Question

Instructions

1. Read the scenario and answer the questions to the best of your abilities and understanding of post-operative nursing care.

2. Critically consider each question before answering.

3. Consult your prescribed books (Nursing Sciences) and Practical Workbook.

Scenario

You are working in a surgical ward and have 4 patients in your care today. Two of your patients were assigned for surgery early morning. It is 12h00 and the theatre called the ward saying that patient One is ready for collection from theatre.

Answer the following questions:

5. One of the reasons for covering the patient with blankets is to avoid hypothermia. Describe the physiological effects of hypothermia on the patient. (5)

6. This patient had an abdominal operation. Why would you position the patient in a semi- fowler’s position? (5)

7. This patient has a wound drainage tube as well as a urine catheter. Explain the reasons for checking on the following:

7.1 Wound drainage tube (3)

7.2 Urine catheter (3)

8. You noticed that the patient is restless and that his pulse and breathing is increasing. Upon enquiring, the patient describes discomfort and pain in the lower parts of his body. 8.1 Describe general measures to relieve pain and promote comfort. (2)

8.2 Dr has prescribed Pethidine 75mg IMI bd for 2 days. There are only 50mg/ml vials in stock.

a. List the principles of safe administration of this medication. (6)

b. Show your calculation of the medication. (4)

c. List the possible side-effects you may observe in the patient. (4)

Answer 1

5. There are certain critical physiological effects that can occur to the postoperative client due to hypothermia,which include reduced metabolic activities, also it can affect the comfort of the patient.Due to hypothermia the heart and respiratory system does not function properly.Aslo there will be shivering,rapid respiration and tachycardia.Shivering can cause increased pain,rapid respiration can cause decrease in the co2 level .

6.Semi fowlers postion is normally used to help the respiratory function of the body.In this postion lungs gets the maximum space to enlarge and get maximum air into it.It also allows the abdominal muscle tension to be relaxed.Thereby it provide maximum comfort to the patient.

7. wound drainage tube- check the wound drainage tube for its position,patency and the measurement.While checking the tube check for the colour and amount of the drain.This is important to check to find out the abnormal bleeding,collection and the fluid loss.When youy are checking the drainage tube check the drain site also for any tenderness or swelling these are the signs of fluid collection.

urine catheter - check the urine cathere for its patency,to avoid further bladder diatension and for the proper draining of the urine.Also check for the urine coulur and the amount to make sure the hydration status of the patient.

8.1 check the pain score

Provide comfortable position for the patient

Provide calm and quiet environment

Diversional therapy

provide psychological support

Administer the analgesics ans per the doctors instruction.

8.2 a. For the safe administration of the drug check the patients vital signs including the temperature,reart rate,blood pressure ,respiration and the pain

know the patient medical history correctly for the respiratory diseases like COPD

Should know allergic history of the patient.

check the patient history to know the history of use of drugs like pethedine.

Follow all the rights of medication administration

Cross check the medicine with senior staff or collegues.

Follow the correct drug calculation formula to obtain the correct dose

follow the institutinal policy for adminiatering drugs like pethedine.

b. The formula to calculate the amount of medicine to draw is

what we want / what we gave x concentration

here what we want is the doctors order ,that is 75mg

what we have is 50mg in 1ml concentration

so when we put the values in the formula it becomes

(75 /50) x 1 = 1.5ml

8.2 The possible side effects include respiratory depression,hypotension.confusion,hallucination,nausea,confusion and flusing of the face .