Post-Operative Patient Care Plan

The assignment focuses on developing a post-operative care plan for a patient with obesity and type 2 diabetes who has undergone surgery. It emphasizes the importance of continuous observation due to potential irregular bodily functions following the procedure, such as an irregular heartbeat, interrupted pulse rate, high blood pressure, and increased respiratory rate. The plan involves a multidisciplinary team consisting of community nurses, technicians, and health educators working collaboratively to ensure the patient's well-being during recovery.

Essay case study

Essay case study
It is important to have adequate amount of understanding regarding the disease in terms of
pathophysiology, aetiology and symptoms pre and post-operative measures. Hence, in the given
scenario of Susan, she is suffering from Cushing syndrome which has happened to her due to
presence of tumour in adrenal gland (Guaraldi and Salvatori, 2012). The essay makes
comprehensive discussion regarding aetiology and pathophysiology of Susan’s condition. It will
also make adequate discussion regarding post-operative measures and multidisciplinary team
involved in treating her.
Aetiology and pathophysiology of Susan’s present condition is important to be analysed
based upon the analysis being prepared for the patient. It can be analysed from the condition that
the patient is suffering Cushing syndrome. Cushing Syndrome is related to collected sign and
syndrome due to chronic and prolonged exposure to cortisol which is basically a steroid
hormone. The main signa and symptoms that are related to this syndrome is abdominal obesity,
high blood pressure, reddish stretch marks, thin arms and legs, lump of fat between the
shoulders, red round face, weak bones and muscles, fragile skins with bare minimum healing
power (Stratakis, 2012). Occasionally, the patient may also feel tiredness, mood swings, and
chronic headache as well. Majority of the cases that are related to Cushing Syndrome can be
treated or cured. If it is caused due to medications, then stopping them can help in stopping the
symptoms related to Cushing syndrome. If the same is caused due to occurrence of tumour, then,
in that case, the syndrome can be treated with the help of a combination surgery including
radiation treatment and chemotherapy. If in case pituitary gland is affected due to its presence,
then in that case, medications can be given to redevelop the lost functions of the gland (Carney
and et.al., 2015). However, in certain cases, it is difficult to remove the entire tumour, which can
increase the risk of death in patient.
The present scenario discusses the condition of Susan Summers who is 40 years old
female. She is obese with the larger side BMI of 35 kg/m2. She has been diagnosed with type 2
diabetes. Moreover, it has been found that she drinks at least one bottle of wine every week. She
has been admitted to the hospital so as t5o treat the changes that has been brought by Cushing
syndrome in her appearances. She has been suffering from this syndrome due to the presence of
benign tumour in the right adrenal gland. In order to treat the same, she has to go through
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laparoscopic right adrenalectomy under the presence of general anaesthesia given to her body
(Blondin, Beauregard and Serri, 2013).
The aetiology of Cushing Syndrome can differ from individual to individual. In some
people it can occur due to excess cortisol secretions and in other cases it can also be related to
dysfunctionality of adrenal glands. The common symptoms related to the syndrome is weight
gain and deposition of fatty issues in some parts of the body, pink, purple or red stretch marks on
thighs, breast, abdomen and arms, slow healing of cuts and insect bites, acne of face and neck,
irregular or absent menstrual periods, anxiety, depression and irritability (Starkman, 2013). The
aetiology of Cushing syndrome includes, that it can be caused due to prevalence of any tumour
in the body. Any tumour in the adrenal gland which leads to major formation of cortisol. It can
also be caused due to tumour in pituitary glands. Hence, in the present case of Susan, it has been
caused due to presence of tumour in adrenal gland of the body leading to excessive formation
and secretion of cortisol.
The pathophysiology of Cushing syndrome in case of Susan is that when the disease is
suspected in one or the other patient, it is done through either dexamethasone suspension test or
24 hours measurement of urine in order to analyse the presence of excessive cortisol in it. In case
of the results being positive in any of the scenario, it is confirmed that the patient is suffering
from Cushing syndrome (Woo and Ehsanipoor, 2013). In order to concrete the results of the test,
a CT scan of adrenal gland and MRI of pituitary gland is performed for better detection of the
results. Hence, in case of Susan, CT scan would have finalised the results related to Cushing
syndrome.
Underlying pathophysiology of deterioration in health post operation plays an important
role in the overall recovery of the patient.it also helps in deciding the overall time that may
patient take to recover from the present condition. Based on the information and tests being
conducted on Susan Summer, it can be analysed that the respiration rate of Susan is quite high.
The ideal respiration rate is actually 20 breathes per minute which is actually 30 breathes per
minute in case of Susan. Further, the Blood pressure is also slightly high, which is required to be
120/80 mmHg however, in case of Susan, it is 160/90 mmHg. The ideal pulse rate is 100 beats
per minute. However, in case of Susan, it is 128b beats per minute (Sato and et.al., 2014). It
shows that heart of Susan is pumping excessive blood. It is a good sign that she is not feeling any
pain. However, it can be due to effect of anaesthesia which was given to her before operation.
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Hence, it can be stated that the body of Susan is not reacting normally after operation and is
