Nursing Assessment and Intervention for Nutritional Imbalance in Post-Operative Patients

Running head: NURSING
Nursing
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Answer: 1
Malley, Kenner, Kim and Blakeney (2015) reported that preoperative assessment and
care in nursing is used to determine the patient’s factors that increase the risks for developing
peri-operative complications. The pre-operative assessment in nursing assists with defining
the vulnerabilities or the risk factors for poor surgical outcomes. If the vulnerabilities of
patients’ risk cannot be lessened then it is the duty of the nursing professional to identify the
risk factors so that they can effectively manage the complexity during the peri-operative care
environment after operation. The pre-operative assessment is devised and operated by a peri-
operative registered nurses and is defined as a critical dimension of surgical care. The case
study highlights the scenario of a 50 year old man named Charles who was initially admitted
to the emergency ward and that transferred to the surgical ward dur to bowel resection. His
surgery is scheduled to be undertaken tomorrow morning and his has no significant past
medical history. He has been suffering from Crohn’s disease for the past 15 years. The first
pre-operative assessment for Charles will be physical examination of his body in order to
ascertain whether his body is capable of withstanding the stress of anaesthesia. Chang and
Urman (2016) reported that surgical procedure and administration of anaesthesia are
associated with complex stress response that is proportional to the overall magnitude of
injury, operating time of the surgery, total amount of the intra-operative blood loss and the
degrees of the post-operative pain. The overall adverse metabolic and the hemodynamic
effects of the surgery generated stress response can present numerous problems during the
peri-operative period. Reducing the stress response to surgery and trauma is the principal
factor for improving the outcome of care and at the same time lowering the length of stay at
the hospital along with total costs of the patient care. Physical health assessment of Charles in
order to ascertain this overall capability of withstanding the trauma of surgery and

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anaesthesia will begin will monitoring of the vital signs after every hour and this include
recording of the blood pressure, level of oxygen saturation (SpO2), pulse rate, oxygen rate
and respiratory rate along with the assessment of the lungs, airways and heart. Vetter,
Boudreaux, Jones, Hunter and Pittet (2014) reported that unexpected abnormal findings on
the physical examination must be investigated before elective surgery.
The case study reports that Charles do not have any significant medical history,
however, Pilkington, Taboada and Martinez (2015 are of the opinion that the anxiety and
stress of surgery leads to the development of hypertension during the pre-surgical condition.
Hypertension is one of the common underlying diseases who are undergoing surgical
treatments. During the induction of the anaesthesia, if there is hypertension, the patients’
experience significant increase in the heart rate and blood pressure. Lonjaret, Lairez, Minville
and Geeraerts (2014) reported that anaesthetic agents interacts with the antihypertensive
drugs leading to the generation of hypotension and delaying the process of recovery of
consciousness during the post-surgical condition in the peri-operative care. Thus if Charles is
found to be hypertensive before the beginning of the surgery then anti-hypertensive drugs
must be used with proper regulation of the dosage depending the strength of the strength of
the anaesthetic drugs. In case of hypotension episodes, causing delay in the process of
surgery, the patients must be treated with intravenous vasopressors. (Pilkington, Taboada &
Martinez, 2015) also highlighted that patients who are suffering from high respiratory rate or
shallow breathing and poor oxygen saturation also experiences delay in the process of
recovery in peri-operative care. Poor condition of the airways or the lungs creates difficulty
in inhaling the external supply of oxygen during the time of anaesthesia (nasal) or at the time
of surgery. So the oxygen saturation level of Charles must be monitored while maintaining
stable SpO2. The physical assessment will also include assessment of the weight and body