Preoperative Fasting Time

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.

The preoperative phase begins when the decision to have surgery is made. It is used to assess the patients suitability for surgery, identify potential risk factors, educate the patient on avoiding complications of surgery and anaesthesia, and plan to meet the patients needs for a safe and sustained recovery upon discharge (Berman, 2014, p. 1015). This process includes addressing all parameters on the preoperative checklist. Fasting is an important part in the preoperative phase. Preoperative fasting is the practice of a patient abstaining from oral food and fluid intake for a certain amount of time before a surgical procedure is performed. This is intended to prevent pulmonary aspiration of stomach contents during general anaesthesia. When

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.

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)

Discuss potential postoperative laparoscopic abdominal surgery complications. Include assessment findings, diagnostic evaluation, and nursing measures designed to prevent these complications from occurring.

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

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

Likewise, the same survey was used to conduct meal rounds to assess food quality and patient acceptance during three different meal periods for three different diets in the 11AB Surgical Ward. The evaluation included three diets: a puree diet, 2.5-gram sodium diet and a VHA regular diet. It seemed that most of the patients understood why they required each one of the diets. However, most of them wanted their food with more flavor and more salt. The eating and feeding concern at CLC is the ability of the patients to get any foods they want from outside restaurants or family members. It is

synthetic cannabinoids are now being used in children going through chemotherapy. These drugs help control nausea and vomiting and are also effective in appetite stimulation. The goal of antiemetic medications is to prevent the child from ever experiencing nausea or vomiting. The continued evaluation of the child's nutritional status, intake, and energy expense must happen throughout the treatment. The height weight and head circumference must be measured regularly during visits the hospital or clinic in children less than three years old. A compromised nutritional status can contribute to decreased tolerance to treatment, changed metabolism of chemo drugs, lengthy episodes of neutropenia, and increased risk for infection. Supportive nutrition measures include oral additions with high protein and high calorie foods. High calorie snacks should be easily available for the child. The most distressing side effects of combination drugs is GI mucosal cell damage, which results in open, painful sores anywhere along the alimentary tract. Oral sores in the mouth or pharynx, along the esophagus can also happen in the

I learned more about what puts these patients at risk for impaired skin integrity, such as using soap around the peristomal skin when cleaning, accurately measuring before flange placement, and emptying the ostomy before it becomes any more than half full. In regards to nutrition, I learned that patients having an ileostomy are at risk for inadequate absorption of iron, magnesium, folic acid, fat, and vitamin B12. These patients are also at risk for an increased loss of water and sodium. They are more likely to develop stones in the kidneys and gallbladder as well. Knowing these details alerts me as to what nutritional supplementation and education the patient might need. For those with urostomies, I learned that it is necessary to monitor hydration status and to encourage the use of vitamin C or cranberry juice to decrease urine pH. This promotes a clean site around the stoma. Lastly, Schreiber’s article taught me more about the patient’s need for education and assistance (possibly financial) with caring for his or her own ostomy after discharge. Because the patient is likely to be discharged quickly, it is important to implement teaching and encourage the patient to share concerns. I am now aware also of education that can be beneficial in relation to body image and returning to one’s usual lifestyle.

After 5 month of chemotherapy, she lost 10kg. This may due to the complication of chemotherapy and radio therapy. Due to this, she might be under risk of malnutrition. Considering her nutrition and mobility, her pressure ulcer risk assessment and fall risk assessment both states minimal risk. Before the surgery, patient was prescribed laxative for bowel preparation pre operation. Thus patient may pay attention to her stoma and change her stoma bag more frequently.

Details about the sample size, inclusion, exclusion, and the methods were appropriately stated and informed consent was given prior to the study. A statistical analysis was used to interpret the data by forming into table of the demographic, operative characteristics, and the clinical outcome (Jakkaew & Charoenkwan, 2012). The primary outcome was to measure the first passage of flatus and patients were instructed to report to flatus, defecation, and feeling of hunger and visual analog scores were used to measure the signs and symptoms of gastrointestinal disturbances (Jakkaew & Charoenkwan, 2012). The outcome assessor who was blinded to the study that helps eliminate the bias when collecting the data evaluated daily assessments. These methods were appropriate to measure the effects of gum chewing after surgery.

Surgery is the oldest type of treatment for cancer. In its earlier use, surgery was not as successful as it is today. This was due to the difficulties involved with the anesthesias, excessive blood loss,

“Indeed, intermittent fasting might achieve much of the benefit seen with bariatric surgery, but without the costs, restriction on numbers and risks associated with surgery.”

The article “Nutritional Requirements of Adults Before Transplantation” by Hwai-Ding Lam, MD, explains concerns regarding the nutritional management of organ transplant patients both pre and post-operatively. Nutritional assessments are important pre-operatively to determine if the patient is an appropriate candidate, and post-operatively to determine a plan of care. The conditions examined include end-stage liver disease, end-stage renal failure, end-stage heart failure, end-stage pulmonary failure, and irreversible intestinal failure. The article focuses on early assessment of the nutritional status of patients with goals including replenishing malnourished patients, maintaining the muscle and energy of patients with adequate muscle and energy reserve, encouraging weight loss in patients based on body mass index, and managing the patient’s symptoms to maximize their quality of life.