Left Hip Revision Surgery : Operative Care, Anesthesia, And Possible Complication Essay

On 01/27/2016, I observed about 22 patients in Postanesthesia Care Unit. Some of the patients were observed after surgeries while others were observed after endoscopy. During my shift, I observed patients awaiting recovery for removal of kidney stones, malignant melanoma (removal of moles), Endometrial Biopsy (EBX), superficial femoral artery (SFA), Hernia repair, Oophorectomy (ovary removal surgery), Cardiorrhaphy (Ventricular repair), Cystolithalopaxy (bladder stone removal), gall stone removal, Ectopic pregnancy surgery, and leg surgery.

2. The medical director makes rounds and writes orders to start an IV of D51/2 NS at 75 m/hr

History:  Margaret Donovan, a 72-year-old white female, was brought to the emergency room by her son-in-law after falling in her bathtub. She was previously in good health, despite leading a relatively sedentary lifestyle and having a 30-pack-year history of cigarette smoking. The only medication she currently takes is Inderal (propranolol) for mild hypertension. She fell upon entering the bathtub when her right leg slipped out from under her; she landed on her right hip. There was no trauma to her head, nor does she complain of right or left wrist pain. However, she reports severe pain in the right hip and upper thigh, and was unable to get up after her fall. An injection

This week, I was given the opportunity to care for two female patients – 205(1) and (2). The first patient, 205-1, was admitted with respiratory distress and had a past medical history of hypertension, schizophrenia and bipolar disorder. She was initially put on 2 L/min of oxygen and placed on oxygen titration protocol with orders to maintain O2 saturations between 88-92%. The patient was oriented to person and place, but had difficulty with time. She was also obese (BMI 30) and deemed a moderate assist with ambulation. Her care plan included total assistance with ADLs, smoking cessation and oxygen protocols, limited salt intake (3mg), and chronic pain management. The second patient, 205-2, was admitted with a right pelvic fracture and had

Discuss potential postoperative laparoscopic abdominal surgery complications. Include assessment findings, diagnostic evaluation, and nursing measures designed to prevent these complications from occurring.

The patient is a 74-year-old female who tells me she did see Dr.[____] and she did get a shot into her hip. She states symptoms are "1000 times better". She does tell me he was done ultrasound and thought she might have a [____] tear, which at this point, if this does not work, she will need likely to have a hip replacement, as he did not think this is fixable at her age.

During my Med-Surg clinical, I was assigned to a patient who was a 94 year female that had several medical conditions. The situation that ensued was difficulty communicating with her, since she did not speak English. Not only did the patient not speak English, but was only alert to herself, as well as extremely confused. As a result, being able to provide effective and quality care became a challenge. The reason for her admission was hyperkalemia, UTI, congestive heart failure (CHF) and acute renal failure (ARF). Unfortunately, the patient had other comorbidities that affected her well being such as diabetes mellitus, hypertension, atrial fibrillation, BPPV, CAD, s/p stent, DVT, CKD, stage 4 sacral decubitus ulcer, cholecystectomy, hip fracture and LE fasciotomy DVT.

The appropriate assessment of patients prior to surgery to identify coexisting medical problems and to plan peri-operative care is of increasing importance. The goals of peri-operative assessment are to identify important medical issues in order to optimise their treatment, inform the patient of the risks associated with surgery, and ensure care is provided in an appropriate environment secondly to identify important social issues which may have a bearing on the planned procedure and the recovery period and to familiarise the patient with the planned procedure and the hospital processes.(American Society of Anaesthesiologists)

As for my family’s perspective, this is going to be mainly based on my mom’s friend’s perspective. His expectation of entering Walt Disney World Magic Kingdom was not to wait in extensively long lines, to be selected randomly to go through metal detectors, be detained for ten minutes, and then must explain his medical history because his hip replacement created the metal detector to be activated. His first encounter with Walt Disney World cast members created the term “moment of truth” and this first approach between him and the cast member security gave a negative effect on my mom’s friend. He was expecting a magical service experience, everything he has seen on television; however, he felt he did not receive this type of expectation,

The pre-operative stage is an important phase in patient’s surgery process. This is the time where the patients is experiencing a lot of anxiety issues and have questions regarding the impending procedure. To help ensure good patient outcomes, it is imperative to provide complete preoperative instructions and discharge instructions (Allison & George, 2014). It is the nurses’ duty to safe guard and protects the patient’s welfare during the surgical experience. Effective preoperative preparation is known to enhance postoperative pain management and recovery. Health professionals need to be cognizant of the contextual factors that influence patients’ preoperative experiences and give context appropriate care (Aziato & Adejumo, 2014).

This clinical rotation I was assigned to observe at the operating room, where they conduct various surgical procedures. The night prior to the clinical, I have to admit, was every bit unnerving. Especially, the fear of not knowing what to expect was daunting. There must have been a thousand scenario of what to expect or what might possibly go wrong playing through my head that night. However, after being introduced to the nurse I would be following, and meeting the surgeon and the rest of the team; my nerves settled down. The surgery scheduled was for a ventral hernia, which seemed routine, but complicated by a previous bowel realignment previously. The whole operation, from beginning to end, lasted a little over four hours. Although, the procedure lasted that long, it did not bother me even bit. In spite of standing for the whole duration of the observation, I never felt tired nor gotten bored. Notably, watching the surgical team working cohesively is like watching an artists who have

Total hip replacement is a surgical procedure to remove damaged bone in your hip joint and replace it with an artificial hip joint (prosthetic hip joint). The purpose of this surgery is to reduce pain and improve your hip function.

Jones is a 64 year old well nourished man with a history of long-standing non-insulin dependent diabetes mellitus (NIDDM). He had an open heart -surgery bypass graft 7 weeks ago. The graft site got infected and had to undergo an emergency surgery to improve circulation to his left lower limb. Mr. Jones is relieved that his leg was saved and he is now being prepared for discharge. He wants to regain his strength so that he can start doing the things he loves. Currently Mr. Jones needs moderate assistance depending on his level of pain or fatigue and ambulates with a walker. Mr. Jones still needs help with activities of daily living. He has urinary and bowel control problems as side effects from multiple antibiotics. Mr. Jones is married and has 4 grown children that provide him with love, care, and support. The nursing staff is teaching Mrs. Jones how to perform sterile wound care for her husband as he will need dressing changes three times a day, blood glucose monitoring and a healthy diet. Social service is helping to keep communication channels open between Mr. Jones, his family and the nursing staff to maintain psychological and emotional health.

S.P. should be up out of bed post-op day 1 and wearing TED hose continuously, as well as wearing SCDs overnight in bed. Constipation prevention should e achieved by administering scheduled doses of Colace. Proper nutrition should be encouraged to include plenty of protein to ensure proper wound healing and avoid development of pressure ulcers (Lewis, Dirksen, Heitkemper, Bucher, & Camera, 2011). S.P. should practice coughing and deep breathing throughout her hospital stay to avoid lung congestion and occurrence of pneumonia infection, educating the patient about smoking cessation assistance can be helpful as well.

The management of postoperative pain has received much interest nowadays. The intensity of postoperative pain depends on many factors such as type and duration of the surgery, type of anesthesia and analgesia used, and the patient’s mental and emotional status (11).