Case Study 2: 63-year-old K.S. has just arrived to the PACU, where the nurse makes the initial assessment. K.S. is
turned, the OR sheets are removed, his skin is observed for redness and pooling of blood, and his head is
elevated 45 degrees. He is on 40% humidified oxygen via a Ventimask mask. K.S’s initial set of vital
signs are 140/80, HR 92, RR 14, T 99° and pulse ox 98%. Fifteen minutes later, the nurse charts his vital
signs as 144/76, HR 100; RR 10, T 99.1° and pulse ox 88%.
1. What action would be appropriate by the nurse based on the vital signs assessment 15 minutes
after arrival to PACU?
2. What age-related factors would the nurse want to consider regarding K.S.’s nursing care?
SOLUTION TO THE CASE STUDY
Systolic blood pressure is elevated; he has redness and pooling of blood, indicating that the operation site is bleeding. Also, the temperature is elevated, which is a sign of high fever, bradypnea, and low oxygen saturation levels. The nurse should give Rapid-acting antihypertensive such as nifedipine to reduce systolic BP. The nurse should examine if the venti mask that the patient has been placed on is appropriately placed, stimulate the patient and increase the percentage of oxygen being delivered. Redness and fever are some of the first signs of infections post-op; therefore, the nurse should examine the wound and antibiotics administered to the patient. Vital signs should be regularly monitored after every 15 minutes for the past hour. The patient should also be placed in a lateral or recovery position and continuous intravenous fluids maintained.
Elderly patients are among the vulnerable groups of the population. There is a decrease in physiological functions because some systems begin to shut down. The onset of functional impairments predisposes older patients to postoperative complications (Olotu et al., 2019). The functional status of the patients should be determined by the adequate perioperative assessment, including chronic disorders, comorbidities, polypharmacy, malnutrition, and risk for falls. Dietary intake and fluids should be monitored because they are crucial in the recovery phase of the patients. The risk for infections and hospital lengths is reduced when oral or enteral diet intake is initiated early. A multidisciplinary approach should be applied to ensure improved health outcomes for the patients (Olotu et al., 2019). The goal of postoperative care is to ensure that the functional status of the client pre-op is maintained by the application of evidence-based practices throughout the phases of surgery.
Olotu, C., Weimann, A., Bahrs, C., Schwenk, W., Scherer, M., & Kiefmann, R. (2019). The Perioperative Care of Older Patients: Time for a New, Interdisciplinary Approach. Deutsches Ärzteblatt International, 116(5), 63.
- Clinical Research and EBP You will identify if clinical research is the same as EBP or consider the obstacles to nursing research in a clinical environment
- Culmination of nursing research and EBP knowledge as students choose a qualitative or quantitative study to critically evaluate, including making a recommendation for utilization in EBP
- Locating Credible Databases and Research that are relevant to EBP around a diagnosis you chose and could be used to help a new hire nurse better engage in EBP
- Describe evidence-based practice (EBP) and its relationship to nursing research, nursing practice, and healthcare. (Domain – Educative Practice, Evidence-informed Practice,‘Process – Scholarship, Patient Safety)
- John Hopkins Nursing Evidence-Based Practice Model Vs The IOWA Evidence-Based Practice (EBP) model
- PICOT: Prepare an evidence-based practice (EBP) PowerPoint presentation on a topic of your choice that is relevant to advanced nursing practice education, leadership, quality improvement, or change.
- Discuss why EBP is an essential component of the practice of a BSN-prepared RN. Identify two ways in which you will continue to integrate evidence into your practice and encourage it within your work environment. What obstacles could challenge this plan, and what steps will you take to minimize their impact?
- Nursing EBP: What is the difference between research- and evidence-based practice projects?
- Dissemination of EBP and research, such as presenting results at a conference or writing an article for a journal, is an important part of professional practice
- How do you see yourself as a change agent guiding others to move from a process focus to an outcomes focus? Discuss this in relationship to your area of concentration – practice and/or education
- Multimedia presentation: health information systems
- Analyze a specific, recent outbreak of a global communicable disease that has crossed international borders (i.e. TB outbreak, Haiti to U.S.)
- PowerPoint: Choose a specific ecosystem to research and analyze the impact of humans on that ecosystem
- Discuss How Geopolitical And Phenomenological Place Influence The Context Of A Population Or Community Assessment And Intervention
- Discuss TWO EXAMPLES of how provisions from a nursing code of ethics influence your practice
- Discuss a scenario in which you, as a nurse, safeguarded two of the following principles for the patient
- SCHOLARLY PAPER About A Nursing Theory