Assistant: Markus Leroy Johnson PAC (Surgical assistant was used for soft tissue protection and retraction and also for maintaining reduction during temporary and permanent fixation use of surgical assistant was medically necessary, and to prove the safety and efficacy of the procedure.)…
DISPOISTION: The patient was discharged three days post-op in good condition on Augmentin 500 mg p.o.q. 8h. And insulin on a sliding scale.…
infusion at 250 mL/hr will exacerbate the volume excess. The other actions are appropriate for…
After successful removal of the gallbladder and an unremarkable anesthetic reversal, Mr. F is transported to the post anesthesia care unit (PACU) and monitored before being transferred to medical-surgical unit. Vital signs are as follows: heart rate, 75/min; blood pressure, 127/82 mm Hg; respiratory rate, 16/min; oxygen saturation, 100% on 2L of O² via nasal cannula; body temperature, 36.9°C. When Mr. F arrives to the PACU, the receiving nurse notices an increase in his heart rate to 91/min and an increase in respirations to 21/min. After administering a 3-mg IV bolus of morphine sulfate for pain and increasing oxygen delivery to 4L/min via nasal cannula, the nurse continues to see a gradual increase in heart rate and respirations as well as an increase in blood pressure and body temperature. Ten minutes later, Mr. F’s vital signs are now as follows: heart rate, 114/min; blood pressure 147/92 mm Hg; respirations, 25/min; oxygen saturation, 98% on 4L of oxygen via nasal cannula; and body temperature, 38.8°C. The nurse again treats with a 3-mg IV bolus of morphine sulfate and increases his oxygen to 5L by mask.…
If the irrigation solution is used in an IV, entering the veins/blood it would burn the person becoming to hypertonic. The solution will attract water…
Perioperative routine practices vary from state to state and even facility to facility. It is important for the surgical nurse to be well versed in perioperative procedures and constantly question the effectiveness and positive/negative outcomes related to each one. Several preoperative procedures take place on the surgical unit of my hospital, and after research and discussions with surgeons, I discovered a preoperative procedure that could be tweaked in order to improve post-op results.…
More investigative studies are needed to test the variation of tissue tolerance during prolonged surgery…
Position- semi fowler, rolled towel under neck or pillow under shoulders to keep airway clear…
b) The patient’s red blood cells will shrivel up because the blood fluid is hypertonic compared to the cells…
Mrs. Jones’ kidneys are impaired. The kidneys regulate their own blood flow as well as GFR. When the kidneys become hypoperfused in Mrs. Jones case, narrowing of the renal arteries, and vessels in the kidneys dilate with the help of prostoglandims to facilitate the flow.…
4. Has anyone ever told you or a family member they had a difficult time opening your jaw during general anesthetic?…
Hadaway, L. (2012). Sterile prefilled saline syringes for acute care patients: A review of clinical evidence, cost-effectiveness, evidence-based guidelines, and safety. Rapid Response Report: Summary with Critical Appraisal, 4(4), 2-5. Retrieved from http://www.cadth.ca/en/products/rapid-response?q=Sterile…
References: BJN (British Journal of Nursing). (2010).Tissue Viability supplement. Vol 19. No.6. 'Validity of the waterlow scale and risk of pressure injury in acute care. Mark Allen Publishing Limited. London.…
For a postoperative patient, assessment should begin with an evaluation of the airway, breathing, and circulation (ABC) status (Smith, 2010). I assessed the airway and carried out suction, then administered oxygen, but I did not do it immediately. She had vomited three times, keeping the airway patent and administrating oxygen are very important for postoperative care (Smith, 2010). In fact, concerning treatment of hypotension in PACU, should always begin with oxygen therapy to ensure hypo-perfused organs meet the need of oxygen (Smith, 2010). The common cause of hypotension is fluid loss, IV fluid boluses will be given to normalize blood pressure (Smith, 2010), which is the reason why the doctor ordered the IV and blood transfusion. When transfusing blood or blood components, assessment is required before, during, and after the transfusion. If the client has an intravenous line in place, assess the venipuncture site for signs of infection or infiltration and patency (Jantzen & Molzahn, 2010). In fact, we did not do very well in blood transfusion and we should keep the IV line running and set up another blood transfusion line in the other…
When hypertonic fluids are infused, osmosis pulls water out of the cells and causes the cells to shrink resulting cells to get rid of excessive free water. The side effect includes, when they shrink at the site of IV infusion, infection at the site of injection, venous thrombosis or phlebitis extending from the site of injection, extravasation and hypervolemia…