Although there is meticulous effort by nurses and other health care professionals in ensuring patient recovery after surgical procedures, many patients experience complications. These post-operative complications include, but are not limited to, wound infection, atelectasis, postoperative ileus, embolism, and deep vein thrombosis. This paper will specifically look at atelectasis, the collapse of lung alveoli due to airway obstruction, and post-operative ileus, the cessation of gastrointestinal movement preventing passage of its contents (Lewis et al., 2014). The purpose of this paper is to provide a greater understanding of the experience of hospitalization for surgical patients by focusing on the two post-operative complications, atelectasis …show more content…
Patients with atelectasis will vary in their manifestations, depending on the degree of area affected. Typically, breath sounds will be reduced or diminished on the side of the alveolar collapse and oxygen saturation will be decreased because air is unable to fill the alveolar sacs where the process of ventilation-perfusion is supposed to take place (Lewis et al., 2014). According to Porth (2015), the patient may also exhibit tachypnea, diminished chest expansion, intercostal retractions, dyspnea, and tachycardia. These symptoms demonstrate how the body reacts and its attempt to compensate for the lack of oxygen. This lack of oxygenation to tissues results in cyanosis (Porth, 2015). An individual undergoing such difficulty to breath will present distressed and anxious. A thorough assessment of the patient and presence of some of these manifestations contribute to the diagnosis of atelectasis, which would be supplemented by a chest radiograph for confirmation (Porth, 2015). Most post-operative patients who fall victim to atelectasis and present with the signs and symptoms described, usually have risk factors that increase their probability of acquiring the …show more content…
There are modifiable and non-modifiable risk factors for atelectasis. Porth (2015) describes how breathing oxygen in large amounts contributes to atelectasis by promoting an increased rate of its absorption in the alveoli. Therefore, high concentrations of oxygen are a modifiable risk factor atelectasis because it can be avoided. Kelkar (2015) identifies chronic alcohol abuse as a risk factor for atelectasis because it is related to a reduction in the amount of surfactant within the alveoli. Lifestyle factors can be altered, therefore, chronic alcohol abuse is a modifiable risk factor for atelectasis. Pain, narcotics given for pain, anesthesia, and immobility increase the risk of atelectasis as well (Porth, 2015). All post-operative patients are encouraged to mobilize in order to prevent complications, unless contraindicated by physician’s orders. Narcotics can be substituted with non-opioid analgesics or non-pharmacological methods of pain relief, although not always ideal. Thus, immobility and narcotics for pain are considered to be modifiable risk factors for
A medical assistant’s cooperation and presence during a surgical procedure is essential in order to provide satisfactory patient care. Although the role of the medical assistant may not shine though as strongly as the physician’s, their subtle presence provide organization in the form of administrative and clinical tasks to facilitate the physician’s demanding profession. During a surgical procedure, such as an incision and drainage of an abscess, the medical assistant is the patient’s first point of contact. The medical assistant’s role in any surgical procedure will begin as the patient schedules an appointment with the providing health care provider.
1. Nine year old Jerry stumbled into a drug store, which is usually open late with very few attendants, gasping for breath. Blood was oozing from a small hole in his chest wall. When paramedics arrived, they said that Jerry had suffered a pneumothorax and atelectasis. Just what do both these terms mean and how do you explain his respiratory distress? How will it be treated?
Mrs. Jones, An elderly woman, presented severely short of breath. She required two rest periods in order to ambulate across the room, but refused the use of a wheel chair. She was alert and oriented, but was unable to speak in full sentences. Her skin was pale and dry. Her vital signs were as follows: Temperature 97.3°F, pulse 83, respirations 27, blood pressure 142/86, O2 saturation was 84% on room air. Auscultation of the lungs revealed crackles in the lower lobes and expiratory wheezing. Use of accessory muscles was present. She was put on 2 liters of oxygen via nasal canal. With the oxygen, her O2 saturation increased to 90%. With exertion her O2 saturation dropped to the 80's. Mrs. Jones began coughing and she produced large amounts of milky sputum.
Because I provide the surgeon with medications, hemostatic agents and irrigation solutions it is crucial to know the proper usage of each, along with the side effects, patient's allergies, and contradictions of certain medications and their reactive
As mentioned above, emphysema affects the alveoli. When you develop emphysema the symptoms may go unnoticed for many years. With emphysema, your alveoli lose their elasticity and that makes it harder for the body to dispel the carbon dioxide. Also, the alveoli will eventually rupture and develop into one larger air sac. (Mayo Clinic)
This essay will discuss the risks for patients during the preoperative, intraoperative and postoperative stages of the perioperative journey and how both patients and healthcare professionals involved in the perioperative stages can work together to prevent perioperative hypothermia.
