabetes Association (ADA). (2017, January). Diabetes care in the hospital. Diabetes Care 2017, 40(1), 120-127. DOI: 10.2337/dc17-S017

Long-term weight loss is the desired end-result following gastric bypass surgery. However, this long-term goal is contingent upon lifestyle changes, including nutrition and exercise. More importantly, postoperative gastric bypass patients often have limited knowledge with regard to how to maximize weight loss. In order to measure changes and progress, two critical concepts to achieve optimal weight loss results are body mass index (BMI) and calculation of daily caloric intake. It is imperative to find out the status of respondents in post gastric bypass surgery (P), if ongoing nutrition and lifestyle training (I) compared to standard postoperative guidance (C) result in greater weight loss and decreased BMI (O) over a period of time (T)?

Equilibrium and Lechatelier’s Principle Prelab questions: 1. The solution that is not changing colour is at equilibrium, because if the colour were changing, the solution would be undergoing a chemical reaction, where the concentrations are still changing. 2. The concentration of Cu(H2O)6 will decrease; Br will increase because it is being added to, and CuBr4 will increase, to keep equilibrium.

On the day of surgery, avoid eating or drinking anything six to 12 hours before the operation. Just take a small sip of water to ingest any medication you are asked to take. Go to the hospital early so you will arrive on time for your surgery.

S.P. should be up out of bed post-op day 1 and wearing TED hose continuously, as well as wearing SCDs overnight in bed. Constipation prevention should e achieved by administering scheduled doses of Colace. Proper nutrition should be encouraged to include plenty of protein to ensure proper wound healing and avoid development of pressure ulcers (Lewis, Dirksen, Heitkemper, Bucher, & Camera, 2011). S.P. should practice coughing and deep breathing throughout her hospital stay to avoid lung congestion and occurrence of pneumonia infection, educating the patient about smoking cessation assistance can be helpful as well.

Starbucks is a business that has been around since 1971 serving a various amount of coffee for people all around the United States. This business started in the city of Seattle with getting port of coffee from around the world. Today they are international business getting in approximately $11 billion dollars a year. With this being said Starbucks is a very high pace, high traffic environment with all the stores giving a home feel to them so when you order coffee you don’t feel like you even left your house.

Diabetes is associated with an increased risk of developing primarily vascular complications that contribute to morbidity and mortality of diabetic patients. Poor glycaemic control leads to vascular complications that affect large (macrovascular), small (microvascular) vessels or both. Macrovascular complications include coronary heart disease, peripheral vascular disease and stroke. Microvascular complications contribute to diabetic neuropathy (nerve damage), nephropathy (kidney disease) and retinopathy (eye disease).