Anesthesia and Post-Operative Nursing Lab Case Study Solution
Implementation:
The implementation of this plan would be followed before the intraoperative phase as aprecautionary measure against the risk possibility. Whereas, during the intraoperative phase, the nurse would provide the patient with extra care to make sure that there would be no excessive blood loss. If it occurs when the patient would be provided care by using a harmonic scalpel for immediate clotting of blood in order to reduce the loss of blood.
Evaluation:
The evaluation of the intraoperative nursing care plan includes:
- No harm to nearby organs
- No excessive loss of body
- No internal injury
- Safe removal of the appendix.
Interventions:
The interventions for the intraoperative phase of the appendicitis patients involves:
- Crystalloid intravenous fluids – an isotonic solution like normal saline or lactated solution of Ringer of about 100-500 ml/hr of IV, with respect to the fluid volume in the patient for the replacement of the loss of electrolytes continuation until the output of urine to 1cc/kg of the weight of the body.
- Antibiotics, in order to control systemic and local infection to bring a reduction in the postoperative wound incident.
- Other drugs like analgesics. (Canada, 2017 )
Patient issue:
After the operative phase, the patient complains about the impaired comfort because of the wound stitching preventing him to relax in a comfortable position.
Postoperative Phase:
Assessment:
The primary assessment activities during the postoperative phase include routine diagnostic tests such as CBC for determination of the increase or decrease in the leukocyte either as a sign of severity of the healing state of the infection. Similarly, the assessment of the complaints in the bladder tension or pain in the lower back.
Nursing Diagnosis:
The nursing diagnosis of the patient suffering from acute appendicitis includes the possible risk of infection related to surgical incisions. Similarly, the other nursing diagnosis might include acute pain related to the postoperative wound of existing appendectomy.
Outcome:
The key outcomes of the postoperative phase are primarily based on:
- Maintenance of normal volume of fluid in the body.
- Maintenance of daily calorie requirements according to daily dietary intake.
- Remain free from the infection’s signs as well as symptoms.
- Expression of the comfort feeling and decrease in the acute pain as compared to the difficulty in the preoperative phase.
Planning:
To provide the patient with great care is necessary for the postoperative phase, this primarily includes the prevention against the ruptured stitches after surgery leading to blood loss, and the maintenance of all the possible risks such as an increase in the WBC count or increased pain.
Implementation:
The implementation of the nursing care plan includes the monitoring of the WBC count leading to increased inflammation and positioning of the body in a comfortable position with great care and support and restricting the patient from performing any forceful movement.
Evaluation:
The evaluation of the postoperative nursing care plan includes:
- Monitoring of the vital signs of the infection within the normal range.
- Maintenance and monitoring of the food intake and its output.
- Monitoring of the pain experienced by the patient.
- Evaluation of the changes in the bowel sounds, the passing of flatus or the movements of the bowel.
- Observe the healing of the wound.
- No weight loss.
Interventions:
The interventions for the postoperative phase of the appendicitis patients involves:
- Continuous monitoring of body temperature as a sign of infection severity.
- Assessment of the incision’s infection signs like pain, swelling and redness.
- Maintenance of NPO status until the normal functioning of the bowel.
- Gradual return to a normal diet as per the improvement in the functions of bowel movement.
- In case of a ruptured appendix, insert a Penros drain or leave it to get healed inside out.
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