Postoperative Care Plan

Therefore, the overall prognosis is guarded in view of the underlying pathology, its extent and the post-operative respiratory insufficiency. The life expectancy is difficult to anticipate but the

As a clinical requirement for my Adult 1: Medical-Surgical course, I had the opportunity to observe a patient in the Operating Room and in the Post Anesthesia Unit of Advocate Good Samaritan Hospital. The procedure that I observed was a left total knee replacement. The patient needed this surgery because she was experiencing osteoarthritis, and this surgery could alleviate her pain and discomfort. I was with the patient from the end of her stay in the pre-operative holding area to the Operating Room, and then to the Post Anesthesia Care Unit. This paper will include background inquiry, preoperative and operative

During the postoperative period (IPO), it is crucial for the medical team to assess the situation after the surgery, while he patient is still in the post-an aesthetic care unit (PACU), recovering from operation he or she underwent. The nurses should cover 8 major points of interest and patients reactions to these medical tests to ensure well being of the patient, as well monitor the situation after surgery, making their professional qualifications, knowledge and skills highly important. Each of these 8 points needs to be benchmarked against the standard procedures and measurements while taking into account the pre-surgical body behavior of the patient and shall be presented separately. Vital signs are checked by presence of the artificial

Surgeons rely on technology, from diathermy to the operating room lights, assistance and team work. The conscientious staff should always ensure that the equipment is functioning and reliable. Hospital acquired conditions are medical complications that has a negative impact on patients during their hospital stay. Medicaid or additional services are not reliable to pay the hospital for any conditions that were developing while in the hospital. Based on surveys through several studies, expertise shows that medical conditions and errors are preventable. The beginning process of surgery usually starts with the patients preparations. Healthcare providers will remove hair that is on the body to be operated on. Patients who are diabetics must have their blood sugar monitor. Before any surgical procedure, healthcare nurses must interview the patient if they are scheduled to have surgery. The steps are getting blood withdrawn for lab work, receiving and E.K.G and information on past medical history. This type of process is to make sure the patient is healthier enough to undergo surgery. The preoperative phase which is the first stage used to perform tests; however the results of testing may come out wrong due to a malfunction in the machine. This can lead to a surgical infections and errors during prep and procedures. The goal of perioperative care is to provide

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).

The patient may have a hard time breathing because she is in pain after having surgery. Since they patient doesn’t want to breath due to the pain it can cause atelectasis and later sepsis if not treated in time. It would be important to teach the patient about splinting and to use an incentive spirometry in order to help her be able to breath. Another risk factor for the patient not being able to oxygenate would be hypovolemia since there is less blood volume which can also lead to less oxygen being able to travel in the blood or able to perfuse throughout the body.

In the last five years, Enhanced Recovery After Surgery (ERAS) pathways for colorectal resection have been thrust into spotlight with evidence of expedited recovery time and improved postoperative outcomes1–5. However, there exists little uniformity in the recommendations and results of published ERAS pathways, and there is some evidence suggesting that the wrong cocktail of bundle elements can increase Surgical Site Infection (SSI) rates6. This inconsistency can be attributed to a lack of consensus on the efficacy of some common bundle elements, such as preoperative antibacterial showering, maintenance of normothermia, and high intraoperative Fraction of Inspired Oxygen (Fi02) 7–15. Such dissonance in studied ERAS efforts

In this assignment we will discuss the holistic assessment process on admission to the clinical area and the duties that the nurse has throughout this process. We will also consider the medical conditions Mr C is presenting with and the appropriate care the nurse should provide relating to specific conditions. We will also discuss the pathophysiology of each of his conditions. Within the assignment we will discuss the post-operative care Mr C will be given by the nurse and the reasoning for this care. Including airway and breathing, circulation, pain management and psychological care. Whilst still in the clinical area we will explore the process of discharge planning and the role of the nurse throughout this process. Lastly we will

Therapeutic measures for a patient with congestive heart failure would be daily weights, dietary sodium restrictions, positioning in high or semi-Fowler’s position, frequent vital signs, oxygen by cannula or mask, medical devices: pacemakers, internal cardiac defibrillator, biventricular cardiac pacemaker, ventricular assist device, medications: digoxin, diuretics, inotropes, nesiritide, beta blockers, surgery: heart valve repair or replacement, coronary

Do not smoke for as long as possible before the surgery. Smoking can increase the chances of a healing problem after surgery.

During my rotation in the operating room at Community medical center, I observed the preoperative, intraoperative, and postoperative care for a patient who underwent a laparoscopic hysterectomy. I believe that an appropriate preoperative plan of care for this patient would have included a full physical exam and an interview for patient history, a pelvic exam to look over and understand the nature of the patient’s complications, blood testing including a CBC and WBC to note any signs of infection or contraindications for the procedure, and a urine test to rule out any urinary tract infections or pregnancy. It would be important to interview the patient and ask questions to determine how the patient is feeling about their procedure and to better assist with any anxiety or pain they may be dealing with preoperatively. It is important to consult with the patient well before the procedure to ensure that she knows to refrain from smoking for at least 8 weeks before the procedure because this reduces the risks of complications such as infections, issues with blood pressure, heart rate, blood flow, and respirations when under anesthesia, and promoting overall health and risks associated with smoking after the procedure. (ASAHQ) It is also important to educate the patient to consume no food or drinks after midnight the night before the scheduled procedure. (Health Communities) During my rotation I observed that the patient did indeed have labs drawn and a urine test run. Her lab

perioperative hypotension is a common problem, incidence is largely unknown. There are evidences suggesting that incidence of myocardial adverse events in the postoperative outcome may be linked to the prolonged episodes of perioperative hypotension. There are few comprehensive resources available in the literature regarding diagnosis and management of these common clinical outcomes, especially in non-cardiac surgery.[1] Perioperative myocardial ischemia is associated with significant morbidity and mortality, 50% of postoperative deaths are due to cardiac complications, the ischema is the major problem amongst.[1] It is an emergency crisis which poses a unique challenge for the anaesthetist in its management. We report a case of Intraoperative myocardial ischemia in an elderly patient with multiple comorbidities who underwent orthopaedic hip surgery . Intraoperative myocardial ischemia was diagnosed on time and was managed successfully.

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

When deciding if a patient is a good candidate for surgery, a number of considerations need to be taken. Can the patient safely undergo the surgery? Will the benefits of this surgery outweigh the negatives? For instance, if a patient is elderly, is it worth the financial, emotional, and physical cost to undergo the surgery? “Dentists must be aware of what potentially can occur and what precautions must be taken to minimize risk.” (Petranker, Nikoyan, Ogle, 2012, p. 163). In all cases, it is crucial to have a detailed medical history of the patient.