Laceration In Right Leg And Has Undergone †Myassignmrnthelp.Com

Question: Discuss About The Laceration In Right Leg And Has Undergone? Answer: Introducation Dave Sawyer is a 26 year old FIFO worker who lives near Collie. One day he completed his rotation of night shifts and went straight home for his RR days. Dave decided to go into the nearby bush to collect wood for his indoor fire, as he was lacking on wood and it was a cold weather. While using a chainsaw, the chainsaw cut through one of the pieces of wood, and D he was unable to take his finger off the trigger in time. This resulted in a jagged 10cm long and deep wound in his right calf which was running parallel along his tibia. Dave went to the doctor and his observations were recorded. He a had a normal body temperature of 36.7oC, increased heart rate of 89bpm, respiratory rate of 20pm. It was also observed that he had an increased blood pressure of 139/68mmHg, normal oxygen saturation level that is 95% and a pain score of 9/10. Dave was given opioid analgesia for his pain. After the wound was dressed he was reviewed by the ED doctor. The doctor advised Dave a surgery for debridement and skin flap to repair the laceration. and is not on any medications. He has no other medical problems. Dave was observed in the ward after his surgery was done at 11:45hrs. The doctors advised that his dressing would stay intact for 72hrs. He should keep his leg elevated to avoid future complications. He would be observed in regular intervals and neurovascular observations would be conducted every four hours. He was awake and alert, and he has a dressing on his right calf and a little amount of sanguineous ooze was observed. Daves observations on return to ward were recorded. His body temperature decreased to 36.7oC and heart rate was decrease to 66bpm.The respiratory rate of Dave also decreased to 16 pm. It was also observed that he had a decreased blood pressure of 109/7mm Hg and a normal oxygen saturation level of 95%. His pain score decreased to 2/10.Dave was given prophylactic Cefoxitin 2g IV during the surgery. His anaesthetist has prescribed 6 hourly administration of Paracetamol 1g IV/PO , Ibuprofen 200-400mg PO TDS, 100mg Tramadol SR PO BD and Cefoxitin 2g IV/ IM 6 hourly for 2 further doses. IV Compound Sodium Lactate 1L is running at a rate of every six hours into Daves left arm. It can be observed from the medical observations of Dave that his pain score is decreased from 9 to 2 that shows that shows that he is experiencing severe pain after the surgery. It was also observed that his respiratory rate and blood pressure also decreased. The temperature of his body also decreased slightly. He has been give analgesic such as ibuprofen and tramadol. Tramadol is similar to opiod analgesic and provides relief from pain. It may also lead to several side effects such as watering in eyes, muscle pain, restlessness running nose sweating and nausea if the medicine is stopped (Lewis Han, 2017).So, the nurses should observe the patient at regular intervals to check for any side effects. He was also given Cefoxitin antibiotic to protect from infections after the surgery. The nurses and clinicians should monitor Davis with care. He should be addressed in a direct manner by the nurse. She should maintain eye contact and sit in front of him. The healthcare supervisor and nursing staff should support and help him and his family in every possible manner (Lewis et al. 2015). Falls risk and pain assessment score can be used to assess the risk of falling and severity of pain in the patient. It can be observed from the medical observations of Dave that his pain score is decreased from 9 to 2 that shows that shows that he is experiencing severe pain after the surgery. It was also observed that his respiratory rate and blood pressure also decreased. The temperature of his body also decreased slightly (Lord, Menz, Tiedemann, 2013). Nursing diagnosis The two prioritized diagnoses for Dave post surgery are primary survey and first aid. Primary survey involves level of consciousness, circulatory volume, and airway. It is very crucial for the nurses and other health care professional to keep a track on these parameters to prevent any risk in future and provide proper care. They should follow six rights of medication which involves giving him proper drug by considering his allergic reactions to drugs and expiry date, proper route of administration such as oral, mouth, buccal, sublingual, gastric tube, and nasogastric tube, correct timing, right client or patient, proper dosage as prescribed by the doctor and documenting about the drug given to the patient. Nurses should also follow ANTT technique (Aseptic non-touch technique for wound care) which involves a few steps to prevent infection. The surface of wound should be cleaned with clean hands and the materials required should be collected beforehand. The wound is c leaned by taking proper precautions such as disposal of waste. Nurses should be alert at all times and protect Dave from all the risks of dangers and harmful situations.If they come across any adverse situations they should inform the management team and ask for professional health services. They should check for his response if he is not comfortable and feeling unwell. If he does not provide any response and seems unconscious, they should consider it as a medical emergency. As soon as the nurses find him in a state of unconscious, they should shout for help and make other people aware that there is an emergency situation so that they can arrange for an ambulance. There should be monitoring in appropriate