Case:
Location: Medical-Surgical Unit
Time: 0800
Report from night shift charge nurse:
Situation:
Sara Lin is an 18-year-old patient who had an emergency appendectomy. It is day 2 postoperative, and Sara is expected to be discharged late this afternoon. We have discontinued her IV antibiotics after her morning dose. She will be getting oral meds today.
Background:
Sara presented in the ED 2 days ago with a 2-day history of nausea, vomiting, and increasing pain. She was taken to surgery that day and had an open appendectomy for a ruptured appendix. She has been stable since arriving to the unit. Her parents have been here with her most of the time and are very helpful and supportive.
Assessment:
Sara is alert and oriented. She needs to be reminded to use her incentive spirometer. Abdomen is soft and tender to touch. Bowel sounds active. She has progressed to regular diet, and she's eating small amounts. No nausea reported since postoperative day 1. The surgery team changed the abdominal dressing early this morning. The incision is closed with staples; the edges are well approximated and only slightly reddened, with minimal serosanguinous drainage. Her sequential compression devices were discontinued, and the drain was pulled this morning. A small amount of bleeding was present; no further bleeding is noted. She had her first small soft brown stool since surgery this morning.
Recommendation:
You will have to transition Sara to oral antibiotics and pain medication. She last had pain medication 4 hours ago. You will need to provide discharge patient education related to incision care, pain medication and antibiotics, signs of postoperative infection, activity restrictions, and surgical follow-up.
Step by stepSolved in 2 steps
- Situation:Sara Lin is an 18-year-old patient who had an emergency appendectomy. It is day 2 postoperative, and Sara is expected to be discharged late this afternoon. We have discontinued her IV antibiotics after her morning dose. She will be getting oral meds today.Background:Sara presented in the ED 2 days ago with a 2-day history of nausea, vomiting, and increasing pain. She was taken to surgery that day and had an open appendectomy for a ruptured appendix. She has been stable since arriving to the unit. Her parents have been here with her most of the time and are very helpful and supportive.Assessment:Sara is alert and oriented. She needs to be reminded to use her incentive spirometer. Abdomen is soft and tender to touch. Bowel sounds active. She has progressed to regular diet, and she's eating small amounts. No nausea reported since postoperative day 1. The surgery team changed the abdominal dressing early this morning. The incision is closed with staples; the edges are well…arrow_forwardThe nurse decides to call the physician and receives a verbal order for “Give Sally Smith 5 mg morphine sulfate q6h PRN for pain.” The nurse should do the following actions. Select all that apply: Check medication rights and allergies prior to administering the medication Document the verbal order in the electronic medical record Ensure the verbal order is signed by the provider within 24 hours Ask the provider for additional order information Perform a check-back and verbally repeat the providers order while still on the phonearrow_forwardCase Scenario/Description Case:Location: Medical-Surgical UnitTime: 0800Report from night shift charge nurse:Situation:Sara Lin is an 18-year-old patient who had an emergency appendectomy. It is day 2 postoperative, and Sara is expected to be discharged late this afternoon. We have discontinued her IV antibiotics after her morning dose. She will be getting oral meds today.Background:Sara presented in the ED 2 days ago with a 2-day history of nausea, vomiting, and increasing pain. She was taken to surgery that day and had an open appendectomy for a ruptured appendix. She has been stable since arriving to the unit. Her parents have been here with her most of the time and are very helpful and supportive.Assessment:Sara is alert and oriented. She needs to be reminded to use her incentive spirometer. Abdomen is soft and tender to touch. Bowel sounds active. She has progressed to regular diet, and she's eating small amounts. No nausea reported since postoperative day 1. The surgery team…arrow_forward
- Chief Complaint: Rajesh Kumar presents to the village health worker complaining of persistent fatigue, weakness, and occasional abdominal pain. He reports feeling increasingly tired despite getting adequate rest and experiencing discomfort in his abdomen. Rajesh describes his symptoms as ongoing for several weeks. He mentions that many other villagers have been experiencing similar symptoms, and there has been talk of a "strange illness" spreading throughout the community. He denies any recent travel or changes in diet. Social History: Rajesh is married with three children. He works as a farmer, tending to crops and livestock on his family's farm. The village is situated in a remote area with limited access to modern amenities. Rajesh mentions that he often walks barefoot around the farm and occasionally experiences minor cuts and scrapes on his feet. Physical Examination: Vital Signs: Temperature 37°C (98.6°F), Blood Pressure 120/80 mmHg, Heart Rate 80 bpm, Respiratory Rate 16 bpm…arrow_forwardDiscuss the nursing priorities for a patient undergoing a bowel resection surgery.arrow_forwardGiven the following Doctor’s Orders, Interpret or Translate the underlined word(s) using the correct medical terms or abbreviations:arrow_forward
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