Surgical Oncology Case Study

For the duration of my surgical follow through experience, I had the pleasure of following RF. RF is a 49 year old male with an admitting diagnosis of cervicalgia cervical herniation, and a scheduled surgery for an anterior cervical discectomy and fusion at C4-C5 and C6-C7. According to Sharon Lewis in “Medical Surgical Nursing”, the cause of a cervicalgia cervical herniation is “the result of natural degeneration with age or repeated stress and trauma to the spine.” (Lewis, 2011) The follow through process was observed from when the patient arrived in the pre-op holding area until the

The patient did not receive standard treatment to prevent the formation of a DVT. What are some possible reasons why this error occurred? The first reason was that the nurses and staff on the floor were so focused on his admitting problem being related to COPD, which caused his respiratory infection, which then caused his kidneys to not function properly. Since his kidneys were not up to par, the staff wanted to make sure that he was not going to go into kidney failure, so that was their number one priority at the time. Secondly, the admitting doctor did not order DVT (deep vein thrombosis) prophylaxis. Based on his thrombosis risk factor assessment, the patient would have scored as a high risk. He should have been placed on sequential compression devices (SCD), and either heparin or lovenox (University of Michigan Health System, n.d.). The most alarming reason was that the nurse did not

This clinical rotation I was assigned to observe at the operating room, where they conduct various surgical procedures. The night prior to the clinical, I have to admit, was every bit unnerving. Especially, the fear of not knowing what to expect was daunting. There must have been a thousand scenario of what to expect or what might possibly go wrong playing through my head that night. However, after being introduced to the nurse I would be following, and meeting the surgeon and the rest of the team; my nerves settled down. The surgery scheduled was for a ventral hernia, which seemed routine, but complicated by a previous bowel realignment previously. The whole operation, from beginning to end, lasted a little over four hours. Although, the procedure lasted that long, it did not bother me even bit. In spite of standing for the whole duration of the observation, I never felt tired nor gotten bored. Notably, watching the surgical team working cohesively is like watching an artists who have

In transport, patient received O2 at 4 liters via nasal cannula, baseline EKG, Normal Saline IV started in left hand, 325 mg aspirin by mouth (po). Patient complained she was short of breath and experiencing severe pain between her shoulder blades. She stated that she has been feeling nasuseated for the past 3 hours. She states she has a history of stable angina and is currently taking medication as needed. She states she did not take the nitroglycerin because she was not experiencing chest pain, just back pain. She states that her last check-up with the Pulmonologist showed that her EKG did not show any changes since her last visit. She denies episodes of syncope. The patient does report that she tripped over something on the floor, which resulted in her falling and hitting her back on a large table. In addition, she states that her heart rate has been ranging from 130/ 90 to 140/92. Patient states her Primary care physician placed her on blood pressure medication 2 months ago due to the increase.

The medical director ordered a postvoid catheterization, which yielded 100 mL of cloudy urine that had

Mr BW had a surgical history of anterior resection for bowel cancer and had undergone a colectomy post iatrogenic perforation. He had known hypertensive and non-compliant with his medication. At the same time, he was known to be alcoholic abuse, seizure and had prostate cancer, which was treated with brachytherapy that was well controlled.

On May 11,2017, beginning of lab, students were given an unknown fluid along with a patient’s background information. A physician has recently inserted a urinary catheter into 62-year-old Steve’s bladder. After a month, Steve has

The patient will require surgery to repair the hole in the intestines, and subsequently will have a drainage tube, NG tube, and feeding tube. All drains will need to monitored for placement/movement, and drainage. Input and output will be closely monitored and recorded. The patient will remain on NPO, or nothing by mouth, to rest the bowels along with frequent assessments to monitor for infection and bleeding. The nurse will need to monitor for bowel sounds, vital sign changes, temperature changes, pain, abdomen girth, and wound/incision inspections. The following labs will require monitoring: CBC, H&H, albumin, BUN & creatinine, glucose, and ABG’s and lactic acid if sepsis is suspected. Careful and frequent monitoring of labs will alert the nurse if the patient develops sepsis, or hypovolemia due to excessive bleeding (Belinhof, et al., 2012). In addition to vital signs and labs, the nurse will also include patient assessment into consideration before drawing conclusions by means of critical thinking. After the full assessment has been made, the nurse will report any findings to the health care provider that require further investigation or

Jones arrived at the operating room at 0745 hrs. Patient was transferred to OR table with arm boards at a 90-degree angle and shoulder braces. Anesthesia administered general anesthesia at 0800 hrs. Anesthesia intubated patient at 0810 hrs. Hair was removed from perineum prior to skin prep. A catheter is inserted into the urinary bladder, the bladder is irrigated. Skin was prepped with Chloraprep from nipple to mid-thigh, and allowed to dry for 5 minutes. He was draped with cuffed towel and an impervious sheet under the scrotum, folded towels, sheet with an aperture, laparotomy sheet and an individual drape sheet. First count with surgical technologist and circulator is accurate.

