Nursing Assignment: Acute Health Problems and Surgical Interventions

This nursing assignment discusses acute health problems and surgical interventions. It includes a table defining acute health problems and their clinical manifestations, characteristics of acute pain, and differences between surgical procedures. The article also describes common symptoms of bone fracture, principles of surgical nursing, and differences between types of anaesthesia.

Running head: NURSING ASSIGNMENT
Nursing assignment
Name of the student:
Name of the university
Author note:

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NURSING ASSIGNMENT
1. The following table identifies examples of acute disease states and illnesses requiring
complex nursing interventions. Complete the table defining each of these acute health problems and
provide three (3) specific clinical manifestations of each of these conditions.
Acute health problems, Definition/what is it?
Acute health problems, Definition/what
is it?
Three (3) specific clinical manifestations of
each.
a. Acute kidney failure:
Acute kidney failure defined as the
condition when kidney lost the ability to
filter waste product and harmful waste
product accumulated which in turn
destabilize the chemical balance of the body.
b. Acute glomerulonephritis :
Acute glomerulonephritis defined as
inflammation and subsequent damage of the
glomeruli, which leads to hematouria, protein
urea.
c. Gastroenteritis :
condition where the intestinal infection
caused by the microbes and intestine become
inflamed, irritated
a. 1) Decreased urine output
2) Fluid retention
3) swelling in legs
b)1) Foamy urine
2) Fluid retention with swelling in neck and
legs
3)Hypertension
c)1) diarrhoea
2) nausea
3) vomiting

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d. Acute pancreatitis :
Sudden inflammation of pancreas caused by
the gallstone affected in the common bile
beyond the point of pancreatic duct junction.
e. Seizure :
sudden uncontrollable electrical disturbance
caused by the disorders of the nerve cell
activity of brain which in turn influence the
change in behaviour
f. Transient ischemic attack:
Condition where blood clot observed in
artery that typically supplies blood to the
brain. It shows Similar to the stroke but
recover within minutes to hours.
g. Angina
Condition that evokes chest pain due
to the reduced flow of blood to the heart
muscles which indicate the risk of heart
d) 1) severe epigastria pain
2) respiratory distress
3) loss of appetite
e) 1)Temporary confusion
2)Uncontrollable jerking movements of limbs
3) Loss of consciousness
f) 1) muscle weakness
2)slurred speech
3) Vision changes.
g. 1) chest pressure
2) dizziness
3) heartburn,

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attack.
h. Myocardial infarction :
Condition where blockage of the blood flow
to the heart muscle observed(LeMone et al.
2015)
i. Vasovagal syncope :
A sudden drop in heart rate and blood
pressure often reaction of sudden trigger
(LeMone et al. 2015)
j. Allergic rhinitis :
hypersensitivity reaction caused by the
environmental allergen
k. Acute bronchitis :
short term inflammation of bronchi of lungs
l. First degree burns on skin
g)1)chest pressure
2) dizziness
3) heartburn,
i)1) Pale skin
2) Tunnel vision
3) Lightheadedness
j)1) sneezing
2) itching
3) watery eyes(LeMone et al. 2015)
k. 1) cough
2) chest discomfort
3) wheezing
l. 1) pain
2) reddening of the epidermis
3)blister

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First-degree burn on skin is defined as
condition where superficial burns observed
that affect the first layer of skin (epidermis).
m. Airway burns:
burns to the airway induced by inhalation of
smoke, steam or toxic fumes (LeMone et al.
2015)
n. Cellulites:
Bacterial skin infection observed in the face,
arms and other areas.
o. Dehydration :
Dehydration is defined as a condition where
body lack the fluid.
p. Epistaxis
Epistaxis is defined condition where
Acute haemorrhage in the nasopharynx and
nostril observed.
m.1) rapid swelling of burned tissue
2) blockage of flow of air to the lungs
3) blisters
n.1) Red area of skin
2)Red spots
3)Skin dimpling
o.1) Very dry skin
2)Fainting
3)Rapid heartbeat
p.1) bleeding from nostril
2) fainting
3)confusion

