The nurse must rewarm the patient after surgery if hypothermia persists. The negative effects of hypothermia include depression of the myocardium, ventricular dysrhythmias, vasoconstriction, and depression of clotting factors (increasing the risk of bleeding postoperatively). If the patient is hypothermic, rewarming may be accomplished by the use of warm blankets, warm humidified oxygen, convective air mattresses, and other individual institutional approaches.The nurse should carefully monitor the pulmonary artery pressures and the CO as well as the BP when interventions are instituted to assess the effect. Some references suggest that hemodynamic parameters be rechecked every 30 to 60 minutes after each intervention during the early postoperative …show more content…
Asimakopoulos G, Gourlay T. A review of anti-inflammatory strategies in cardiac surgery. Perfusion. 2003;18:7-12. [Context Link] 7. Deglin JH, Vallerand AH. Davis's Drug Guide for Nurses. 8th ed. Philadelphia, Pa: FA Davis; 2003:857-860. [Context Link] 8. Rose E. Off-pump coronary artery bypass surgery. N Engl J Med. 2003;348:379-380. [Context Link] 9. Henke K, Eigsti J. Bypass injury. Dimens Crit Care Nurs. 2003;22:64-70. [Context Link] 10. Kjaergaard S, Rees SE, Gronlund J, et al. Hypoxemia after cardiac surgery: clinical application of a model of pulmonary gas exchange. Eur J Anaesthesiol. 2004;21:296-301. [Context Link] 11. Walden SM, Meyer P. Pulmonary management. In: Baumgartner WA, Owens SG, Cameron DE, Reitz BA, eds. The Johns Hopkins Manual of Cardiac Surgical Care. St. Louis, Mo: Mosby; 1994:161-182. [Context Link] 12. Naughton C, Reilly N, Powroznyk A, et al. Factors determining the duration of tracheal intubation in cardiac surgery: a single-centre sequential patient audit. Eur J Anesthesiol. 2003;20:225-231. [Context Link] 13. Urden LD, Stacy KM, Lough ME. Thelen's critical care nursing diagnosis and management. St. Louis, Mo: Mosby; 2002:269-270. >466-475>. [Context
Inadvertent perioperative hypothermia is a common anesthesia-related complication with reported prevalence ranging from 50% to 90%.(ref 3,4 of 4) The clinical consequences of perioperative hypothermia include tripling the risk of morbid myocardial outcomes and surgical wound infections, increased blood loss and transfusion requirements, and prolonged recovery and hospitalization.(ref 5)
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.
Breathing is the most important AL (Roper et al, 1998). A detailed assessment of her airway would be performed because protection of the airway throughout anaesthesia is essential (Yates, 2000). This does not just include recording of respiration rate and oxygen saturation (SpO2) but also noting any use of accessory muscles, shortness of breath, auscultation of chest and lungs areas for wheezes/crackles and asking patient about history of any respiratory illness/smoking (McArthur-Rouse, 2007).
When I see a patient before they go into an operation, I like to speak to them to make sure they have an understanding of what surgery will be performed and what the process will be in regards to transporting them from the pre-operative area, to the operating room, and then to the recovery area. The environment of the operating room can be a scary place for patients, it is a cold, bright room with lots of equipment in it that patients have probably never seen before. I like to explain to my patients what the room will be like and let them know I will be with them the whole time if they need anything. The main topic is usually the temperature of the room, approximately 65 degrees, so I like to make sure the patients know we will have warm blankets waiting for them. Whether the surgery being performed is diagnostic or therapeutic, I like to be sure the patient has an understanding of what is being done for their health. I am very proud of being a nurse and do my best to be sure my actions prove it. I strive to do the best for my patients since one of the many responsibilities of being a nurse is to be their advocate, which I take very seriously as my patients cannot usually speak for themselves as they are under
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
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
Table1: The type of VSD and additional cardiac anomalies, pulmonary artery hypertension (PAH), the number and age of the surgery in the studied patients.
As we are well aware, being a patient at a hospital can prove beneficial or problematic. As it is with the most critical of patients, they require a closer level of surveillance and monitoring than those on other med-surg associated units. As the care of an ICU patient can escalate quickly, it’s critical to assess the needs of your patient in a timely manner. Looking at a ventilated patient who requires many different modalities, assessing the need for such ther...
St. Louis, MO: Elsevier Ackley, B.J., Ladwig, G.B., & Flynn Makic, M. (2017). Nursing diagnosis handbook (11th ed.). St. Louis, MO: Elsevier University.
NG tube was aspirated with a syringe before apply any anesthesia to prevent any aspiration during and after the surgery; monitor blood pressure, SpO2, rectal temperature, ETCO2, and fluids to maintain vitals in normal ranges. Blood transfusion was placed on hold in case of any
Respiratory therapy refers to both a subject area within clinical medicine and to a distinct health care profession. During the 20th century, there were many health care fundamental transformations. Here are 10 possible predictions of what may occur in the future of respiratory care: (1) Less focus on raising PaO2 as a primary goal in managing patients with acute hypoxemic respiratory failure. (2) More attention to the adequacy of tissue oxygenation in such patients, irrespective of PPaO2, and the emergence of “permissive hypoxemia,” analogous to permissive hypercapnia, in managing them. (3)
List all Current Medications (Add to table as necessary). Complete detailed medication forms per instructor discretion.
(Royal United Hospital Bath Trust, 2007) Hence I chose breathing and maintain safe environment as in this stage they are the most important and also because ‘surgery causes physiological stress’ in the body. (Torrance and Serginson 2000 as cited in Huges, 2004) Immediate post-operatively, it carries the risks of shock and haemorrhage and my primary goal is to ensure that John’s recovery is as well as possible. (Newton, 1991 and Huges, 2004 and Nursing Times, 2013) And also his surgery was under general anaesthesia hence it is important to observe for any signs of changes in respiration that could indicate respiratory depression/failure. In order to maintain safe environment for John, his breathing would also come under same topic as if his breathing is impeded then his safety is not
Firstly, nurses are expected to practice evidence-based health care hence a mastery of information about the essential and safe dose of drugs for a patient is very important for a nurse. Consequently, it could be the determinant between the life and the death of the patient. Pharmacology is a discipline which is mandatory for the nurse to excel in to be efficient in discharging his/her duties. Understanding which drug to use, the right dosage, the expected side effects which may occur and the contra-indications of the various drugs are key in the preservation of
Spark Ralph, S. & Taylor, C. M. (2011). Nursing diagnosis reference manual (8th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.