Nursing and Health Breakdown Case Study

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Nursing and Health Breakdown: Pre-Operative Nursing Care Case Study

The patient in this case study is named Joe Taylor. Joe is 76 years of age, weighs 99 kgs, 153 cm tall and smokes 25 cigarettes each day. Joe is admitted to the ward and is scheduled for the repair of a right inguinal hernia. The following objectives exist in this study:

(1) This study will identify information obtained from a nursing admission and the importance of obtaining this information.

(2) As well, this work will discuss the purpose and necessity of obtaining baseline data from the patient; and finally

(3) This work will discuss the ethical and legal requirements of the nurse during the preoperative period.

Preoperative Nursing Assessment: Baseline Data Requirement, and Ethical-Legal Considerations

(1) Preoperative visiting is stated in the work of Pudner (2005) entitled "Nursing the Surgical Patient" to be "a new concept." (Pudner, 2005 Pudner additionally relates that the preoperative assessment should be ideally conducted the day prior to surgery. The preoperative assessment provides the nurse with the opportunity to explain the surgical process to the patient and to answer any questions that the patient might have about the surgery. As well the nurse must ensure that the patient listens and understands the information they are receiving. Included in the information procured from the patient by the nurse during the preoperative assessment is complete information on the patient's condition and care, a record of any problems that have arisen and the action taken, evidence of care and intervention and the patient's response, a record of the physical, psychological and social factors that might affect the patient, a record of events and decision-making, and a baseline against which improvement or deterioration can be measured. (Pudner, 2005, paraphrased)

(2) It is important that the nurse collect baseline data from the patient in order to effectively monitor the patient over the course of a surgical procedure specifically as to any data that is characterized by variability that occurs naturally in each individual. (Enrico, Lonner and Moulton, 2008) The standard requirements for hospitals in conducting pre-admission work are varied however the nurse will inform the patient of the necessary information so that they can assist in their own preparation for the surgery. The nurse will question the patient concerning any changes in health status and will provide pre-operative instructions concerning medications and other information that assist the patient in preparing for the surgery. (Enrico, Lonner and Moulton, 2008, paraphrased) Information collected will include the medications the patient is taking, their general condition, and blood work and other clinical lab work will be conducted.

(3) The nurse must also make sure the patient signs consent forms prior to the surgery so as to protect the hospital from any ethical or medical liability. All forms should be signed and witnessed with the date properly affixed upon the document. Finally, the nurse is responsible for explaining the possible risks and complications associated with the procedure which include such as bleeding, transfusion, infection, wound infection, dehiscence, pain, scaring of tissues, failure of the procedure, potential injury to other surrounding structures, deep venous thrombosis, pulmonary embolus, myocardial infarction, heart failure, stroke, death, or a long-term stay in the Intensive Care Unit (ICU).

The work of Burney, et al. (1997) entitled "Core Outcomes Measures for Inguinal Hernia Repair report that baseline data collection is important since the "Demands on the medical profession to develop performance measures and demonstrate cost-effectiveness make it imperative that a uniform approach to the measurement of outcomes for common conditions be adopted.."

Part B: Post Operation Wound Management

Part B of this study is related to post-operative wound management. While Joe Taylor's dressing was being changed a thick yellow discharge was noted to be oozing from the wound. Within the context of this case this work will define and explain the purpose of assessment in relat5ion to wound care and identify and discuss the nursing interventions undertaken when assessing the wound. As well this work will identify and discuss the nursing interventions undertaken in relation to aseptic technique. Two causative factors of wound breakdown will be described.

Wound Care

The work of Sussman and Bates-Jensen (2007) entitled "Wound Care: A Collaborative Practice Manual" reports that wound assessment data are collected for five purposes including the following: (1) examination of the severity (stage) or the lesion; (2) determination of the status of the healing of the wound; (3) establishment of a baseline for the wound; (4) preparation of a plan of… [END OF PREVIEW]

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"Nursing and Health Breakdown."  Essaytown.com.  August 12, 2010.  Accessed December 14, 2019.
https://www.essaytown.com/subjects/paper/nursing-health-breakdown/4777.