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q. Cerebral haemorrhage :
Condition where blood vessels were
ruptured and the bleeding inside the brain
observed (LeMone et al. 2015).
r. Traumatic brain injury :
brain dysfunction induced by the outside
force, usually due to violence (LeMone et
al. 2015)
s. Renal calculi
Small, hard deposition that forms in
the kidney and it give rise to a painful
phenomenon when passed.
t. Sepsis :
Severe bacterial infection arises when injury
occurred in the own tissues due to the
bacterial infection.
u. Cardiogenic shock :
It is a sudden shock in heart where heart
cannot pump enough blood to meet the needs
q.1) trouble swallowing
2) sudden onset of severe headache
3)trouble with language skills
R1) Sleeping more than usual
2) Nausea or vomiting
3) Headache
S.1) Pain during urination
2) blood in urine
3) sweating
t. 1) changes mental status
2) a blood pressure reading
3) Respiratory rate higher than 22 minutes
per breath(LeMone et al. 2015)
u.1)Rapid breathing
2)Loss of consciousness
3) Low blood pressure

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of body.
2. Briefly describe the characteristics of acute pain (in 60 – 90 words)
Acute pain is defined as the pain that lasts three to six months in patients and generally linked
to the soft tissues such as spined ankle (Lewis et al. 2016). The characteristics are following:
 Tensed muscles usually observed in the individuals
 Limited ability to move the limbs
 Frequent appetite changes observed in individual.
3. Briefly describe the key difference between deep vein thrombosis and venous
thromboembolism (in 30 – 60 words).
Venous thromboembolism is a broader term, which includes deep vein thrombosis and
pulmonary embolism where blood clot forms in the veins, arms and legs that travel in the
circulation, lodging in the lungs where as deep vein thrombosis observed especially in legs
(Lewis et al. 2016).
4. Briefly describe four (4) common symptoms of a bone fracture.
Four features of a bone fracture are following:

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 Deformity of the limb which was fractured
 Pain in the injured area, which get worse over the time
 swelling of injured place
 loss of function of the injured bone
5. Briefly describe the key difference between greenstick and impacted fractures (in 40 -
70 words).
Greenstick fracture defined as a fracture in a young, soft bone in which the bone bends and
breaks which usually occurs in the infancy and childhood when bone become soft. On the
other hand, impacted fractures occurs when the broken bone are joined by the forced of the
injury(Lewis et al. 2016)..
6. List three (3) key principles of surgical nursing.
Three principle of the surgical nursing are following:
 Infection control (Pride 2017)
 Aseptic handling of patient
 Recovery oriented care

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7. Briefly describe the key difference between elective surgery and emergency surgery
(in 70 – 100 words).
 Elective surgery is defined as the surgical procedure, which that is scheduled in,
advanced since it does not involve the medical emergency. A wide range of the
surgical procedure considered as the elective procedure (Pride 2017). For example,
bariatric surgery, colostomy, cholecystectomy On the other hand, emergency surgery
is a surgery procedure, which immediately performed in the clinical setting where a
person may die or permanently harmed.
8. Briefly describe the key difference between general, local and epidural anaesthesia (in
50 – 80 words).
Greatly anaesthesia is defined as the state produced when the patient received medication for
producing anaesthesia. Local anaesthesia is any techniques where the absence of the
sensation specific part of the body and other parts of the body mildly affected. Epidural
anaesthesia is a regional anaesthesia that blocks the pain in the particular region of the body.
9. Briefly describe the key difference between spinal anaesthesia and peripheral nerve
block (in 50 – 80 words).

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Spinal anaesthesia is also called spinal block, which is form of the neuraxial regional
anaesthesia involving the injection in the subarachnoid space through needle. On the other
hand, peripheral nerve block defined as the surgical procedure where neuralgia blocks or
regional blockage by either injection or any toxic exposure (Pride 2017).
10. Define the following surgical interventions and briefly describe the surgical
procedures involved in each of them.
a. Open reduction (in 40 – 70 words)
 Open reduction is defined as a surgical procedure where fracture fragment are
exposed by dissecting the tissues and bone is dislocated for accurate alignment (Pride
2017).
Procedure:
 General anaesthesia
 Making incision
 Broken part will put back to place
 Insertion of pin to attach with the bone to hold the part
 Incision will be closed by staple
b. Amputation (in 50 – 80 words)

