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In: Nursing

Case Scenario: Your unit received Mrs. C as admission from post-anesthesia care unit (PACU) Mrs. C...

Case Scenario: Your unit received Mrs. C as admission from post-anesthesia care unit (PACU) Mrs. C is 82-yrs old and underwent Right Colectomy (Right-Sided Colon Resection) to remove a non-malignant tumor. Vitals were stable in PACU. Mrs. C has “PIV in Right AC” (peripheral IV catheter in right arm), indwelling urinary catheter, naso-gastric tube (NGT) and “O2 per NC at 4L/min” (oxygen through nasal cannula going at 4 liters). Mrs. C received Morphine Sulfate 5 mg through IV push in the PACU and has a PCA (patient-controlled analgesia) Morphine Sulfate 1 mg every 10 min. You assess level of consciousness and note Mrs. C is slow to respond to your questions.

6.) When Mrs. C is ready for discharge how will you evaluate whether your nursing interventions and overall careplan was effective?

Solutions

Expert Solution

Mrs. C is ready for discharge only when the full set of vital signs [heart rate, blood pressure, respiration rate, temperature, Glasgow Coma Scale (GCS)] , pain score and sedation score are within normal limits. senior medical review must be obtained if any of the following occur:

  • respiratory rate less than 10 breaths per minute
  • SpO2 less than 92%
  • systolic blood preassure less than100mmHg
  • heart rate less than 50bpm
  • GCS less than 14
  • Sedation score greater than 1

effectiveness of the intervention and the care plan is identified by assessing whether the goals are met appropriately.

  • evaluate and document the therapeutic response to pain via the numerical or visual analogue scale. reassessment of the pain within 3 to 5 minutes of the morphine adminstration of each dose shows satisfactory reduction in the pain level
  • sedation scoring: while measuring the sedation the scoring should not be more than 1. the tool used for scoring is:
    • 0- wide awake
    • 1- easy to arouse
    • 2- constantly drowsy, unable to stay awake
    • 3- difficult to rouse or unresponsive.
  • oxygen saturation is maintained within the room air (92-100%)

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