Acute Nursing Care for Surgical Patients: Clinical Issues and Interventions

This report from Desklib discusses clinical issues and nursing interventions for surgical patients, including diarrhea/constipation, infection, and abdominal pain. It also covers discharge planning and priorities for post-operative care.

Acute -Nursing the Surgical
Patient

Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
Analysing case study for identifying potential clinical issues along with relevant nursing care....3
Identification of three priorities..............................................................................................3
Nursing intervention with rationales for each three clinical issues........................................4
Discharge planning..........................................................................................................................6
Plan and priorities discharge advice for Wendy.....................................................................6
CONCLUSION................................................................................................................................7
REFERENCES................................................................................................................................8

INTRODUCTION
Laparotomy refers to a surgical incision into an abdominal cavity. It is performed to
examine aid diagnosis and abdominal diagnosis which is referred to any problems. In this report,
there is discussion about the 65 years old lady who have recently go through open right hemi-
colectomy surgery. There are other medical history like high cholesterol level, hypertension,
problem of asthma, late nigh respiration problem etc. In this report, there is discussion about
identification of various clinical issues along with relevant nursing care. This report address the
three priorities that is concerned with clinical issues 24 hours after post-surgical care. It also
includes various nursing interventions for each clinical issues along with rationales. There is
some description about plan and prioritising discharge advice for patient. Post-operative plan
consist of education, surgical procedure, medication along with post-operative complications,
lifestyle modification and psychosocial issues (Afiyanti, 2021).
MAIN BODY
Analysing case study for identifying potential clinical issues along with
relevant nursing care
Identification of three priorities
After hemicolectomy surgery there is chance of getting some complication or clinical
risks which can be there post surgery. There is identification of some of clinical issues which are
associated with patients and needed to address effectively to provide better care and resolve the
health related issues. There are some of the issues which area going to be discussed further.
Diarrhea or constipation- This is one of the priorities in clinical issue which can be
there post-suregery. This can either due to using anaesthesia pre-operation. This can stay for few
days.
Infection- There is chance of infection when there is intestinal surgery. This can be due
to including prolonged procedures and inadequacies or due to antiseptic preparation of skin.
Pain in abdominal area- In patient, there abdominal pain that can be severe and can be
there that can cause due to leak at the point of anastomosis. During surgery surgeon removes
colon section or reattaches of colon is known as anastomosis (Azeem, 2020).

Nursing intervention with rationales for each three clinical issues
Nursing intervention for diarrhoea or constipation- There are various intervention for
diarrhoea and constipation which are going to be discussed further.
Diarrhoea- there is need for diagnose test which can help to provide the confirmation about the
complication of diarrhoea. This is the one where blood test, stool test, colonoscopy is
recommended for the diagnosis. After confirmation there is need to get information about the
treatment which is highly able to provide better relaxation to the patient. In many cases it has
been seen that diarrhoea get treated itself after few days. To provide better treatment there doctor
or physician can recommend medication or other treatment.
Antibiotics is highly recommended by the doctor for get over through the Diarrhoea.
When it has caused due to impact of bacteria or parasites then antibiotics can help to get over
through it (Gouda, 2018).
It can be advised that there is need to replace the salts and fluids which can help in
providing better quality of drinking water or juice. There are also home remedies which can help
in the intervention process. This can lead to create the better health impact and are high effective
in managing diarrhoea. These home remedies includes-
Drinking plenty of clear liquids- This includes water, juices or broths. There is need to
avoid caffeine and alcohol.
Taking low-fiber foods and semisolid- this can help to get better bowel movements
which can help to return it normal. There is need to try soda, crackers, eggs, chicken or eggs.
Avoid certain foods- there is need to avoid some food which can have negative impact
and enhance diarrhoea. This includes dairy products, high fibre foods, fatty foods etc. for few
days.
Taking probiotics- These are the microorganisms which can help to restore healthy
balance within intestinal tract for boosting good bacteria level. They are available in capsule or
liquid form. These can add to some foods like yogurt (Kamal Masaud and et. Al, 2021).
Constipation is the health condition where stools become difficult to pass. This is the one
in which bowel movement become less frequent. This can be there due to using anaesthetia
which are used pre-operation. There are various nursing intervention which are going to be
discussed further.

Taking large amount of fluid- This is the process in which there is need to take large
amount of fluid which can be there in large amount like 2000 to 3000 mL/day. Due to surgery,
patient is also recommended to take liquid food which can help to provide better and effective
impact on health. This can also provide relief form the constipation within patient.
Patient need to perform some physical activity- This is the intervention which can help
patient to perform some physical activity which can help to provide better facilitate defecation.
Performing various activity which can lead to create physical exercise
Medication and management- This is the another option which can use as the
intervention for the better health and getting relief form the constipation. There are various
medication which can be used for the treatment of constipation. Management can also be used
like specific exercise and specific meal (Kamal Masaud and et. Al 2021).
Nursing intervention for infection post surgery- In some cases after surgery, there is
chance that patient can get infected due to having various condition. Nursing intervention can
help to reduce the risk of infection. This can be done through using some implementing
strategies which can help to reduce the infection. There are many of the intervention which are
going to discussed further.
This can be due to including prolonged procedures and inadequacies or due to antiseptic
preparation of skin
Ensuring that antiseptic preparation should be disinfected or sterilised before use-
This is one of the intervention which should be there for avoiding the infection within patient
during surgery. This can help to eliminate germs that can help to reduce the chances of getting
infection which is due to procedure of surgery.
To maintain hygiene- There is high need to maintain hygiene for the body part where is
cut due to surgery. It is essential to take care of that part and need to maintain hygiene. This can
help to reduce the risk of getting clinical issues like infection post surgery.
To ensure about the sterilised item which can use for surgery- There is need to get
ensure about the surgical item which are going to be used in the surgery. This can help to reduce
the chances of getting infection due to unsterilised item used during surgery (Okafor and et. al.,
2017).
Intervention for Pain in abdominal area- There are various medication can be used to
reduce the pain of abdominal area. This can be there due to many reason like leak of

