Darren's Post-Surgical Recovery Case Study

This case study examines Darren's recovery after surgery for cholecystitis. The 50-year-old patient with a history of hypertension, hyperlipidemia, depression, GERD, and COPD presents several health challenges. The analysis focuses on nursing interventions addressing acute pain management, smoking cessation guidance, and risk reduction for infection during his hospital stay.

CLINICAL CASE
STUDY

Table of Contents
INTRODUCTION...................................................................................................................................3
MAIN BODY..........................................................................................................................................3
CONCLUSION........................................................................................................................................6
REFERENCES........................................................................................................................................7

INTRODUCTION
Clinical case study is based on case of 50 year old man suffering from Cholecystitis
for which he has been presented in hospital for immediate surgery. It will outline nursing
problem to his case and three appropriate interventions to it. Apart from this, it will outline
evidence based effectiveness of analysed nursing intervention.
MAIN BODY
Nursing practices plays an important role in managing patient services. It is important
for practitioners to follow every step of defined procedure in order to serve best clinical and
medication services to service users. Darren Roberts is 50 year old married man who
smokes 30 per day from approximately last 20 years and also is a alcoholic despite of the fact
that he is sidelined from major health problems like, hypertension, Hyperlipidemia, minor
depression and also from Gastric Oesophageal Reflux. He continuously takes medication for
all these issues and now is been experiencing upper abdominal pain specifically at night with
vomiting and nausea. He ignores his medical visits and therefore in last one month he
experienced major upper abdominal pain due to which Darren was admitted in emergency
department. However, after diagnosis health professionals found out that he is suffering from
Cholecystitis, due to which he was immediately shifted to surgical ward. Cholecystitis is
acute redness around the walls of gallbladder, which is small digestive organ of body beneath
liver. It is the situation caused by stones in bladder that blocks the tube which is connected to
small intestine. Darren is presented in surgical ward for elective Laparoscopic
Cholecystectomy which is severe surgery to remove gall bladder performed by specialist
medical professionals. In this surgery, the professional make few small incisions instead to
one large. Incisions are surgical cut and generally small incisions are 4 which vary in length
by inch. Therefore, the nursing problem with Darren is Potential for pain due to incisions
where he can experience pain of >3 /10, as per Numeric pain rating scale. Apparently, it can
be risky for Darren for at least four hours after surgery because it is a critical situation where
the incisions wounds are fresh and very sensitive due to which person go through acute pain.
The nursing problem of pain increases because it comprise risk of inflammation, bile leakage,
bleeding and infection due to wrong touch, temperature etc. Acute pain is nursing problem
because it is the situation where person turns vulnerable and is unable to resist pain. The
incisions are deep and therefore as per habits of Darren, it is important for the health

practitioner to ensure appropriate care for the patient in surgical ward. Managing patient
care at the time acute pain after surgery is the most critical situation that increases the chance
of vomiting, infection, nausea etc. Patient care in case of Darren can be difficult and severe
because he is alcoholic and smoker, therefore reducing his habits to prevent chance of
infection, Nausea, Vomiting especially for 4 hours after surgery. Acute pain is the situation
which involves the risk of life and therefore is the most common nursing problem after
surgery where body organ is removed.
The SMART goal for Darren Nursing will be focused on short term and long term
plan where nurse will ensure to minimize pain of surgery and to reduce his smoking habits
which can be problem to him like infection, nausea, vomiting etc. The nursing interventions
aims at providing safe and secure environment to patient, which are focuses on 5 rights of
medication practices that is right person, right dose, right time, right route, right drug.
Management of acute pain related to surgical incisions is the foremost intervention to nursing
problem where the practitioner will ensure that Darren is facing minimum pain as per pain
scale which helps in rating scale from 1 to 10. Acute pain is the situation which can make
Darren restless and crave for smoke or alcohol. Further, after surgery the nursing care
practices assures that person is able to sleep which helps in preventing infection, pain and
restlessness (Tsai and et.al.,2013). In this the practitioners’ goal will be to provide Darren
medication prescribed by doctor. This nursing intervention is based on making sure that Darren is
relieved from pain and is resting stabilize conditions.
Second nursing intervention will be focused on preventing risk for infection which is
concerned with surgical incisions (Medical Diagnoses:Acute Pain related to surgical
incision. RC - End Stage Renal Disease, GERD, COPD, Hypertension, Chronic Anemia,
Sinus Bradycardia, 2018). For this, the practitioner will ensure Darren remains in observation
at least for 4 weeks. Apart from this, the nurse care practices will ensure that temperature in
ward of Darren in free from Bacterial infection and is at mild temperature not too cold and
not too hot. The care of nurse intervention will comprise on providing every basic need to
bed to Darren who will help in minimizing pain and quick recovery. On the hand, Darren
avoids taking medication and is smoke and alcohol addict therefore preventing risk
intervention will ensure that he is not getting anything which can impact his incisions and
health (Halabi and et.al., 2014). If in case he is experiencing incisions pain more than 4 on
pain scale, it is the responsibility of practitioner to inform physicians because this indication
can be life threatening for Darren.

