Answer To: 1 2803NRS_Acute_Nursing_Practice_Essay_T1_2021_v.1 2803NRS Acute Nursing Practice - Trimester One,...
Sunabh answered on May 15 2021
2803NRS 1
2803NRS 2
2803NRS ACUTE NURSING PRACTICE
TRIMESTER ONE, 2021
A3: WRITTEN ASSIGNMENT
Table of Contents
Introduction 3
Nursing Practice 3
1. Risk-Factors and Pathophysiology of the Patient 3
2. Two Comprehensive Post-Operative Assessment 3
3. One Potential Complication with Its Development, Risk Factor and Nursing Assessment for Identification of Complication 4
4. Care Plan for Reducing Risk of Potential Complication 6
5. Reflection on Care Plan Applying Gibb’s 7
Conclusion 8
References 9
Introduction
The aim of the study is to identify the risk factors and the complication that the patient Dianna Diamond was showing so that the complication that can arise during her post-cholecystectomy surgery. Based on the details provided by the case study, the risk assessment will be carried out for the patient after her surgery. Based on the evidences of complication, the plan of care and its outcome will be evaluated in the study. At the end of the critical analysis and identification of the plan of action, a reflective analysis on the personal learning will be carried out.
Nursing Practice
1. Risk-Factors and Pathophysiology of the Patient
The risk factors, the patient, Dianna Diamond, showed, were hypertension, depression, high Body Mass Index of 28 and hyperlipidaemia. In addition, she was having abdominal pain that radiated to her shoulder with a pain intensity of 8/10. In addition, the pain showed general pain as well as nausea for six months. Gallstone and inflammation often occurs when the patient have obesity or is overweight, have high blood pressure and poor diet (Mungazi et al., 2019). It was evident that Dianna was not having adequate physical exercise and not consuming sufficient fruits and vegetables. In addition, hyperlipidaemia is another condition that increases the level if cholesterol to a supersaturated level such that the cholesterol form crystals with formation of lump like gall stone.
2. Two Comprehensive Post-Operative Assessment
One of the post-operative assessments was that after the surgery, the patient was observed to be drowsy even though she was rousable. This can be because of several reason like inappropriate secretion of anti-diuretic hormone secretion, sodium loss or due to the infusion of mannitol leading to hypernatremia. As explained by Praveen et al. (2019), in patients such as Dianne who has hypertension often shows hypokalaemia after laparoscopic cholecystectomy.
Hypokalaemia results in the intensification of non-depolarisation of muscle relaxant. This is often caused due to the respiratory alkalosis with the reduced proton concentration within the cells and drawing potassium ions in to the cell. Electrolytic disturbances leading to the drowsiness of the patient is common amongst the patients with cholecystectomy. The patient stated after regaining consciousness she complains of having pain with an intensity of 6/10.
Upper abdominal pain is a common symptom in gallstone patient in addition to atypical discomfort. Even though the patient after the cholecystectomy was found to have lesser pain, the pain seemed to persist. This according to Merle et al. (2020) can be due to the concomitant morbidity, which in case of the patient was hyperlipidaemia. As explained by the case study the patient who initially had a pain score of 8/10 complained of pain 6/10 after surgery.
This is common in many cases of cholecystectomy where there is a persistent symptom for upper abdominal pain after the surgery. As revealed by Kawahara et al. (2017), after the surgery of the patients there were evidence of the patients showing abnormal finding when the images are examined. In case the patient’s condition is severe, the patients are provided with symptomatic control like analgesic, antacid and anti-inflammatory agents. According to the case study, Dianne was already put on analgesics after her surgery.
3. One Potential Complication with Its Development, Risk Factor and Nursing Assessment for Identification of Complication
One of the complications, which occurs during the cholecystectomy surgical process, is the venous gas embolism. As explained by Li et al. (2020), in many cases after the insufflation of carbon dioxide, it was observed that patient have a deteriorated level of...