Case Study, Chapter 19, Postoperative Nursing Management 1. Rita Schmidt, 74 yea
ID: 247677 • Letter: C
Question
Case Study, Chapter 19, Postoperative Nursing Management 1. Rita Schmidt, 74 years of age, is a female patient who was admitted to the surgical unit after undergoing removal of a section of the colon for colorectal cancer. The patient does not have a colostomy. The patient has several small abdominal incisions and a clear dressing over each site. The incisions are well approximated and the staples are dry and intact. There is a Jackson-Pratt drain intact with minimal serous sanguineous drainage present. The patient has a Salem sump tube connected to low continuous wall suction that is draining a small amount of brown liquid. The patient has no bowel sounds. The Foley catheter has a small amount of dark amber-colored urine without sediments. The patient has sequential compression device (SCD) in place. The nurse performs an assessment and that the patient's breath sounds are decreased bilaterally in the bases and the patient has inspiratory crackles. The patient's cardiac assessment is within normal limits. The patient is receiving O2 at 2 L per nasal Hg heart rate 110 bpm; respiratory rate 16 breaths/min; and the patient is afebrile. The patient is confused as to place and time. (Learning Objectives 4 and 7) cannula with a pulse oximetry reading of 95%. The vital signs include: blood pressure, 10050 mm a. Explain the assessment parameters used to provide clues to detect postoperative problems early and the interventions needed. b. What gerontological postoperative considerations should the nurse make?Explanation / Answer
a-Colorectal medical procedure is performed for some maladies, for example, colorectal malignancy, ulcerative colitis, Crohn's ailment, mechanical inside hindrance and repetitive diverticulitis, regularly bringing about real reproduction. Damage, ischemia, rectal prolapse and proctological issue may likewise require vast or little gut resection. Potential dangers of colorectal medical procedure are principally those of any real stomach medical procedure, and typically happen while the patient is still in the doctor's facility. On account of the numerous signs for and the different degrees of colorectal or little entrail resections the rate and range of entanglements vary.
The absence of accord on characterize and grade postoperative complexities has extraordinarily hampered the assessment of surgeries. Another grouping of confusions, started in 1992 by Clavien and Dindo depends on the sort of treatment expected to rectify the complexity. The standard of the characterization is straightforward, reproducible, adaptable, and material.
b-When all is said in done the postoperative death rate in geriatric careful patients is low. In spite of the expanded pervasiveness of preoperative interminable restorative conditions, most patients do well postoperatively. Be that as it may, the ASA arrangement, crisis medical procedure, a background marked by hypertension, aspiratory, neurologic and coronary corridor maladies builds the chances of building up any postoperative unfriendly occasions in elderly patients. What's more, metastatic ailment increases in patients more seasoned than 80 years. Elderly patients who experience laparoscopic colorectal medical procedure have a noteworthy shorter length of doctor's facility stay and less entanglements contrasted with open medical procedure. Subsequently, laparoscopy can be viewed as a careful alternative in all patients paying little heed to age.
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