required to be kept under observation. Hence, a deteriorated health of the patient can be observed
through the common test on the body being conducted.
In the present condition of the patient, an integral role in played by nurses who has been
appointed to take care of Susan. Nurse must involve in continuous observing the values of Blood
pressure, pulse rate, temperature, respiration breaths per minute and pain score. It will help in
giving instant treatment to the patient if her health deteriorates. It is important for the nurse to
keep a check so that experienced health care professional can be called in case of emergency
(Keil, 2013). Nurses also plays an important role in giving medications and injections time to
time that plays an important role in overall recovery process of the patient. It also fastens up the
whole process as well. Moreover, it is important that if the patient is under observation then at
least one nurse must be present in the room. Moreover, maintain records of the same can ease
down the process of comparing values in a well-defined manner (Health care professional
development: Working as a team to improve patient care, 2014).
There are various Members of interdisciplinary of healthcare team that are involved in the
care of patient before discharge. The members can be in the form of technicians, surgeons,
nurses, health care professionals, health care educators. These people tend to ensure that before
discharge of the patient, he / she is adequately equipped enough to keep herself fit and in
workable condition when discharged from the hospital (Deipolyi and et.al., 2012). The health
care educators help in ensuring that as per the suitability and health conditions of the patients,
Susan takes on the healthy diet and indulge into healthy lifestyle. Healthcare professionals also
ensures that what are the best techniques to be adopted for Susan so that she does not hamper her
other disease so as to recover with the one she is presently suffering from. Hence, in that case,
health care educator plays an important role in addressing the cause of disease and how the same
can be cured through healthy lifestyle. For instance, Susan is suffering from diabetes type 2,
hence, in that case the medications that are taken up by her must not worsen her diabetes.
Moreover, taking almost no sugar in the food and exercising can help in appropriately addressing
the situation. Health educator plays n important role in finding out these methods for her (Mehta,
Lonser and Oldfield, 2012). Another important role is played by the technicians in the team.
They are the people who are indulge in testing the body condition of the patient regularly. In
order to perform this function, all the MRIs, CT Scans and blood tests are generally conducted
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by these technicians. Hence, the values being find out by them are addressed so as to analyse the
condition and compare the same with the previous one. The third important role in the team is
played by community nurses who can help in daily routine activities of Susan. Moreover, another
role is played by them where they are responsible for injections and medications of the patient
and ensure that all of them are given timely to the patients (Dekkers and Sørensen, 2013).
CONCLUSION
Based on the above essay, it can be concluded that Susan is indulged in going through
adrenalectomy under general-anaesthesia since she is suffering from Cushing syndrome. Since, she is
obese, she is also suffering from diabetes type 2. After operation, she is facing certain irregular functions
in her body which requires constant observation. It can be in the form of irregular heartbeat, interrupted
pulse rate, high blood pressure, increased respiratory rate, etc. hence, there are three main members in the
multidisciplinary team that are involved in taking appropriate care of the patient. These are, community
nurses, technicians and health educators.
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REFERENCES
Books and Journals
Guaraldi, F., & Salvatori, R. (2012). Cushing syndrome: maybe not so uncommon of an
endocrine disease. The Journal of the American Board of Family Medicine. 25(2). 199-
208.
Stratakis, C. A. (2012). Cushing syndrome in pediatrics. Endocrinology and Metabolism
Clinics. 41(4). 793-803.
Carney, J. A. & et.al. (2015). Germline PRKACA amplification leads to Cushing syndrome
caused by 3 adrenocortical pathologic phenotypes. Human pathology. 46(1). 40-49.
Blondin, M. C., Beauregard, H., & Serri, O. (2013). Iatrogenic Cushing syndrome in patients
receiving inhaled budesonide and itraconazole or ritonavir: two cases and literature
review. Endocrine Practice. 19(6). e138-e141.
Starkman, M. N. (2013). Neuropsychiatric findings in Cushing syndrome and exogenous
glucocorticoid administration. Endocrinology and Metabolism Clinics. 42(3). 477-488.
Woo, I., & Ehsanipoor, R. M. (2013). Cabergoline therapy for Cushing disease throughout
pregnancy. Obstetrics & Gynecology. 122(2, PART 2). 485-487.
Sato, Y., & et.al. (2014). Recurrent somatic mutations underlie corticotropin-independent
Cushing’s syndrome. Science. 344(6186). 917-920.
Keil, M. F. (2013). Quality of life and other outcomes in children treated for Cushing
syndrome. The Journal of Clinical Endocrinology & Metabolism. 98(7). 2667-2678.
Deipolyi, A. & et.al. (2012). The role of bilateral inferior petrosal sinus sampling in the
diagnostic evaluation of Cushing syndrome. Diagnostic and Interventional
Radiology. 18(1). 132.
Mehta, G. U., Lonser, R. R., & Oldfield, E. H. (2012). The history of pituitary surgery for
Cushing disease: Historical vignette. Journal of neurosurgery. 116(2). 261-268.
Dekkers, O. M. & Sørensen, H. T. (2013). Multisystem morbidity and mortality in Cushing's
syndrome: a cohort study. The Journal of Clinical Endocrinology & Metabolism. 98(6).
2277-2284.
Online
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Health care professional development: Working as a team to improve patient care. 2014.
[Online]. Available through < https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4949805/
>.
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