Mrs. Robin, date of birth January 5, 1950, is a preoperative patient of Dr. Hu’s. She...

Mrs. Robin, date of birth January 5, 1950, is a preoperative patient of Dr. Hu’s. She is scheduled for an abdominal hysterectomy at 9 a.m. She has been NPO (fasting) since midnight. She is allergic to penicillin. The night nurse reported that she got little sleep and expressed a great deal of anxiety about this surgery immediately after her surgeon and anesthesiologist examined her at the time of admission. Preoperative medication consisting of atropine was administered at 8:40 instead of 8:30 as per order. Abdominal skin was scrubbed with Betadine per order, and an intravenous (IV) drip of 1 L 0.45 saline was started at 7 a.m. in her left forearm. She has a history of chronic obstructive pulmonary disease, controlled with an albuterol inhaler, but has not used this since admission yesterday.

Situation

• Grab the listeners attention• Convey immediate need

Background

• Sets the context• Only the relevant circumstances to this situation • The facts

Assessment

• What do you think the problem is• Be specific

Recommendation

• What do you suggest be done or ordered? What will correct the problem?

first read the short paragraph and give the answer in assesment questiob...

Solutions

Expert Solution

* what do you think the problem is? Be specific

1.Patient is having severe anxiety ,It is because of inadequate knowledge regarding the surgical procedure and outcome. Here we have to give adequate information regarding the surgical procedure it includes need of the surgery, duration of the surgery, procedures and the outcome and also provide counseling and guidance to the patient it will helps to reduce the anxiety level .

2. Atropine administrated at 8.40 insted of 8.30 as per order . Atropine injection is giving before anasthesia to decrease mucus secreation,such as saliva.during anasthesia and surgery atropine is used to help keep the heart rate normal. Commonly atropine administering 30 minitues before the surgery here the surgen ordered atropine 30 minitue before the scheduled time of surgery ,But the administration done late.

3. In this case scenario , client have history of COPD and discontinued drug. It may affect the patient, there is a chance of breathlessness, disturbed respiratory rate. So it necessary to assess the oxygen saturation ,and Oxygen administration need to be given .

4. Client is having allergy to penicillin so the administration of these drug should be avoided .

Hysterctomy is generally a safe procedure ,but with any major surgery comes the risk of surgical and and post surgical complication such as commonly infection, hemorrhage,vaginal vault prolapse, injury to utreus,bowel and bladder .

Nightingale answered 1 year ago

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