NURSE 100 Nursing the Surgical Patient

PART A

As the patient has been reported with the medical history of Myocardial Infarction, Asthma, Hypertension, Obstructive sleep apnoea (OSA), Hypercholesterolemia. So before taking patient under operation and administer General Anaesthesia; it is important to critically analyse the issues, possible contradictions and medical conditions may arise with the administration of anaesthetic drug. Anaesthesia act by relaxing the muscles but in case MI; it may cause Myocardial depression and effect myocardial contractility by ANS which may depress myocardium. Asthmatic patients increase risk of developing bronchiole contraction when receiving general anaesthesia. Rapid decrease in level of oxygen can lead to hypoxemia.   General anaesthetic medications give cardiac depressant effect which can lead to reduce systemic vascular resistance. Prolonged increase in blood pressure can affect many organs throughout the body which can leads to organ malfunction. General anaesthesia can be dangerous Wendy because of medical history of obstructive sleep apnoea as it slows down breathing and anaesthesia can make patient more sensitive to its effect. Patient with OSA can find it too difficult to regain consciousness and take a breath post surgery (dos Santos Felix et. al., 2019). Anaesthesia tends to increase the level of cholesterol as a part of healing process after surgery which can worsen the condition of hypercholesterolemia in case of Wendy.

The clinical issues can be prioritise in case of Wendy as; Abdominal pain, Diarrhoea and Tumour in ascending colon. Abdominal pain is pain that an patient feel anywhere between chest area and groin area. Abdominal region also referred as the belly region or stomach region. Intensity of pain cannot always be used considered as a measure to analyse the seriousness of the condition due to which stimulation of pain takes place. For example; sometimes stomach cramps or gas can stimulate very bad belly pain while fatal conditions like early appendicitis or colon cancer may only cause pain or even sometimes no pain. Colon cancer includes some symptoms includes; Persistent alterations in bowel habits, patient may suffer constipation or diarrhoea or change in stool consistency, sometimes blood in stool , abdominal discomfort, such as pain, gas and cramps can be felt. Patient might lose body weight, unsatisfactory bowel discharge, weakness. Symptoms of colon cancer may or may not be appear in the early stage of the disease. Appearance of symptoms depends on the size of tumour and its location in intestine (Gillis & Wischmeyer, 2019). First by experiencing the symptoms of diarrhoea; patients can get some relief by making changes to their eating and drinking habits. For example; eat-low fibre foods, drink clear liquids, consume 6 to 8 small meals a day, avoid eating foods that can cause irritation to digestive tract and it is better to prefer probiotics.

Patient should follow some steps to provide protection the skin. Frequent elimination of watery stool can cause skin irritation around anal area. Development of colon cancer takes place takes place when tumorous growth takes place inside intestinal area. It is the third most common of cancer in United State. Colon is the area of large intestine where body tends to draw out body and salts from accumulated solid waste. Development of cancer takes place in different stages and these stages mainly indicate the criticality of the situation along with the range and size of tumour developing inside. It begins with Stage 0 and reach to Stage 4. Stage 0 is called as carcinoma in situ and at it is very early stage of the cancer. It is easy to treat cancer at this stage and tumour has not grown farther than the inner thin layer of the colon. In stage 1; cancer growth reach to the next layer of tissue, stage 2; is a stage in which cancer seems to reach to the outer layer of colon but within the boundary of colon. While in stage 3; cancer has grown through the outer layer of colon and reach to one of three or all three of the lymph nodes. Till stage 4; cancer seems to grown beyond the walls of the colon. Progression of stage 4 reaches the cancer of colon to the distant parts of the body (Jones et. al., 2020). Nursing intervention for abdominal pain is to encourage the patient to disclose any pain or discomfort Wendy is experiencing Patient may strive to tolerate pain instead of asking for pain relievers; it is important to encourage patient that they should report their pain which can help the professionals to provide treatment suitable for the patient condition.

Rationale for pain management is important because pain interferes  with routine activities, and its management can reduce the impact of pain and patient can improve functions and help to improve quality of life. Nursing intervention for diarrhoea is to encourage the patient to increase intake of liquid die, review medications, educate patient about adapting changes in diet to improve the condition of diarrhoea, administer appropriate antidiarrhoeal to the patient, administer IV fluids and improve electrolyte balance in case of severe diarrhoeal condition. Nurses should encourage patient to promote relaxing and stress relieving habits, they should be promoted to maintain skin integrity, educate patient on proper food handling. Advice them to bring suitable lifestyle modifications and educate on post-surgical expectations. Rationale for the nursing intervention of Diarrhoea help patient to balance electrolyte (Li et. a

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