Third, nursing intervention will focused in reducing smoking and alcohol habit of
Darren because it is the most dangerous habit that can lead to pain, nausea vomiting, etc. In
this the focus of nurse to make Darren learn about smoking and tobacco free life. For this the
focus on use will be to take regular follow up with basic habits of Darren. During treatment
the nurse will ensure that he is not moving out of ward without anyone who can keep a check
over him. This intervention is the basic which will help in making Darren control his smoking
habit. Like, after surgery, at the time of acute pin he will crave for smoking but it is the only
habit that can impact his health or can lead to intervention (Robles and et.al., 2011).
Therefore, the practitioner will ensure that he is getting appropriate attention. Thus, in
surgical cases the person feels restlessness and craves for a habit that is why for Darren it is
important for the nurse to deliver quality care with safe environment.
Nursing intervention are the crucial part of medical and clinical practices as it helps
the nurses in managing safe and secure environment around patient. Like in case of Darren
the three nursing intervention that is to management pain of Darren which occurs just after
surgery. Acute pain is life threatening and very sensitive situation where it is important for
the health practitioners to ensure that the service user is resting properly without movement
because it helps in minimizing pain. Further, the effectiveness of invention is reflected by
measurement on the scale which helps the nurses in making rating pain of patient on scale of
1 to 10. The follow up on scale helps the nurse in determining condition of patient accurately
which prevents risk. Apart from this, keeping a check over unethical habits of patients is
another intervention which helps in delivering effective nursing care. Like, in case of Darren
he has the habit of smoking 30 cigarettes daily therefore to prevent after surgical risk the
health practitioner goal was for smoking cessation. As per (Rice, Hartmann-Boyce and Stead,
2013), research of nursing intervention to smoking cessation, it has been analysed that
numbers people wants to quit their smoking habit but are unable to do so due to lack of
support and advice from health professionals. However, nurses are the core of medication and
clinical services and their services are based on providing care services to patients. The
counselling nurses to service users helped numerous people in quitting their smoking habits
with period of 6 months which reflect effectiveness of smoking cessation nursing intervention
(Solomkin and et.al., 2010). Apparently, nursing intervention, preventing risk for infection
helps the health practitioners in deriving different ways which can lead to infection to service
users like in case of Darren, the nurses ensured that the ward he is in is of mid temperature
and is bacterial free. The patient after surgery is prone to infection therefore intervention of

prevent it helps the nurses in managing quality of care and helps in providing safe and
appropriate recovering conditions. Hence, effectiveness of nursing intervention is reflected in
Invasive procedures, increased exposure to pathogen, Chronic disease, Lack of immunization,
inadequate primary defence, like tissue damage and cut in skin and inflammatory response
(Timby and Smith, 2013).
CONCLUSION
The report summarized case of Darren Recovery who is 50 year old man and is chain
smoker and alcoholic. He is been suffering from various health issues that is, hypertension,
Hyperlipidemia, minor depression and also from Gastric Oesophageal Reflux and lastly
diagnosed with Cholecystitis due to which he has been presented to surgical ward. He report
outlined nursing problem and three nursing intervention like smoking cessation, preventing
risk and acute pain management.

REFERENCES
Books and Journals
Halabi, W.J. & et.al., (2014). Surgery for gallstone ileus: a nationwide comparison of trends
and outcomes. Annals of surgery. 259(2). pp.329-335.
Robles, L. & et.al., (2011). The addition of a nurse practitioner to an inpatient surgical team
results in improved use of resources. Surgery. 150(4). pp.711-717.
Solomkin, J.S. & et.al., (2010). Diagnosis and management of complicated intra-abdominal
infection in adults and children: guidelines by the Surgical Infection Society and the
Infectious Diseases Society of America. Clinical infectious diseases. 50(2). pp.133-
164.
Timby, B.K. & Smith, N.E., (2013). Introductory medical-surgical nursing. Lippincott
Williams & Wilkins.
Tsai, T.C. & et.al., (2013). Variation in surgical-readmission rates and quality of hospital
care. New England Journal of Medicine. 369(12). pp.1134-1142.
Online
Medical Diagnoses:Acute Pain related to surgical incision. RC - End Stage Renal Disease,
GERD, COPD, Hypertension, Chronic Anemia, Sinus Bradycardia. (2018).
[Online]. Available through:
<http://www.pterrywave.com/nursing/care%20plans/112.aspx>.
Rice H. V., Hartmann-Boyce J. & Stead F.L., (2013). Nursing interventions for smoking
cessation. [Online]. Available through:
<http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD001188.pub4/full>.