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Amputation defined as the elimination process of a limb by surgery or trauma. In clinical
setting, it is used for reduction of pain or because of affected limbs due to gangrene (Linton
2015). .
Procedure:
 Elimination of the diseased tissue or broken vein
 Smoothing the areas of bone
 Sealing off the blood vessels
 Cut the bone and artificial bone attached to it.
C. Total hip replacement (in 50 – 80 words)
Total hip replacement is a surgical procedure of removing diseased cartilages and bone of
bone and replaces it with prosthetic implant (Linton 2015).
Procedure:
 general anaesthesia has been given to the patient
 a cut along the side of the hip and moving the muscle connected to the joint
 Removal of balls and artificial joint is attached to the the thighbone.
d. Craniotomy (in 50 – 80 words)
A craniotomy is the surgical removal of part of the bone from the skull for exposing the
brain. Specialized tools were used for removing the brain flap and replaced after the surgery
(Linton 2015).
Procedure:

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 make a skin incision
 perform craniotomy by opening skulls
 exposure of brain
 stimulation of the cranial nerve in order to correct the problem
 close the skull
e. Tonsillectomy (in 50 – 80 words)
It is a surgical procedure to remove the tonsil, which located in the back of your throat. The
procedure required to remove the infected tonsil (Linton 2015).
 general anaesthesia
 incubation
 incision through hot scissor
 tonsils are removed along with other adenoids
 bleedings were controlled
f. Appendectomy (in 50 – 80 words)
Appendectomy is defined as a surgical procedure to remove the appendix. it is a common
emergency surgery performed by surgeons for removing inflamed appendix (Huber 2017).
Procedure:
 general anaesthesia

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 incision in the lower right side of the abdomen
 Appendix is removed
 wound is closed with stiches
g. Laparotomy (in 50 – 80 words)
Laparotomy is a surgical procedure that involves the large incision through the abdominal
wall for gaining access to the abdominal cavity. It is also known as a celiotomy (Huber
2017).
Procedure:
 General anaesthesia
 single cut through the skin and muscles
 clear view of underlying organ
 after diagnosis, laparotomy were sewn close
h. Hysterectomy (in 40 – 70 words)
Hysterectomy is defined as a gynaecological surgical procedure to remove all or parts of the
uterus, which involve removal of cervix, ovaries, and fallopian tubes along with other
structures (Huber 2017).
Procedure:
 General anaesthesia
 single cut through the skin and muscles

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 removal of the parts of the uterus
 wound is closed with stiches
I. Prostatectomy (in 50 – 80 words)
Prostatectomy is defined as a gynaecological surgical procedure to remove all parts of the
prostate gland. The procedure took place in the benign condition that causes urine retention
(Huber 2017).
.
j. Cataract extraction (in 50 – 80 words)
Cataract extraction is defined as a surgical procedure to remove a clouded lens (cataract)
from the eye of the patient ad replaces it with new lens (Lewis et al. 2016).
Procedure:
 local anaesthesia
 Two very small incisions in cornea
 viscous material was injected into the front part of the eye
 Capsulorhexis
 Hydrodissection pie
 emulsification of the cataract
 Viscoelastic removal

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 sealing of wound
11. Briefly describe the characteristics of internal bleeding due to trauma and its
management (in 150 – 200 words).
Internal bleeding is defined as one of the most severe consequences of the trauma and
generally results from the obvious injury that requires immediate clinical attention. The
patient may experience severe consequences, which in turn can cause death (Lewis et al.
2016). There are certain characteristics of the internal bleeding due to trauma, which are
following:
 swelling of the places where internal bleeding observed due to the trauma
 light headedness
 dizziness
 fainting
 Large area of deep purple skin that resulted from the internal bleeding
 Symptoms of shock also observed sometimes for the patient.
Management:
The treatment procedures depend on parts of the body where internal bleeding observed.
However, assessment can be done for the patients with the internal bleeding. After
assessment, the health professionals should ensure that patient has a open air way, able to