anastomosis, due to colon surgery etc. There are various types of analgesic which can be used to
reduce the chances of abdominal pain which are going to be discussed further.
Nonopioid Analgesia- This works on opoid sparing techniques that used various
analgesic mechanisms of action for pain management post operation. This includes
acetaminophen, ketamine. There can also be use of anticonvulsants gabapentin like horizant,
neurontin, gralise etc.
Discharge planning
Plan and priorities discharge advice for Wendy
There is need to plan and priorities the discharge advice which can help Wendy to get her
home. In this, nursing staff need to provide information and instruction about the medication and
all the required instruction. There is need to discharge plan for Wendy which includes some
basic advice that includes Wendy should not focus on not to life weight which can make pressure
on the surgery part which is not good for surgery and health. There is also need to provide some
basic advice to the Wendy during discharge which is associated with taking care of her health
and time to time medication. For discharge Wendy there is need to complete all the formalities
like making proper patient records of pre and post surgery. Record of patients complication and
intervention which are used to manage complication and all small details related with patient
health which can be used in future (Wang, 2021).
Nursing staff should provide guidance about the meal tyep which should be taken by the
patient, general information which is necessary to follow by Wendy at home. There should also
be instruction about the medication which should be there during some specific condition.
During discharge planning, there in need to focus of post-operative education which includes to
provide information about the types of diagnosis and all related information about the active
issues which are there able impact the patient health. There is also need to focus on the delivery
of instruction in effective way. Nursing staff need to get proper communication with patient and
caring person about the medication and its time with proportion. This can help to get proper
medication and avoid the confusion regarding medication and time to time treatment. Providing
medication information is highly necessary to avoid the change of getting miss of doses due to
any reason. Information should include the consequences of not taking medication at time. There
is also need to deliver information about the services needed which can help to delivery better

and effective delivery of services needed according to requirement. Nursing staff should also
instruct patient and relative about that patient should not life weight. This can have negative
impact on the surgery which can lead to create pressure on the site of surgery can be cramp or
bleeding on site. Such type of regular instruction which are necessary to include that can help
patient to avoid the normal things which can create direct negative impact on the patient health
on the site of surgery (Younis, 2021).
There is also need to provide surgical procedure which are there followed for better
treatment and health improvement. This is highly effective and can help patient to take care of
their health which is required for better caring of their health. Nursing staff should also guide
patient to take much liquid food which can help in caring about health. Healthy food and other
specific choice of food is recommended to take as the meal. This can help to avoid health related
issue which can be there due to taking hard food.
Discharge plan includes the planning which includes early identification along with
assessment which is required by the assistance in which there is need to collaborate with the
patient which can help nursing staff to focus on delivering of better learning and education for
better care at home. This can be highly effective and taking care of patient by facilitation
planning for discharge. In this, there is need to get ensure about all the procedure which has been
followed to confirm all the documentation which are there able to provide correct following of
all the procedure which should be followed before discharging any patient. Here, Wendy should
provided all the instruction and information which is related with providing all the instruction
that is needed to follow post-operation (Zhang and et. al., 2021).
CONCLUSION
From above discussion, it can be conclude that there is need to take car of patient which
is post-operation. Post-operation there is need to take various intervention can been there for
various priorities. In this report, there is discussion about various priorities which can impact the
health after surgery. There are various clinical issue that can be there post-operation. In this
report, there is discussion about various intervention and their rationale that can provide various
information about the treatment and management of various clinical issues. There is also
discussion about the plan and priorities of discharge plan along with various advice which can
help to educate patient to take care of themselves at their home.

REFERENCES
Books and Journals
Afiyanti, 2021, The Changes of Physical and Psychological Sexual Complains in Women with
Post Treatment Cervical Cancer After Sexual Nursing Intervention. Jurnal Ners, 6(1),
pp.68-75.
Azeem, 2020. Effect of Nursing Intervention on Nurses’ Knowledge and Practice Regarding
Cataract Surgery.
Gouda, 2018. Effect of Nursing Intervention Guidelines Regarding Osteoporosis Prevention on
Staff Nurses Knowledge and Behavior.
Kamal Masaud and et. al 2021. Impact of Protocol of Nursing Intervention on Sexual
Dysfunction among Women with Cervical Cancer. Journal of Nursing Science Benha
University, 2(2), pp.203-224.
Kamal Masaud and et. al, 2021. Impact of Protocol of Nursing Intervention on Sexual
Dysfunction among Women with Cervical Cancer. Journal of Nursing Science Benha
University, 2(2), pp.203-224.
Okafor and et. al., 2017. OUTCOME OF NURSING INTERVENTION ON KNOWLEDGE
AND USE OF NURSING PROCESS AMONG NURSES IN ZONAL HOSPITALS,
RIVERS STATE, NIGERIA.
Wang, 2021. 5G Network for embedded web medical system and nursing intervention after
cardiovascular intervention in hospital. Microprocessors and Microsystems, 82,
p.103866.
Younis, 2021. Effect of Implementing Pre and Post-Operative Nursing Intervention on Nurses
Performance for Caring of Children with Musculoskeletal trauma.
Zhang and et. al., 2021. The Effect of 5A nursing intervention on living quality and self-care
efficacy of patients undergoing chemotherapy after hepatocellular carcinoma surgery.
American Journal of Translational Research, 13(6), p.6638.