Patient Profile J.A., a 68-year-old woman with a herniated lumbar…
Question Answered step-by-step Patient Profile J.A., a 68-year-old woman with a herniated lumbar… Patient ProfileJ.A., a 68-year-old woman with a herniated lumbar disc at L4, is scheduled to have an L4 lumbar laminectomy using a posterior approach. She has a history of low back pain, osteoarthritis in the left hip, and hypertension. She is in sever pain (score 8) and cant move but her son is supporting her as he is educated and understand his mother emotional state .She is taking the following medications:Metoprolol 50 mg PO twice daily; last dose last nightIbuprofen 600 mg PO three times daily; last dose yesterday morningGarlic supplement daily; last dose yesterday morning Subjective DataHas low back pain that radiates down her right legHas pain in left hip that worsens with activityHas not had anything to eat or drink since midnight last nightHas smoked one-half pack of cigarettes per day for the past 47 yearsStates that she is allergic to sulfa and latex Objective DataPhysical ExaminationBlood pressure 140/82, pulse 84, temperature 98.6°F, respirations 20Height 5′ 5″, weight 195 lbs., BMI 32.4 kg/m2Diagnostic StudiesECG normal sinus rhythmLab valuesSodium 139.0 mEq/LPotassium 3.4 mEq/LHCO3 25.4mEq/LChloride 99.5mEq/LBUN 10mg/dLCreatinine 1.1mg/dLWBC 7000/µLRBC 4.3 million/µLHematocrit 36%Hemoglobin 12 g/dLPlatelets 164,000/µLGlucose 98mg/dL Interprofessional CarePreoperative Orders • NPO after midnight• Type and crossmatch 2 units of packed red blood cells• Start an IV of lactated Ringer’s at 75 mL/hr.• Ensure that surgical consent form is signed and placed in the chart• Administer ceftriaxone sodium 1 gram IV when called to ORQuestions 1- Explain the rational for each request of the preoperative orders and enumerate the preparation must be done in the day of the surgery for this patient What preoperative teaching should you provide to this patient?2- Do you think this patient is eligible for signing the consent? Rationale your answer3- What risks exist for F.J. as she undergoes surgery?4- What are your priority actions as F.J. awaits surgery?5- After reviewing J.A.’s chart with the above data, what information should the perioperative or circulating nurse make the operating room staff, surgeon, and anesthesia care provider aware of?6- What position should J.A. be positioned on the operating room table and what should be considered when positioning her for the surgical procedure7- What is involved in a surgical time-out& sign out ?8- Describe a plan for J.A.’s anesthesia during surgery.9- Select the pain type for this patient with rational for your answer and develop related intervention to control her pain postoperatively & on discharge Health Science Science Nursing Share QuestionEmailCopy link Comments (0)
