Summary Of Frusemide And Spank K

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

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 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)

My main priority would be to dehydrate the patient with a normal saline IV, then administer drugs for her pain, the dilaudid that the physician ordered for her. Then I would administer 5 ml’s of Vancomycin to treat the C. Diff.

Irrespective of the potential metabolic acidosis, Initial management of both DKA and HHS is focused on rehydration. The aim is to replace fluids in the both the intravascular and extra vascular spaces, while simultaneously diluting glucose levels (and thus lower osmolality) and counter-regulatory hormones (Raghavan, 2014) The Monash Health HHS & DKA

This adverse event should be escalated properly so that the administration and other doctors are aware of the outcome. This death could have been prevented, and others should be able to learn from this. We don’t know the full story from this short problem described in the book, but many questions arise from the situation. Was she completely aware of the risks? Did she know she was not a good candidate for the surgery?

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

The surgery was scheduled for the next day as long as the bloodwork came back fine. Well, nothing in life is ever one hundred percent planned, and sometimes life throws you, or in this case Checkers a curve ball. Her blood work came back as being anemic, and with signs of possible cushings. Not good. Surgery was postponed one week and we are hoping the new blood work in a week will be better and that the tourniquet made of sutures holds.

A 67 year old patient is having a total hip replacement surgery performed. The patient has no past surgical history. The patient has chronic back pain and has been on oxycodone 15mg every six hours for the past five years. Other than chronic back pain, the patient has no other significant medical history. Using Ward’s postoperative pain management model, this patient is over 65 years old and is advised to start with lower doses of pain medications. The patient should avoid chronic NSAIDs, but can be started on a gastrointestinal protector such as a proton pump inhibitor. The patient does not have a history of renal failure, but is opioid tolerant. This shows that the patient should remain at their current dose of opioids and expect to give more than a patient who is opioid naïve. Therefore, using this model as a provider, the author would be cautious of the patient’s age, but since the patient is tolerant to opioids the author would expect to give more than they would to a normal patient that is 67 years

General anesthesia may be needed if there are complications. This is because you need special care when you are under general anesthesia.

Today I came into the operating room and saw a sleeping patient being put onto their stomach. The patient is an obese female. The surgeon for the operation was Dr. Arias and the anesthesiologist was Dr. Speck. The procedure was a right L4-5 microscopic lumbar discectomy. The patient claimed to have pain on their right, which was a result of part of the spinal cord pinching a nerve. The radiologist in the O.R. took some X-rays, and shortly afterwards, Dr. Arias marked the area where he made the incision. Iodine was applied to the lower back of the patient. Dr. Arias scrubbed in and began making an incision. A microscope was given to Dr. Arias so he could zoom in or out of the wound and see a better view for the operation. Dr. Arias told me he

Two days following surgery, Mrs. K developed symptoms indicative of cognitive impairment and include: agitation, restlessness, attempting to remove her urinary and intravenous catheters, and laughing and crying unexpectedly (emotional lability). Mrs. K’s daughter has been unable to

Effects from the surgery itself, such as bleeding, infection, and risks of anesthesia. These risks are rare.

It is worth noting that Ms. [Name] is requiring a substantial amounts of pain medication. She was discharged from [Place] 2 months ago, on a fentanyl patch (100 mcg) and Dilaudid 20 mg p.o. q.4-6 for pain. She now has be able to taper down to 12 mg every 6 hours of Dilaudid while maintaining the fentanyl patch. This is certainly a substantial amounts of medication and is 1 of the reasons to prompt referral a to Dr. [Name]. It may seem that the total pancreatectomy is a significant intervention at this point in time, but after accomplishing a pancreatic drainage and _____(trying) pancreatic rest, there is not much more that we can do. The only other alternative would be to put her into a chronic pain management type

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