Wounds, Meds and Complex Care in Nursing Practice

1. The preoperative break inlist on what postulates to be through with(predicate) to take c atomic number 18 of a forbearing can be found on the unhurrieds chart, usually under the doctors orders and/or the patients notes. 2. The National Institute for clinical Excellence recommends that blood interrogatorys should be taken prior to having a surgery regardless of patients healthy condition, unless contraindicated. This is done to provide information ab come out conditions that could affect the treatment that a patient would need (Lab Tests Online, 2004).Blood tests to be included in this routine preoperative testing are a adequate blood count, blood clotting tests, blood typing, blood gasses, blood glucose, and a sickle cell test (Lab Tests Online, 2004). A full blood count will measure haemoglobin and the number of other types of cells in the blood (Lab Tests Online, 2004). Blood typing is for blood transfusion, in case needed. Blood clotting test to envision if blood clots normally and how long it takes to clot (Lab Tests Online, 2004). Blood gasses, measures the amount of oxygen and carbon dioxide in the blood, as well as its acidity, and blood glucose to check for diabetes.Sickle cell testing if the patient has risk factors. 3. The registered oblige is responsible for reporting any discrepancies in the lab results of the patient to the doc in charge. 4. Preoperative precept should include orienting the patient with the surgery that she is going to go through. Ask what she understood from the physician and coif her questions for further clarification. laterwards, explain the patient what to expect during her recovery period, and what are her surgical exercises.Also, enlighten the patient on the risks of post-op recovery like pulmonary embolus, DVT and UTI, and the possible ways on how to avoid these, through deep subsisting exercises and corrosion of anti-embolic stockings (University of South Australia, 2000). Finally, inform her of what other cognitive processs are to be done after the surgery, for example, utilization of catheters and IV therapy. 5. A preoperative shower employs the use of a 2% chlorhexidine gluconate polyester cloth in scrubbing the patients body as a preventive preparation aimed at reducing the patients skin colonisation before the incision is made (Bjerke, 2001). . The anaesthesiologist is the one to administer the anesthesia. 7. A general anaesthesia will snitch Mary unaware of what is happening during the operation, it will make her not feel anything, it will even cat her to sleep (Rashiq, 2007). Penthidine is the analgesic of choice postoperative to not feel bruise (JBC Handbook, 1997).8. An epidural anaesthesia is called an epidural block and requires the injection of anaesthetics in the epidural membrane that surrounds the spinal cord (Sarafino, 2006). Epidural blocks are close to commonly administered during labour and delivery (American Pregnancy Association, 2007). . Marking the legs p reoperative is done traditionally by estimating the redact of the hip joint by palpation of the greater trochanter (The, 2006). 10. Epidural infection, strikingness damage, backache, headache and urinary belongings (Faure, 2000). 11. a. Ensure patients tag is the same with her chart. b. make sure patient is not wearing any metals, jewelleries, etc. c. ensure is certain about undergoing the operation d. ensure that patient has gone through all the necessary diagnostic tests e. ensure that patient is still on NPO. 12. The patients chart, diagnostic test results, patients consent.13. Vital sign assessment has to be done every 15 minutes for the first hour and special attention will be brought to the patients respiration, repayable to the anaesthesia, and circulation and sensation of the extremities especially in the affected areas. Output is likewise monitored. Patient still on NPO until anaesthesia wears off totally. 14. No, this is a common postoperative effect. Continue monito ring sidetrack. 15. Decrease in water system fruit is common postoperative due to opioid drugs, immobility, and decreased oral inlet (Merck, 2005). The physician may order Credes manoeuvre to be implemented and Betanechol can be administered (Merck, 2005). 6. Neurovascular checks are important to go over if there was nerve damage or internal bleeding and a circulation problem, or even infection, which could have been caused by the surgery. The neurovascular check is comprised of the five Ps, namely pain, paralysis, paraesthesia, pulses, and pallor (Judge, 2007). Check for these in the patients limbs. 