Acute surgical admissions are a common practice for most hospitals and therefore, nurses. The ability of a Registered Nurse to understand the pathophysiology and manifestations of more common illnesses allows for greater advocacy for patients; and enables the nurse to better evaluate the interventions in place.
Completion of this assessment will test your knowledge relating to the pathophysiology, clinical manifestations, investigations and treatments of a common acute surgical admission. The assessment will further determine your ability to interpret and apply this knowledge to the holistic nursing care of a patient with this illness.
To complete this assessment, you will need to read and understand the case study presented below and provide detailed responses to each of the points listed. Your detailed responses should be presented in the format of a report, summarising the scenario and its implications. For each point, you should have a separate heading.
The points to address in your report, are as follows:
- Summarise the situation and patient identified in the case study.
- Identify and describe the illness and relevant pathophysiology of the illness indicated.
- Identify the common clinical manifestations (signs and symptoms) for the illness you described.
- Consider and discuss the legal and ethical implications of consent giving whilst under the influence of intravenous narcotics.
You must decide whether the patient is fit to consent, and if not, who may be able to
consent for her. You should discuss potential confidentiality and privacy issues in relation to her location for admission.
- Identify the potential issues that could be faced when undergoing surgery in this case study, related to pain, digestion and oxygenation and formulate an intervention plan that explains how to manage each one.
Note: This plan should be a paragraph on each aforementioned issue, which includes the considerations for each intervention and the clinical reasoning behind them.
Case Study – Janet
Read the below case study then complete your response.
Janet is a 48-year old; she has a BMI of 42 and is a single mother of two. She has been admitted to the ward from the emergency department (ED) with a preliminary diagnosis of Cholecystitis after increasing abdominal pain and nausea.
Janet’s observations on arrival are T=36.7, P=88, BP=104/74, RR=10, SaO2=98% on 2L/min Oxygen via nasal cannula. She has a resting pain score of 2/10 which increases to 5/10 on movement after analgesia. She has been given IV Paracetamol, IV Morphine and IV Normal Saline. She has been admitted to the ward awaiting further investigation and review by the general surgery consultant. Janet has been admitted to a shared room on the surgical ward with another patient. Her morphine was administered 45 minutes ago with some effect on her pain, the surgical registrar is going to consent her for surgery when she arrives on the ward in 10 minutes.