manner and clinical assessments should be repeated in order to keep a track on the signs and symptoms so that surgical complications are recognized in an adequate manner.His body systems should be assessed such as respiratory system and nervous system. Respiratory system If Dave seems unconscious, there is also a risk of obstruction in the airway and the nurses should open the airway as soon as possible by lifting his chin and head in a tilted position. After opening the airway, nurses should check whether the patient is breathing normally or not for at least 10 seconds. The movement of chest should be observed in a careful manner and they should listen to his sounds of breathing and feel his exhaled breathing. If the nurses observe that Dave is not breathing properly, they should start Cardiopulmonary Resuscitation and call for a defibrillator. The compression in the chest should start as soon as possible with the rate of 100-120 per minute. Nervous system During the post operative care the nervous system of Dave should be checked by the doctors and several tests should be conducted to check whether there is a proper blood flow in his body. Planning The nurses and other health care professionals should provide proper nursing care post operation. He should also be provided psychosocial care to get rid of depressive symptoms developed due to the disease. SMART nursing care approach involves Specific, Measurable, Attainable, Relevant and Time Bound efforts . The first aspect Specific focuses on clear and easy nursing which can be understood by the patient. Measurable encompasses the objective that nursing should reach the target. An increase or decrease should be measurable. Attainable focuses on completing the objective of learning within time wit guidance from physicians and nurses (Potter, 2014). Relevant addresses the goals of nursing and their impact. Time Bound elaborates that nursing care should provide proper time for the successful implementation (Leininger McFarland, 2014). Implementation There are various tools for the assessment of pain that can be used if he is feeling discomfort. The nurses and other healthcare professionals should help him and provide psychosocial care along with palliative care so that he gets well soon( Maslow, 2013). He should be treated empathetically and with courteousness and should be counseled properly so that he can explain the severity of his pain. Strategies that can be employed to make sure that the pain of Dave is adequately addressed are proper communication with him so that he is able to describe what he is feeling. A health counselor should help Dave to improve their emotional response, get rid of pain, anxiety, distress and low self esteem that has developed post surgery. He should follow a balanced diet, perform exercise, and socialize with family and friends ( Festini, 2014). Nursing orientation plays an essential role in educating the patient about the vision and of the learning process. It also provides information on probable learning methods. The students get acquainted with the working environment. Nurses should to ensure that every multidisciplinary team member has followed up (Maslow, 2013). He should be advised to take precautionary measures to prevent the mental and physical issues like proper rest and sleep intake, taking support and advice with other individuals who have undergone the same surgical procedure, counseling with a psychiatrist and sharing his feelings that will help them and make him feel positive. They should be empathetic and courteous towards their patient and should follow all the ethical values and principles in providing care to him (Lehne Rosenthal, 2014). They should also have excellent decision making skills that will help them to promote the well being of Davis. Evaluation Potential complication/s and post-operative education Self-management of disease such as having well balanced diet, proper sleep and physical exercise should be taught. Maintenance of personal hygiene and regular medication should be monitored (Ball et al. 2013). Psychosocial care will provide him emotional support. He should be provided proper physiotherapy sessions and rehabilitation services if required. Information on prevention strategies should also be given to him. Involvement of the interdisciplinary team The interdisciplinary team for Dave involves the hospital staff of the OT. They would play an important role in providing person centered care to Dave and getting well soon. The nurses in the OT sterilize and clean the surgical tools. They also remove the drapes that covered the leg of patient and would prepare samples taken from the patient in order to test (Leveck Jones, 2016). The nurse also keeps a check on the condition of the patient by monitoring his signs and symptoms. They also make sure that he is stable enough to take him to the recovery room. They can also help in providing follow up after the treatment to track the side effects of the medications prescribed to him. Conclusion Hence, it can be concluded that nurses and physicians should follow protective measures to prevent infection or accidents. Prioritizing patients can prevent further complications, increased hospitalization and unnecessary deaths. Nurses and other staff in the OT should provide proper post operative care so that he does not suffer from ny kind of infection. There should be proper follow-ups to keep a track on any other symptoms developed after the surgery. References Ball, J. E., Murrells, T., Rafferty, A. M., Morrow, E., Griffiths, P. (2013). 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