Pre Operative Care For The Patient With Diabetes

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 The steps are getting blood withdrawn for lab work, receiving and E.K.G and information on past medical history.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

Scenario: Mr. B, a 67-year-old-man, came to the ER complaining of severe pain to his left hip and leg after falling over his dog at home. Left leg appears shortened with swelling in his calf, bruised, and limited range of motion.Mr. B has a history of impaired glucose tolerance and prostate cancer. Home medications include atorvastatin and oxycodone for chronic back pain. Mr. B’s labs, taken during a previous visit with his primary care doctor, revealed elevated cholesterol and lipids.

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)

According to the Wound, Ostomy, and Continence Nurses Society, (WOCN), before focusing on the ostomy care, the nurse should establish a relationship with the patient and their family. A comprehensive assessment should be performed that focuses on all aspects of the patient’s wellness; physical, psychosocial, cultural and spiritual. The nurse informs the patient about dietary needs, bathing/showering, and returning to work (Cronin, 2005). In doing so, the nurse gains the patient’s trust and confidence helping ease them throughout the intervention process. The assessment allows the nurse to fully recognize the patient not as another client needing a procedure but as a person who is going to have questions, concerns, and needs (WOCN, 2010).

An elderly patient is complaining of a bad cough at her yearly physical. She has recently been diagnosed with diabetes and regularly takes prescription pain medication for her arthritis.

NH hospitalization record reveals a medical history of a non-injurious stroke, numerous episodes of sickle cell crisis, acute chest syndrome and chronic asthma. NH is prescribed a daily regimen of medications including a daily dose of 15,00 mg hydroxyurea, 1 mg folic acid for his SCD and 44 mcg of inhaled fluticasone for his asthma. Currently, while suffering from sickle cell crisis, NH is prescribed oxycodone 5mg, Toradol 21 mg IV solution, acetaminophen, and morphine as well as a continuous IV drip of D5 ½ NS, KCL. Due to the opioids and level of pain NH has endured the last 4 days (since beginning of crisis) he is exhausted and considered a fall risk due to his fatigue and reports that he naps off and on throughout the day and only gets out of bed to use the

During the discharge process, Mr. K was instructed to follow-up with his primary care provider. The inpatient team also gave Mr. K prescriptions for a new anti-hypertensive medication. Sadly, they did not provide any instructions about his previous anti-hypertensive drugs. As a result, Mr. K continued to take the old and the new anti-hypertensive medications. Since his next appointment was within three weeks, he decided to wait instead

Ms. Castellanos reports she suffers from arthritis, dizziness, and headaches due to a head injury, hypertension, and cataract (both eyes). Client reports she underwent cataract surgery 10/8/15 in the left eye and 10/25/15 in the right eye. Client continues to reports she is currently taking the following medications: Meclizine 25mg, Simvastatin 40 mg, Gabapentin 300mg, Oyster Shell Calcium tab 500-200mg, Omega-3 Ethyl Esters 1mg, Losartan-HCI 100-12.5mgG, Amitiza 24 mg, and Sertraline. Client continues to report she is seen by Dr. Molinas Alveris tel3 718-4264747 located at 9319 Roosevelt Ave Fl 1, Jackson Heights, NY 11372.

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.

All three providers have agreed that prescribing a pharmacologic and non-pharmacologic treatment regimen must result from clinical judgment based on a thorough assessment of the patient and the patient’s environment, present and past medical history, current home medication, the determination of differential diagnosis and appropriate diagnostic procedure, a review of potential alternative therapies and specific knowledge about the drug chosen and the disease process it is designed to treat (Woo & Robinson, 2016; p.6).

Member experienced moderate pain due Dx. Osteoarthritis, have an unsteady gait, experiences dizziness (new medication Flomax 0.4 milligram) and is a risk of falling (score 11). He needs assistance of daily living. Goes to bathroom frequently due to Enlarged prostate.

The offender returns to clinic today for a number of issues. 1. Diabetes mellitus type 2: This has been well controlled on oral metformin and the patient reports that she has no concerns in this regard. Last hemoglobin A1c was 5.9 about a month ago and all other labs within normal limits except for a quite high LDL at 171. She has not been on cholesterol-lowering therapy in the past. In addition, her TSH was very slightly elevated at 4.740 which can be considered the upper limit of normal. She has not noticed any significant constipation, excessive fatigue, or cold intolerance but she has had continued trouble with weight gain and thinks she may benefit from some low-dose thyroid replacement. 2. Chronic low back pain: At

This assignment shall focus on a patient called Audrey Smith, a 75 year old lady who has been transferred to the ward from the emergency department with a fractured neck of femur, small haematoma to the left forehead, soft tissue injury and bruising to the left shoulder following a fall at home involving her dog. On admission to the ward at 14.00 hours, Audrey has an intravenous transfusion in progress, an indwelling catheter insitu, she is alert and orientated to time and place and is responsive with a GCS of 14. The plan is for Audrey to go to theatre for arthroplasty of left hip at 17.00 hours. She is nil by mouth and requires hourly neurological observations. The author shall discuss the holistic nursing interventions Audrey shall receive to ensure she is safe, her hygiene and comfort, elimination and nutritional needs are met.

Gilmartin, J. (2003). Day surgery: Patients’ perceptions of a nurse-led preadmission clinic. Journal of Clinical Nursing 13, 243-250.

This textbook focuses on medical-surgical nursing which covers basic topics such as concepts of nursing to more complex issues such as fluid balances within the body, oxygenation and blood perfusion, and breathing or respiratory issues. The purpose of a medical-surgical textbook for nursing students is to give them a foundation to build their future knowledge upon. This type of textbook will teach them the very basic concepts a nurse needs to know and later in their schooling they will learn more in depth illnesses, treatments, and procedures.