Question

Rita Schmidt, 74 years 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’s a Jackson-Pratt drain intact with minimal serious 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 bowl sounds. The Foley catheter has a small amount of dark amber colored urine with sediments. The patient has sequential compression device (SCD) in place. The nurse performs an assessment and notes that the patient’s breath sounds are decreased bilaterally in the bases and the patient has indpiratory crackles. The patient cardiac assessment is within normal limits. The patient is receiving O2 at 2L per nasal cannula with a pulse oximetry reading of 95%. The vital signs include blood pressure 100/50 mmHg; heart rate 110 bpm; respiratory rate 16 breaths/min; and the patient is a febrile. The patient is confused as to place and time.

Qn.1. Explain the assessment parameters used to provide clues to detect postoperative problems early and the interventions needed.

Qn 2. What gerontological postoperative considerations should the nurse make?

Answer 1

1-Pre agent evaluation is essential before the lion's share of elective surgeries, end goal to guarantee that the patient is fit to experience medical procedure, to feature issues that the careful or soporific group should know about amid the peri agent period, and to guarantee patients' security amid their excursion of care. Moreover, pointless cancelations or inconveniences because of improper medical procedure might be kept away from, notwithstanding costs both to the patient and wellbeing administration. The post agent administration of elective careful patients starts amid the peri agent period and includes the careful group, sedative staff, and unified wellbeing experts. Suitable observing and rehashed clinical appraisal are required, alongside help for all significant organ frameworks, including cardiorespiratory capacity, renal capacity and liquid and electrolyte adjust, and mindfulness for indications of early careful complexities, for example, draining and contamination.

Regular conditions which can influence peri agent mind incorporate ischaemic coronary illness, congestive heart disappointment, constant respiratory infection, diabetes mellitus and liver or renal brokenness. As analgesic medications can have articulated unfavorable impacts frameworks, it is beneficial enquiring about chest torment, dyspnoea, lower leg swelling and palpitations. The nearness of a hack, sputum generation and any sign of aviation route block will give important data.

A fantastic marker of cardiorespiratory capacity is resistance of activity. A smoking history ought to likewise be taken as smokers are hard to anesthetize because of their upper aviation routes being delicate to the dry gases utilized amid anesthesia, and their danger of hypoxia is more noteworthy. Evaluation and documentation of liquor admission is required, as enlistment of liver chemicals by liquor may abbreviate the activity of analgesic medications and may distinguish the danger of potential liquor withdrawal. The utilization of recreational medications, for example, intravenous sedatives ought to likewise be perceived, all things considered patients may have poor venous access, might be in danger of septicaemia, hazard to the careful group. Steroids require sufficient cover intra-operatively keeping in mind the end goal to maintain a strategic distance from a hypotensive emergency.

2-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.

Individuals who need to wind up careful attendants go to nursing school and careful nursing. They are regularly required to pass examinations managed by the administration or by nursing accreditation sheets before being permitted to function as medical caretakers, and they may likewise be relied upon to go to intermittent proceeding with training classes so they stay aware of advancements in the nursing field.