Nursing The Surgical Patient

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Nursing Question

Objectives

After completing this assignment and the relevant research students will be able to: 

1. Demonstrate the use of research evidence for nursing practice applied to the care of a client,
2. Augment skills in clinical decision making and reasoning through synthesising and analysing information required to care for a client. 
3. Apply appropriate assessment, problem solving, planning, prioritising of interventions to care for the selected client scenario chosen
4. Demonstrate the nurse’s role in monitoring and timely intervention in response identified client needs 
5. Demonstrate the ability to communicate specific patient care issues succinctly according to scholarly writing and referencing conventions

Assignment Task 

Title:   Nursing the surgical patient

Task: You are to write a 1600 (+/- 10% excluding in-text references) word assignment utilizing scholarly resources involving the case scenario below. Further detail is provided below.

Case study 1

Fred Brown is a 72-year-old man who has been admitted for a left knee replacement. He has a history of COPD, depression, and hypertension. Fred is frail and he lives alone.

Fred has had his knee replacement today, and returned to the ward late in the evening at 2100 hours. You are the nurse looking after him on the night shift. He has a PCA for pain relief and IVI Normal Saline running at 100mls per hour. Fred has a sedation score of 1 since coming back from theatre. He has Oxygen running at 2L per min via nasal prongs. He has a vacudrain insitu and a large dressing over his knee. 

Assignment FAQ’s answered (very important to prepare assignment)

• • This assignment is to be written in the 3rd person in connected prose and can be written under headings. 
  • You must include the marking guide within your assignment.
  • Acceptable font for this assignment is Times New Roman or Arial and line spacing is 1.5 or 2.  

• Include a brief introduction and a conclusion.

• • Utilize appropriate academic resources, including research for all sections of the assignment and reference accordingly using APA.
  • Your text book will be a valuable resource for this assignment, however it is expected that you read widely and provide at least 14 additional references for your assignment.
  • Follow the marking guide
  • Use mostly  USQ E-LIBRARY to research academic references. 
• Assignments are only accepted through the on-line assignment portal located on the study desk and must be passed through TURNITIN prior to submission

Task in detail:

Section 1

1. Develop an appropriate nursing approach for the client in the scenario and include relevant assessment, potential problem / issue identification, and interventions (including monitoring) in the case outlined. In your analysis these actions should be based on nursing evidence for practice and referenced appropriately. 
2. Your discussion should explain the rationale for those nursing actions. You will need to develop your nursing actions from the literature and justify why the care you have proposed is best practice. Your care will need to be prioritised and cover both physical and psychosocial needs and be mindful of the presenting co-morbidities of the person. Your focus in this section will centre on the care of the patient in the initial 24hours post-surgery. This section should be the major part of your essay. (approx 800 words)

Section 2

• Discuss the co-morbidity COPD and the potential issues impacting on recovery post-operatively for Fred after having a general anaesthetic. Include in your discussion the possible complications that could arise and how Fred might deteriorate. Detail the interventions the nurse would initiate to decrease risk to the patient and include your rationale for interventions. (300 words)

Section 3

3. Identify and briefly discuss discharge planning for patient. Identify from the literature the discharge planning would need to be put in place for the case scenario. Keep this section brief. (approx 300words)

Introduction and conclusion (200 to 300 words)

Nursing Solution

Total knee replacement is observed to be the commonly performed procedure in elderly patients. It is one of the most effective treatments in knee problems when other nonsurgical treatments and methods fail. However, this surgical procedure is associated with a wide range of risk of complications that may be observed to be increased or more in advanced age (Kuperman, Schweizer, Joy, Gu, & Fang, 2016). Hence, the main purpose of this essay is to discuss one such case where a 72-year-old patient has been admitted for the total knee replacement. This essay will discuss various nursing approaches, issues, complexities, and necessary interventions that may be required for the care of the patient postoperatively to avoid any kind of complications and deterioration of the patient. 

Section 1: Nursing approach for the care of a client

Pulmonary complications are the common and significant cause of postoperative mortality and morbidity. Moreover, there are various risk factors that are associated with the development of several postoperative pulmonary complexities or complications like smoking status, high BMI (Body Mass Index), and history of COPD (Agostini et al., 2010). In this case, as the patient has a medical history of COPD, it is very important to adequately evaluate respiratory functions. The first approach, as a registered nurse, in this case, would be to assess the presence of airway obstruction in the patient. Presence of noisy breathing changed voice, or increased efforts in breathing are the indicators of partial airway obstruction. While incomplete obstruction, there is no respiration inspite of great effort (see-saw sign or paradox respiration).