Country : Australia
Assignment Task:

Part A: Pre-Operatively

Peter Thompson is a 64-year-old man who has been admitted to hospital due to acute abdominal pain. Mr Thompson has had a two-day history of increasing abdominal discomfort and has not had his bowels open for 5 days. His past medical history includes type 2 diabetes of which he is on medication for, asthma that is managed with Ipratropium bromide (Atrovent) and Salbutamol oral inhalers, laparotomy for a small bowel restriction following a multi vehicle accident 15 years ago, mild hypertension, high cholesterol (all of which are normally controlled), has worn glasses for the past 20 years and has obesity. Mr Thompson lives alone however he has two supportive children that help him out. His wife of 44 years passed away 5 weeks ago following a prolonged battle with cancer.

When Mr Thompson reported to the emergency department this morning at 0800 he reported of feeling nauseous, no appetite, fatigued and lethargic. Further investigation in the emergency department revealed a small bowel obstruction requiring surgery tonight. It is believed that this may be a possible complication from previous bowel surgery following his traumatic abdominal injury when he was involved in a multi vehicle accident 15 years ago. 

On arrival to the ward a top to toe assessment was completed for Mr Thompson, including viral signs. Mr Thompsons vital signs are stable except for an increased respiration rate which was 24 respirations per minute. His vital signs are: Heart rate 70 beats per minute, Blood Pressure 140/75, Oxygen Saturations on room air 98%, Temperature 36.6 and had a pain score of 5/10, Mr Thompson also has no known allergies. His abdomen is firm to palpate and distend and he is sitting in a semi fowlers position. Mr Thompson also has a naso gastric tube in that is on free drainage, and a small amount of yellow/green fluid has drained.

In preparation for theatre it is crucial that Mr Thompson is well informed of the procedure that is going to take place and that any questions he may have can be answered. As a lot of anxiety can form around surgery (NCBI, 2018), it is important to be aware and comfort Mr Thompson where needed and give him a lot of clarification and information to help support him through this time. Mr Thompson will be informed of the preoperative procedures such as insertion of an intravenous cannula, premedications and what to expect once anaesthesia is induced. He will receive information regarding post-anaesthetic, informing him on how he may feel. As well as what to expect postoperatively such as pain management, mobilisation, intravenous fluids and wound drains, and what they will expect him to do in order to minimise his hospital stay and speed up his recovery (Koutoukidis, Stainton & Hughson 2017). 

A consent form will be signed by Mr Thompson prior to surgery and he will also have his rights read out to him as well as any other valuable information. He will have the opportunity to ask any further questions to ensure he is well informed and aware of what to expect. Mr Thompson will then be made sure he is comfortable and content before surgery commences.

 

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  • Posted on : June 16th, 2019
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