Question

1. Rita Schmidt, 74 years of 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 is a Jackson-Pratt drain intact with minimal serous 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 bowel sounds. The Foley catheter has a small amount of dark amber-colored urine without 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 inspiratory crackles. The patient’s cardiac assessment is within normal limits. The patient is receiving O2 at 2 L per nasal cannula with a pulse oximetry reading of 95%. The vital signs include: blood pressure, 100/50 mm Hg; heart rate 110 bpm; respiratory rate 16 breaths/min; and the patient is afebrile. The patient is confused as to place and time. (Learning Objectives 4 and 7)

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

What gerontological postoperative considerations should the nurse make?

Answer 1

The should ambulance facility ready to prevent postoperative problems.
Medication and food should be given to increases muscle tone function also to improves gastrointestinal track and urinary tract function properly, circulatory system should be stimulated care should be taken to prevent thromboembolism , medication for speed wound healing should be given. The vital capacity and the normal respiratory rate in female patient or male should be maintained.
Blood pressure, 100/50 mm Hg is low it can be caused due to hypotension, respiratory rate 16 breaths/min which is normal.
The heart rate that is over 100 bpm are is tachycardia and can form arrhythmia (too fast) when person is at rest
The normal urine colour can be pale yellow to deep amber while formation of Sediment in urine is due to urinary tract infections (UTI) or bacteria, protein or wb
Other problem could be hypotension that is
loss of consciousness or uneasiness, chest pain, hypoxemia
the patient need to be treated to avoid heart infarction
it could be due to blood loss or body fluid loss
In the early stage of operation inspiratory crackles can cause airflow obstruction, COPD or it may be due to bronchiolitis .