Acute Care Assignment

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HLTEN512B Implement and monitor nursing care for clients with acute health problems NURS5286C

1. Identify and discuss 8 aspects of Mrs. Lee pre-operative nursing care? It is an important role of a nurse to ensure that patients are prepared for surgery not only in a physical way but also in a psychological way so they have informed consent of the procedure being undertaken, have psychosocial support and are educated on the expected and unexpected outcomes. For Mrs. Lee, these 8 aspects of pre-operative nursing care may include: Providing psychological support: Because it is already stated that Mrs. Lee’s family is quite anxious, it may very well be also making her anxious about her surgery. Catering to the psychological support needs of a surgical patient will include being there for the patient and answering any questions relating to their fears and concerns regarding the surgery and the post operative period. The answers to these questions need to be honest and factual. If necessary, it may be arranged for Mrs. Lee’s spiritual adviser to come and speak with her also.

Providing pain management information: Following on from the psychosocial support needs, one of the reasons that Mrs. Lee may be anxious could be due to the amount of pain she thinks she will be in post surgery or she may be even scared of developing a drug addiction to analgesics. Educating the patient on the types of analgesics they may be given is important, as is how the medication may be administered. Mrs. Lee could be provided with pain management brochures if they are available.

Teaching techniques for preventing respiratory complications: As Mrs. Lee is having surgery and more than likely will be going under general anesthesia it is important to reduce any risk of potential respiratory complications by the use of deep breathing techniques, incentive spirometry and pursed lip breathing to assist and maintain an open clear airway. The patient should practice deep breathing exercises hourly with encouragement from the nurse for the first 2-3 days post surgery. Coughing exercises should also be done frequently to ensure the airways are free of secretions.

Promoting activity and exercise: It is important to promote exercise and activity as inactivity may cause thrombi and emboli’s as well as respiratory complications which will lead to a delayed recovery time post op. As a nurse, we need to ensure our patients are well informed on activity and exercise post surgery because we do not want a potential DVT. Mrs. Lee will need to be informed that she may be required and encouraged to be out of bed and walking at 8 to 12 hours post op and that the time out of bed will increase daily, and that she will be given analgesia if she requires it.

Preparing the surgical site: The nurse will be required to prepare the surgical site whether that be by shaving the area if the patient is rather hairy, washing the skin with antimicrobial soap, swabbing with antimicrobial solutions and wrapping the area in a sterile drape to protect from bacteria. Povidone-iodine is what is mostly used as an antimicrobial solution. The site for the surgery will be identified and marked with a texta (marker pen) which is usually done by the surgeon and verified by other staff e.g., the nurse and written in the documentation. It is important to identify right patient, right procedure and right site.

Carry out the pre-operative routine: The pre-operative routine involves: identifying the patient and procedure with the use of arm and leg bands as well as documentation; fasting for 6+ hours ensures that the GI tract will be empty and non active preventing the risk of aspirating on undigested food; elimination of the bowel will reduce the risk of constipation and distention post surgery; consent signature is extremely important as your patient is signing a legal document agreeing to the surgery and it means that they understand the procedure at full; valuables are to be...
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