17. Loss of wheel around pulses might mean lack of arterial flow (Judge, 2007). This should be reported immediately to the registered nurse or the physician, whoever is readily available.18. Any deviation from the normal baseline data regarding neurovascular checks should be reported immediately to the physician to avoid amputation of the affected extremity. 19. Log roll patient w ith abductor hip in place. To prepare the patient, she should be placed on one side of the bed, and rolled like a log to the unaffected side of the hip replacement. 20. A postoperative wash will make the patient feel comfortable and refreshed, also it will minimize infection. 21. Her pain might increase or decrease and this can signal a change in the source of pain. Also, the narcotics infusion rate can be changed if pain is lessened. 2. Two or more nurses to ensure that the correct rate is delivered. 23. As a student nurse, I cannot change infusion rates for narcotic pain relievers because I do not have the permission yet that will make me accountable for any unpleasant consequence that might arise from the situation. rase under the watchful eye of my instructor, I cannot do it. 24. Narcotics have to be watched for their side effects, especially respiratory depression. Observations that can be noted when a patient is with a narcotics infusion include clients respiratory rate, as tonishment and drowsiness (BP Cancer Agency, 2008).5. Heparin injections are administered as a prophylaxis for blood clots (Science News, 1988). 26. Bleeding can be a complication of heparin use because it prevents clotting. Be wary of the following signs black, tarry stools and bleeding from gums when brushwood or flossing teeth, continued redness or pain after an injection, nosebleeds, red urine, unusual bruising coughing up blood (Drug Information Online, 2008). 27. Positive nitrate may indicate bacterial contamination, and traces of protein and blood are not alarming (Eccles Health Sciences Library, 2008).28. Yes. This is because catheter removal will help in eradicating any possible bacterial contamination. 29. A urine model should be sent for a culture and sensitivity test to determine what bacteria is infecting the patients urinary tract. Sample should be sent to the laboratory immediately. 30. The needed equipment shall be gathered. After washing ones hands and explaining to the patient what procedure is to be done and what the precept behind it is, the waste pipe tubing directly below the aspiration port will be clamped with a rubber band or clamp (Integrated Publishing, 2007).This is to ensure that an adequate amount of urine for a specimen can be taken. A syringe will be used to aspirate the urine specimen. After gathering enough urine, the clamp shall be removed. 31. Inserting an indwelling catheter requires that the equipment needed be gathered first. Then the procedure is to be explained to the patient. She should be placed in a dorsal recumbent position. Using the sterile technique, the patient should be draped with sterile dressings. Sterile gloves will then be worn.Catheter tip is to be lubricated and placed on the sterile catheter tray. The labia are to be separated with the thumb and forefinger and a rescind of a mop up with sterile povidone-iodine shall be done from the meatus toward the rectum. This shall be done thrice discarding ea ch swab after one swipe. Catheter is to be inserted two to three inches into the urethra, and an additional inch once there is urine flowing. Balloon will be inflated once it is inside the bladder. Traction is gently applied to the catheter and drainage is taped to Marys thigh. (Kaplan, 2007)32. To remove an indwelling catheter, a small syringe is attached to the puffiness port on the side of the catheter and all the fluid is drawn out (Moore et al, 2007). Afterwards, slowly pull the catheter out (Moore et al, 2007). 33. Patients are on set monitoring of fluid balance because they are receiving fluids through their IV therapies and postoperative patients are still weaning off from their anaesthesia, making urine retention a side effect. A positive fluid balance occurs when intake is greater than output, and a negative fluid balance happens when intake is lesser than output.34. Fluid overload can bring about fluid and electrolyte imbalance, dysrhythmia, high blood pressure, non-pitt ing oedema, diarrhoea, missile vomiting, among many others (Williams, 2008). Osmotic diuretics can be administered per doctors orders, patient should be on strict I&O, IV fluids should be checked hourly, fluids should be restricted (Williams, 2008). 35. The medications should also be reflected on the output of Mary if it is working. 36. total intake 500ml IVF + 2160 ml tea and Milo + 360ml water = 3020 total output 1400ml urination + bowel The patient is in a positive balance.