post op

This scenario based assignment will discuss the pre-operative and post-operative care of 56 years old lady name Lucy who will be going under thyroidectomy. Lucy suffers from Graves’ disease and is diabetic. If Lucy was a real patient, her name will not be mentioned in the assignment to maintain confidentiality (NMC, 2008). Holistic assessment will be performed once Lucy is admitted to the ward before surgery. Pathophysiology and essential care of her medical condition will be discussed following holistic assessment. Her post-operative care will be discussed into four parts which are airway and breathing management, circulation, pain management and psychological care. Following the post-operative care, discharge planning and care that she will require in the community will be discussed. Reference will be made to Roper, Logan and Tierney model.

Upon admission to the ward holistic assessment would be performed. Lucy would be assessed according to 12 activities of living (AL), mentioned in Roper, Logan and Tierney model. This holistic approach enables to develop a care plan that will identify the problems for Lucy in performing certain activities, whilst allowing her to remain independent with other activities.

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).

To set base line data her vi...

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...breathing, eating/drinking, mobilising, communicating, sleeping, and eliminating. The surgery was success and she was discharged without any complications.

To conclude, holistic assessment should be performed on admission to reduce perioperative and post-operative complications, for successful outcome of surgery and to prevent delay in discharge. Patients with diabetes undergoing surgery present a great challenge for health care providers. It is important to carefully monitor and control diabetes before, during and after the surgery to eliminate complications. Post thyroidectomy, there are many complications and patients should be monitor carefully for them as early detection can save life. Discharging a patient is a complex procedure and should include clinical care, social care, making appropriate referrals and it should involve the patient and the family.