Question Answered step-by-step Scenario Mr. Henry, a 70-year-old man, admitted for elective right… ScenarioMr. Henry, a 70-year-old man, admitted for elective right inguinal hernia repair. He had a right groin swelling for three-months duration. He was diagnosed with Hypertension and Type II Diabetes mellitus 20 years ago. No past surgical history. On assessment, Mr. Henry has a 4 cm by 5 cm right inguinal swelling that is reducible and non-tender on palpation and a positive cough impulse. He states that the swelling sometimes extends down into his scrotum. On admission: Temperature 37.1 0C, Pulse 80 beats/minute, Respiration 20 breaths/minute, Blood Pressure 150/92 mmHg, Oxygen saturation 99%, RBS 128 mg/dL, Height 156 cm, Weight 137.5 lbs. Mr. Henry has repeated doubts regarding surgery, and he is fearful of contracting COVID-19 while in hospital as he is yet to be vaccinated. He is also concerned about the risks involved with having surgery and his recovery period as he is a farmer. He denies any known drug or food allergies. Consent form has been signed. Patient had COVID-19 testing prior to surgery and had negative result.  Pre-Operative Plan of Care:- Admit to ward- Allow HTN and DM diet as tolerated- Supervised ambulation- Vital signs q6hrly with blood sugar monitoring- IVA, CBC, RFT’s, GXM, PT, PTT, INR- CXR, ECG- Panadol 1g TDS/PRN- Nifedipine 20mg po bd- Insulin sliding scaleRBS (mg/dL)Insulin R (units)< 1500151 - 2002201 - 2504251 - 3006 301 - 350 8351 - 40010> 40012 and inform SOD – Keep NPO from midnight for surgery in the morning- IVF 2L/24hrs NS/RL once NPO- Allow patient to dry swallow of anti-hypertensive medications on morning of surgery- Informed consent signed SENARIO PROGRESSION:Mr. Henry has successfully undergone open right inguinal hernia repair with mesh under General Anesthesia. He returns to the ward drowsy but arousable and complains of feeling cold. His last vital signs from the Post Anesthesia Care Unit (PACU) are B/P 105/76, P 102, R 18 bpm and T 35.5 C.  SpO2 97% on room air, Blood Glucose 180mg/dl. His hemovac drain contains 60 ml serosanguinous fluid. Dressing to operative site is intact but a 2cm blood stain is apparent.  He has an IV in right arm infusing Lactated Ringer’s at 40 gtt/min.  Mr. Henry moans softly and while transferring from the theatre trolley to his bed; he verbalizes pain 6/10 on a Pain Scale of 0-10.      Following surgery, the post-operative plan is as follows:- Keep NPO until fully awake then allow sips of clear fluids and graduate diet as tolerated- Routine post-op vital signs, then q4hrly once stable- Continue Blood glucose monitoring per routine with sliding scale insulin coverage as needed- IVF Lactated Ringer’s alternate with Normal Saline 3000mls in 24 hours – Amoxicillin 1.2g IV TDS- Metronidazole 500 mg q6h- Tramadol 100 mg IV/IM and Gravol 50 mg IV/IM BD- Sterile dressing change upon discharge with normal saline- Chest physiotherapy and incentive spirometer- TED stockings- Repeat bloods -Patient to sit out in chair as soon as possible once stable QUESTION: Using the following five (5) body systems (CNS, CVS, GI, Respiratory, & Skin) explain the immediate post-operative assessment and interventions to be carried out on Mr. Henry. Give rationales for your interventions.  Health Science Science Nursing NURS 3010 Share QuestionEmailCopy link Comments (0)

Question Answered step-by-step Scenario Mr. Henry, a 70-year-old man, admitted for elective right… ScenarioMr. Henry, a 70-year-old man, admitted for elective right inguinal hernia repair. He had a right groin swelling for three-months duration. He was diagnosed with Hypertension and Type II Diabetes mellitus 20 years ago. No past surgical history. On assessment, Mr. Henry has a 4 cm by 5 cm right inguinal swelling that is reducible and non-tender on palpation and a positive cough impulse. He states that the swelling sometimes extends down into his scrotum. On admission: Temperature 37.1 0C, Pulse 80 beats/minute, Respiration 20 breaths/minute, Blood Pressure 150/92 mmHg, Oxygen saturation 99%, RBS 128 mg/dL, Height 156 cm, Weight 137.5 lbs. Mr. Henry has repeated doubts regarding surgery, and he is fearful of contracting COVID-19 while in hospital as he is yet to be vaccinated. He is also concerned about the risks involved with having surgery and his recovery period as he is a farmer. He denies any known drug or food allergies. Consent form has been signed. Patient had COVID-19 testing prior to surgery and had negative result.  Pre-Operative Plan of Care:- Admit to ward- Allow HTN and DM diet as tolerated- Supervised ambulation- Vital signs q6hrly with blood sugar monitoring- IVA, CBC, RFT’s, GXM, PT, PTT, INR- CXR, ECG- Panadol 1g TDS/PRN- Nifedipine 20mg po bd- Insulin sliding scaleRBS (mg/dL)Insulin R (units)< 1500151 - 2002201 - 2504251 - 3006 301 - 350 8351 - 40010> 40012 and inform SOD – Keep NPO from midnight for surgery in the morning- IVF 2L/24hrs NS/RL once NPO- Allow patient to dry swallow of anti-hypertensive medications on morning of surgery- Informed consent signed SENARIO PROGRESSION:Mr. Henry has successfully undergone open right inguinal hernia repair with mesh under General Anesthesia. He returns to the ward drowsy but arousable and complains of feeling cold. His last vital signs from the Post Anesthesia Care Unit (PACU) are B/P 105/76, P 102, R 18 bpm and T 35.5 C.  SpO2 97% on room air, Blood Glucose 180mg/dl. His hemovac drain contains 60 ml serosanguinous fluid. Dressing to operative site is intact but a 2cm blood stain is apparent.  He has an IV in right arm infusing Lactated Ringer’s at 40 gtt/min.  Mr. Henry moans softly and while transferring from the theatre trolley to his bed; he verbalizes pain 6/10 on a Pain Scale of 0-10.      Following surgery, the post-operative plan is as follows:- Keep NPO until fully awake then allow sips of clear fluids and graduate diet as tolerated- Routine post-op vital signs, then q4hrly once stable- Continue Blood glucose monitoring per routine with sliding scale insulin coverage as needed- IVF Lactated Ringer’s alternate with Normal Saline 3000mls in 24 hours – Amoxicillin 1.2g IV TDS- Metronidazole 500 mg q6h- Tramadol 100 mg IV/IM and Gravol 50 mg IV/IM BD- Sterile dressing change upon discharge with normal saline- Chest physiotherapy and incentive spirometer- TED stockings- Repeat bloods -Patient to sit out in chair as soon as possible once stable QUESTION: Using the following five (5) body systems (CNS, CVS, GI, Respiratory, & Skin) explain the immediate post-operative assessment and interventions to be carried out on Mr. Henry. Give rationales for your interventions.  Health Science Science Nursing NURS 3010 Share QuestionEmailCopy link Comments (0)