Chamberlain, R., & Martindale, R. (2007, October 31). The role of the surgeon and the surgical care team: proactive strategies for preventing postoperative ileus. Evidence-based Management of Postoperative Ileus, 1-7. Retrieved from www.esng-meded.com/surgerynews/e-supplement_001.pdf
An electrocardiogram (ECG) is one of the primary assessments concluded on patients who are believed to be suffering from cardiac complications. It involves a series of leads attached to the patient which measure the electrical activity of the heart and can be used to detect abnormalities in the heart function. The ECG is virtually always permanently abnormal after an acute myocardial infarction (Julian, Cowan & Mclenachan, 2005). Julies ECG showed an ST segment elevation which is the earliest indication that a myocardial infarction had in fact taken place. The Resuscitation Council (2006) recommends that clinical staff use a systematic approach when assessing and treating an acutely ill patient. Therefore the ABCDE framework would be used to assess Julie. This stands for airways, breathing, circulation, disability and elimination. On admission to A&E staff introduced themselves to Julie and asked her a series of questions about what had happened to which she responded. As she was able to communicate effectively this indicates that her airways are patent. Julie looked extremely pale and short of breath and frequently complained about a feeling of heaviness which radiated from her chest to her left arm. The nurses sat Julie in an upright in order to assess her breathing. The rate of respiration will vary with age and gender. For a healthy adult, respiratory rate of 12-18 breaths per minute is considered to be normal (Blows, 2001). High rates, and especially increasing rates, are markers of illness and a warning that the patient may suddenly deteriorate. Julie’s respiratory rates were recorded to be 21 breaths per minute and regular which can be described as tachypnoea. Julies chest wall appeared to expand equally and symmetrical on each side with each breath taken. Julies SP02 levels which are an estimation of oxygen
The hospital promised early ambulation following hernia surgery. The hospital facility was designed to encourage movement without unnecessarily causing discomfort. Postoperative regimen designed and communicated by the medical team to patients
The ability to swallow is an intricate process that includes the coordinated effort of cranial nerves and multiple muscles. Pathophysiology of aspiration is such that, food or liquid is misdirected down the respiratory pathway. In most cases aspiration will occur as it travels via the straighter path to the right main bronchus and onward to the right lower lobe of the lung (Eisenstadt, 2010). Dysphagia’s incidence after a stroke varies due to the location of the stroke and occurs between 28%-79% of the time (Lakshminarayan et al., 2010). Current state has bodies of authority without an approved dysphagia measure based on evidenced. These entities hospitals would look to for consensus and guidance are the American Heart Association (AHA), Centers for Disease Control (CDC), and The Joint Commission (TJC) (Solis, n.d.). Without the endorsement of a screening tool, hospitals may not be persistently utilizing a dys...
Saint John’s One Day Surgery (ODS) offers patients a convenient and efficient same day surgical procedure that allows most patients to return home on the same day to recover. The objectives of this paper is to describe the physical environment of the ODS unit and explain the unit’s criteria so that the patient’s surgery may proceed as planned. It will also discuss some of the many roles of the ODS nurse and list one actual diagnosis and two potential nursing diagnoses, with associated supporting evidence, for a patient in the ODS on this particular day. This paper will conclude with my personal experience, both positive and negative, during
Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2010). Brunner & Suddarth’s textbook of medical-surgical nursing (12th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Cancer has some very painful and serious effects on a person's body. Most of this uncomfort is due to the numerous treatments people go through to destroy the cancer cells. One of the more dangerous treatments is surgically removing the cancer. There is a huge possibility that it may take many surgical procedures to remove the cancer areas, and there are always risks that there will be complications. An example of this is when Peter Teeley went under the knife for a standard removal of a cancerous tumor on his appendix. The surgeon forgot to inform the anesthesiologist that Peter had been throwing up all week, and when it happened in the operation, fluid rushed into his lungs causing aspiration pneumonia (Bashe and Teeley16). Of course this does not happen all the time but is always a huge risk when under the knife.
The role of the nurse in the preoperative area is to determine the patient’s psychological status to help with the use of coping during the surgery process. Determine physiologic factors directly or indirectly related to the surgical procedure that may cause operative risk factors. Establish baseline data for comparison in the intraoperative and postoperative period. Participate in the identification and documentation of the surgical site and or side of body on which the procedure is to be performed. Identify prescription drugs, over the counter, and herbal supplements that are taken by the patient that may interact and affect the surgical outcome. Document the results of all preoperative laboratory and diagnostic tests in the patient’s record
Although students were not allowed in the recovery unit, I was able to talk to one of the recovery nurses. I learned that a nurse’s duty of care includes monitoring the patient’s vital signs and level of consciousness, and maintaining airway patency. Assessing pain and the effectiveness of pain management is also necessary. Once patients are transferred to the surgical ward, the goal is to assist in the recovery process, as well as providing referral details and education on care required when the patient returns home (Hamlin, 2010).