Question

Apply the critical thinking skill of interpretation to thispatient situation by–underliningtherelevant information and circling or bolding the medical terminology.

Situation: Sara Lin is an 18-year-old female patient who had an emergency appendectomy. It is day 2 postoperative, and Sara is expected to be discharged late this afternoon. We have discontinued her IV antibiotics after her morning dose. She will be getting oral meds today.

Background: Sara presented in the ED 2 days ago with a 2-day history of nausea, vomiting, and increasing pain. She was taken to surgery that day and had an open appendectomy for a ruptured appendix. She has been stable since arriving to the unit. Her parents have been here with her most of the time and are very helpful and supportive.

Assessment: Sara is alert and oriented, appropriate for age. She needs to be reminded to use her incentive spirometer. Abdomen is soft, tender to touch. Bowel sounds active. She has progressed to regular diet, and she's eating small amounts. No nausea reported since postoperative day 1. The abdominal dressing was changed by the surgery team early this a.m. The incision is closed with staples; the edges are well-approximate and only slightly reddened with minimal serosanguinous drainage. Her sequential compression devices were discontinued, and her Jackson-Pratt drain was pulled this morning. A small amount of bleeding was present; no further bleeding is noted. This morning, she had her first small soft brown stool since surgery.

Recommendation: You will have to transition Sara to oral antibiotics and pain medication. She last had pain medication 4 hours ago. You will need to provide discharge patient education on incision care, pain medication and antibiotics, signs of postoperative infection, activity restrictions, and surgical follow-up.

Answer 1

Patient Education

Incision Care

• Advise to clean wound with saline water and to apply sterile dressing with the help of parents .
• Adivise to assess the wound for signs of infection like redness, swelling ,pain etc.
• Advise to wear loose clthings it will help to reduce irritation around incision.
• Advise to take shower daily but dont bath in bath tub or swimming pool.
• Advise to tharoughly cover the incision while taking shower.
• Pain medications and antibiotics
• Educate about the impotance of taking medication correctly.
• Advise to take mediction as prescribed by the doctor.

Signs of post operative infections

Signs of infections are;

• Fever,chills, pain redness, shortness of breath ,swelling . bleeding
• Advise to seek medical help if you notice any of the above signs.

Activity Restriction

• Advise to slowly start the activities as it will help in faster recovery.
• Dont drive as you taking medications.
• Don't lift heavy objects untill your doctor say to do so.
• Stop the sports activites for few weeks.

Surgical follow up

• Perform regular followup as advised by the surgeon and seek his help immediately if you feel any discomfort or notice any abnormlities in the wound healing process.