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breathing and stable pulse, hear rate (Lewis et al. 2016). Moreover, patient should be
administrated by intravenous vitamin K, frozen fresh plasma and platelets.
12. Outline five (5) key considerations when monitoring and managing a person on
intravenous infusion via peripherally inserted central catheter (PICC)/midline/central venous
catheter (CVC).
In both three cases, the key considerations are following:
 hand hygiene
 clear the tip of the catheter
 assess the patient before insertion
 ensure that no occlusion occurs
 ensure that no bacterial infection occurs
13. Outline five (5) key considerations when monitoring and managing a person on
continuous positive airway pressure (CPAP).
 Level of consciousness
 Oxygen requirement
 Breath rate
 Use of accessory muscles
 Compliance with the procedure

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14. Outline five (5) key considerations when monitoring and managing a person on
Bilevel positive airway pressure (BiPAP).
 Proper Inspiratory Positive Airway Pressure should be maintained
 Resting volume of the lungs should be maintained.
 Accurate respiratory rates (Lewis et al. 2016)
 Time taken by patient to deliver breath
 Do not block intake filter
15. Outline five (5) key considerations when assisting a person with fluid intake via
nasogastric tube.
 Turn the patient onto their side and ensure that the patient does not lay flat.
 It should be ensured that tube is securely anchored to the patient’s nose for preventing
excess movement of tube
 Ensuring secure tapping by health professional
Monitoring respiratory distress (Huber 2017).
 Feeds should not be hanged for more than 4 hours

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16. Identify four (4) complications of acute bed rest.
 Deep Venous Thrombosis
 Muscle weakness.
 Malnutrition
 Cardiovascular complications
PART B – CASE STUDY QUESTIONS
Irene underwent a tonsillectomy under general anaesthesia and was transferred to your
surgical ward from the recovery unit. Irene was conscious and oriented. She had swallowing
difficulty and throat pain. She was allowed to sip a small quantity of water until further
reviewed by the doctor.
Irene’s vital signs post-transfer to the surgical unit are as follows:
Time: 1630
Vitals: T – 36.8 degreecelcius, P – 74/mt, R – 16/mt, BP – 120/80 mm Hg, SpO2 – 98% in
room air.
Other observations: Irene is awake and lying on her bed.
Time: 1830

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Vitals: T – 39 degreecelcius, P – 86/mt, R – 22/mt, BP – 130/86 mm Hg, SpO2 – 98% in
room air.
Other observations: Irene appears irritable.
1. Briefly describe the expected responses from an enrolled nurse in this situation.
Irene underwent tonsillectomy under the general aesthesia and transferred to the surgical
ward for the recovery unit. The first response as a registered nurse would be assessment of
the health status of the Irene. After that assessment, the medicines prescribed by the doctors
should be given to the patient along with the antipyretic medications.
2. The registered nurse asked you to continue monitoring Irene’s level of consciousness.
Which clinical assessment should you undertake?
The clinical assessment should be the temperature and vital signs of the patient in every half
hour. Moreover, along with the vital signs, Glasgow Coma Scale should be measured for the
consciousness of the patient (Huber 2017).
.
3. The eye opening score was 2 at the time of your clinical assessment. What does this
indicate? What is the recommended nursing intervention in this scenario?

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The eye opening score was two for Glasgow Coma Scale was indicated poor score. it means
patient was drowsy and need immediate clinical assessment. Therefore, registered nurse
should contact the physician (Huber 2017).
.

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References:
Huber, D., 2017. Leadership and Nursing Care Management-E-Book. Elsevier Health
Sciences.
LeMone, P., Burke, K., Dwyer, T., Levett-Jones, T., Moxham, L. and Reid-Searl, K.,
2015. Medical-surgical nursing. Pearson Higher Education AU.
Lewis, S.L., Bucher, L., Heitkemper, M.M., Harding, M.M., Kwong, J. and Roberts, D.,
2016. Medical-Surgical Nursing-E-Book: Assessment and Management of Clinical Problems,
Single Volume. Elsevier Health Sciences.
Linton, A. D. 2015. Introduction to medical-surgical nursing. Elsevier Health Sciences.
Pride, S.Y., 2017. defining Medical-surgical Nursing.