The RUNNING HEADER: A student's name assignment 9 Assignment Mrs Carey

RUNNING HEADER: ASSIGNMENT 1
Assignment
Student’s Name
Institutional Affiliation

Assignment2
Assignment
Mrs Carey is a 42-year-old mother of two school-aged children who are admitted to your
ward on modelling of a scheduled laparoscopic cholecystectomy following a recent
admission for cholecystitis. Mrs Carey works part part-time as a librarian and has a
supportive husband who is a full time accountant. She is a practising Jehovah's Witness.
Mrs Carey has a history of asthma and anxiety and her BMI is 30. Preoperatively she was
anxious about the operation.
Following a 4 hour operation, she has now returned to your ward. The recovery room
nurse hands over to you that Mrs Carey required an open Cholecystectomy for a
gangrenous gall-bladder. She was a Fentanyl PCA in-situ, IV fluids. 1 x exudrain from her
surgical site and a wound on her right subcostal region with staples and a clear-com feel
dressing. She is on oxygen at 2 L via nasal prongs. She is drowsy but moaning and
complaining of pain at her surgical site of 8/10.
Introduction
Mrs Carey's condition caused her to undergo which is a form of surgery that allows the doctor to
remove her gall bladder. This is because of her current condition cholecystitis which is an
inflammation of her gall bladder. This occurred after drainage from the gall bladder became
blocked which caused a lot of severe pain to her. Her condition of narrowed airwaves also
contributed to the risen levels of anxiety, (Strasberg, 2019).
Mrs Carey is also clearly obese counting that her BMI was at 30. It is estimated that the higher a
person’s BMI the higher their chances of developing health issues. A healthy BMI is
recommended for about 24 and below.She has a condition gangrenous cholecystitis which causes

Assignment3
complications due to acute cholecystitis. This was caused by the increased tension on the gall
bladder walls. The recovery room nurse required that an open cholecystectomy is performed on
her which would involve a surgical operation in which her abdomen will be opened to allow
cholecystectomy removal of her gall bladder, (Sedaghat, 2017).
Her fentanyl patient-controlled analgesia in-silu which provide her with better analgesia with
fewer side effects during hepatic resection surgery. The IV fluids would help her reduce
hydration which is caused mainly by vomiting, hemorrhage and diarrhea. The exudrain was
responsible for drainage along with the use of drainage bags. Her right subcostal region had
staples because of the surgery. Afterwards, she received a com feel dressing which would help in
the management of the postoperative wounds and her skin abrasions.
Being at 2 L via nasal prongs allowed her an oxygen therapy to proceed even during eating. Her
observations of a Temperature of 37.3 C, a pulse of 92 beats/min, a respirations 20 breaths/min,
Oxygen saturation 97% and Blood pressure at 145/85 revealed that she was at a normal state.
Her prescriptions of Flixotide 100 microg inhale BD, Ventolin 5 mg inhale PRN/QID, Fentanyl
PCA 1 Microg/ML IVI, Enoxaparin 40 mg S/C nocte and Cephazolin 1 gm IVI TDS were
facilitated recovery, (Strosberg, 2017).
Body
A post-operative comprehensive assessment on Pain.
Pain assessment for Mrs Carey is quite subjective in nature because it will require the use of
comprehensive practices in a bid to reflect on her experience of the pain. This comprehensive
assessment of pain aims at determining the decisions in the evaluation of Mrs Carey's pain in a
postoperative clinical setting. Knowledge is limited especially in the area of assessing pain in

Assignment4
surgical wards even though a lot of studies have done addressed in regards to pain management.
There is a huge role that needs to play in advising for the standards of pain management that
need to be adopted on surgical wards, (Meissner, 2015).
A number of barriers seemed to interfere with the process of pain management for Mrs Carey's
case. Having attention seeking patient can suffer as a barrier especially when there are family
interferences when the assessment is taking place.
Mrs Carey's self-reported pain served to the best of interest because it improved the pain
assessment and empowered her in her pain management. Pain is also considered a vital sign
which also includes Mrs Carey's temperature, heart rate, her respiratory rate and her blood
pressure. It also indicates the importance of genuinely assessing the patient’s pain, (Çift, 2018).
This process works with the first identification of patients with pain which in our case is Mrs
Carey. Secondly is the examination of the signs of the physical illnesses and especially the tissue
injuries that would bring the patient to the hospital. It is also recommended that patients go
through regular assessments in order to screen their pain. This would help because different
patients show different expressions of pain and there is a possibility of exaggerations.
Some of the questions to ask are How does one know when a patient is in pain? How is the
patient's pain measured? How is it then utilized in the measuring of pain? How is pain assessed
on daily practice? What is the place of painkillers in revealing a patient from pain? What is pain
assessed after the patient has taken pain killers? How is pain assessed especially when a patient
is displaying a high level of pain? Are there any shared strategies between the specialists that
would help in managing the pain? Are there any examples for each of the following mentioned
above?