Posted: March 23rd, 2023

PACU Surgical Patient

Question 1: Diagnostic, Palliative, Elective, and Therapeutic, Surgical Procedures

Diagnostic surgical procedures are the procedures undertaken to provide further insight into the causes and severity of a condition before any operations take place. The procedures include imagery examinations such as upper endoscopy and colonoscopy.

Palliative Surgical Procedures

Palliative surgical interventions are often demanded to cure the condition, but sometimes, a process can be conducted to assuage pain or eliminate dysfunction. In essence, palliative surgery is the term used in defining the procedure in which an intestinal painful obstruction or masses are removed.

Elective Surgical Procedures

 These are the procedures that are scheduled in advance. Surgical operations are conducted when a condition does not involve a medical emergency and the health situation remains stable for a reasonable period.

Therapeutic Surgical Procedures

 Therapeutic surgery is a medical procedure aimed at curing and restoring the health of the patient without surgical interventions.

Question 2: The initial nursing assessment and management immediately after transfer from the post anesthesia care unit

 After undergoing anesthesia, a patient is usually weak and vulnerable. As such, effective nursing assessment and management of the condition is required to enhance positive output.  The initial nursing assessments include:

• Positive patient identification
• Physical assessment including the observation of the heart rate, blood pressure, temperature, and respiratory rate
• Recovery support, including mobility restriction, balanced nutrition, and educational workshops needed both to patient and caregivers

Immediately after the transfer from the post anesthesia care unit, a number of procedures should be undertaken. The first step contains the routine post anesthesia orders, including identification of the patient, clinical handover, the determination of the potential complications, and a clinical pathway to recovery. The second component constitutes of patient observations, including the documentation on data on heart rate figures, respiratory rate, blood pressure, temperature, baseline neurological assessment, and the assessment of wounds.

Question 3: The rationale for nursing interventions in preventing postoperative complications

The intervention’s logic lies on the initiatives’ reasons and output. In addition, the intervention measures assist the nursing team in observing and building a complete picture of the patient’s health status after surgery. A surgical process oftentimes leads to the destruction of tissues, the weakness of body organs and the abnormal functioning of heart and lungs.  It is, therefore, justified to invest resources and time in preventing postoperative complications because their occurrence puts the life of the patient at risks. Moreover, such complications can also delay the recovery process.

Question 4: Assessment data for the surgical patient

The three categories of assessment data for a surgical patient include:

1. History, including the past and current medical, surgical, family and social backgrounds in which factors likely to affect the surgery procedure are identified. For example, if the patient is under medication on other health conditions such as diabetes and hypertension, the course of action in the surgery process can be impacted.
2. Physical examination of airways, lungs and heart, and evaluation of vital signs are important. The obtained information, in this case, gives further insight into the condition with which the patient has been hospitalized.
3. Information from the laboratory tests and screens, the facts from the patient’s history, and the physical examinations give the clinicians the idea of the state and nature of the condition. However, details on the intensity and severity can only be determined using the lab tests and MRI.

Question 5: Information needed for the postoperative patient in preparation for discharge

The discharge of the postoperative patient is a sensitive procedure, Moreover, if the process is not effectively undertaken, it can lead to unfavorable outcomes and a possible readmission due to complications. The discharge should be based on information such as the state of the surgical wound, pain management, available resources of patient care at home, the transportation on a regular basis, the quality of life, and examination procedures required to avoid complications and identifying issues in need of emergency medication. The consideration of such features assists in the discharge of the patients whose condition is stable, and their transfer from the hospital to their homes will not affect the recovery process. 

Question 6: Surgical Cases

Patient A has gallstones, an infected gallbladder, and his white blood cell count is about 27,000. Therefore, the patient is suffering from gallbladder disease, and the WBCs’ number implies that the body is trying to fight the condition. In addition, the seriousness of the disease intensifies due to nausea and vomiting for 24 hours. As such, the patient is in an acute state and would require an emergency therapeutic, surgical procedure to cure the condition and restore his health.

Conversely, Patient B has a poorly functioning gallbladder but has no stones or infection. Besides, his WBC count is normal, and the invalid is not in pain. The patient is, therefore, suffering from acalculous gallbladder disease, which is not an emergency case, and hence is referred to a local surgeon’s office. Thus, the diagnostic surgical procedure is appropriate for the patient as the clinician/physician would require more insights into the condition before starting the treatment.