Nursing the Surgical Patient: Analysis of Potential Clinical Issues and Relevant Nursing Care

Nursing the Surgical
Patient

Table of Contents
INTRODUCTION...........................................................................................................................3
Part A: Analyse the case to identify potential clinical issues and relevant nursing care ................3
Nursing priorities ...................................................................................................................3
Pathophysiology ....................................................................................................................4
Nursing intervention ..............................................................................................................5
Part B: Discharge planning .............................................................................................................7
CONCLUSION ...........................................................................................................................10
REFERENCES ............................................................................................................................11

INTRODUCTION
In the health care system after the laparotomy, care of a surgical patient is consider as the
post surgical care. Which involves the evidence based interventions in context to the post
surgical nursing issues, as nursing priorities (Nascimento & Jesus, (2020)). Patient after the
hemicolectomy for a poorly differentiated adenocarcinoma, face huge health issues and
complications, such as the acute patient, berating issues, frequent urination etc. In this report
identification of the potential clinical issues is done in context to the post surgical situation,
which should be relevant for the nursing care. Identification of the nursing priorities,
pathophysiology and the nursing interventions for the patient post surgical issues is done, along
with evidence of intervention rationales.
Part A: Analyse the case to identify potential clinical issues and relevant
nursing care
Nursing priorities
Patient is 64-year-old female with the medical history of hypertension, and
hypercholesterolemia, Myocardial infarction, Obstructive sleep apnoea (OSA), hypertension and
asthma. Due to the three month history of the abdominal pain and diarrhoea she had diagnosed
with the CT scan and revealed the tumour in the ascending colon. In context to that analysed
chronic issues, she re-saintly retuned from the open right hemicolectomy. registered nurse key
priorities in context to this patient is analysed for which the selected interventions are planned.
Below is the explanation of three nursing priorities (Holle & Lopez, (2019)).
post-operative pain
One of the most common issues which is faced by the patient after the surgery and have to
manage by the nurse is acute pain. This pain is related to the surgical incision and reflex muscle
spasm. These complaints are proved by the registered or documented complains of restlessness,
irritability, moaning, guarded body posture. So the registered nurse key priority is can be
management of the acute pain with relevant intervention (Campbell & Scott, (2021)).
Ineffective breathing pattern
Another nursing priority related to the patient health issue is ineffective breathing pattern.
This is basically involves the respiratory irritation, airway obstruction, increased secretions. This

nursing issue is evidences by dyspnoea, crowing, low oxygen saturation. As the patient is having
the history of asthma this become more important to manage the berating pattern of the patient
with educate interventions.
Hemorrhage
Patient is having the history of myocardial infarction, hypertension and after the surgery,
this increases the chances of hemorrhage due to the ineffective vascular closure or alterations in
coagulation. This is another key priority of the nursing care practices during the post surgical
care (Rohatinsky, & Hellsten, (2020)).
Pathophysiology
Patient primary condition was associated to her medical history Hypercholesterolemia, as
it has been identified that increase serum cholesterol level have be reported positively associated
with the risk of the colon, rectal, prostatic cancer (Ehrenfeld & Gonzalo, (2019)).
Hypercholesterolemia is further associated with the risk of asthma, as the patient of given case
study has already faced in her medical history. High blood pressure and high cholesterol is also
linked, because due to the high cholesterol plaque and calcium arteries become hardened and
narrowed, due to which hart strain much harder to pump blood, as result of which blood pressure
become high. Obstructive sleep apnoea is phased by the patient due her excessive weight. risk
of premature atherosclerotic disease is associated with the hypercholesterolemia, as identified in
the patient case. The current medication of the patient, such as Simvastatin 40mg nocte is
associated with the health risk like headache, nausea, stomach pain, constipation and muscles
damage. Aspirin 100 mg mane was the medication which is possibly the causative of the patient
adenocarcinoma. Because this is proved that Aspirin cause gastrointestinal ulcerations and
abdominal pain, which lead to the adenocarcinoma (Akuji & Thomas, (2019)). Ventolin prn
medication is associated with the risk of chest pain, fast heart beet seizure etc. laparotomy is
further associated with some clinical issues like post-operative pain, Ineffective breathing
pattern, haemorrhage as this has been identified from the current observation 0800, that patient
Pulse is 110, which is the dedicator of irregular breathing. Pain score 6 on a scale of 0-10 and
estimated blood loss (EBL) in OT 600ml. The key assessment data sources which is used to
collect the information for the development of effective care plain, are pre-operative clinical
data and post operative clinical data (Ladwig, & Makic, (2019)).