A 62-year-old white male presented to the hospital for a scheduled ventriculoperitoneal shunt removal. The patient had developed cysts in the brain seventeen years ago in 1998 leading to increased intracranial pressures from accumulation of cerebrospinal fluid. After discovering the brain cysts, the patient underwent a ventriculoperitoneal shunt placement. Two years after the shunt was placed, the patient underwent another procedure for shunt revisions due to complications with infection. Now, the patient is presenting for removal of the shunt. In the pre-op holding area, the patient’s vital signs were taken. The patient’s blood pressure was 153/75, heart rate 80, respirations 18, oxygen saturation 93% on room air, and temperature was 36.5 degrees Celsius. Prior to the patient’s surgery, lab work was performed consisting of a CBC and CMP. The patient’s white blood cell count was 11.7, platelets 379, hemoglobin was 10.8 and hematocrit was 33. The patient’s potassium level was 3.7, calcium 9.1, sodium 145, BUN 35, and creatinine 2.21.

D/A: Maurice Brown had one appointment this week. On 12/14, he was seen by Doctor Nat Ramani of the GI Associates of Delaware. According to Doctor’s note, consumer tolerated procedure well. He did not have fever, rash, or chills post procedure, but still complains of having periumbilical abdominal pain frequently for 2-3months. He describe pain as sharp in nature, rates it 7 out of 10, wakes him up from sleep at night, no exacerbating factors, radiates to both sides of his abdomen, alleviating on passing gas and having a BM. On 12/14, 12/17, Mr. Brown went for his dialysis. On 12/17, he went twice, in the morning at 10:00 a.m. and in the afternoon at 4p.m. when this writer his Case Manager asked him how his treatment was going? He said ‘’fine,

The patient is a 45 year old man who had GI surgery 4 days ago.  He is NPO, has a nasogastric tube, and IV fluids of D51/2saline at 100 mL/hr.  The nursing physical assessment includes the following:  alert and oriented; fine crackles; capillary refill within normal limits; moving all extremities, complaining of abdominal pain, muscle aches, and "cottony" mouth; dry mucous membranes, bowel sounds hypoactive, last BM four days ago; skin turgor is poor; 200 mL of dark green substance has drained from NG tube in last 3 hours.  Voiding dark amber urine without difficulty.  Intake for last 24 hours is 2500mL.  Output is 2000mL including urine and NG drainage.  Febrile and diaphoretic; BP 130/80; pulse 88; urine specific gravity 1.035; serum

Two wide bore cannula, were inserted and a full set of bloods was taken including blood cultures. 15 litres O2 via a rebreather mask was applied. Intravenous fluids were commenced and rapidly infused. An ECG was done by the intern. She was checked and rechecked for any signs of bleeding and an internal examine was done by the consultant to check for any retained products. Intravenous antibiotics were also started and given. All drugs such as anaesthetic drugs or analgesia that Susan had been given that day were also checked to see if it had been an adverse reaction. Over the next 40 minutes she began to improve and was transferred to the labour ward for closer observation.

Pain can be categorised as either acute pain or chronic pain. Acute pain is short lasting and will commonly subside once healing has taken place (Mac Lellan 2006). It is often a sudden onset and usually lasts less than 6 months. The main example of acute pain would be the pain experienced post surgery. Chronic pain on the other hand is a prolonged and persistent pain that remains long after the normal healing process of 3- 6 months. A common example of such a pain would be chronic back pain (Mac Lellan 2006). For the purpose of this assignment, the management of acute pain post surgery will be discussed with reference to a particular scenario, which followed the care and pain management given to a patient post appendectomy.

You might not be feeling healthy or you have observed some growths on your body that are making you panicky. What type of doctor do you need to find to get the appropriate diagnoses and treatment options desirable to continue living a healthy and long life? Maximum hospitals have a division of surgical oncology that deals precisely with both the management and treatment of tumors. You need to comprehend that not all tumors are oncogenic, but nonetheless, you need proficient advice in treating any condition that encompasses uncharacteristic growths.