Perioperative Nursing Theory, Case Study of Jessica

Perioperative Nursing Theory, Case Study of Jessica 1
Perioperative Nursing Theory, Case Study of Jessica
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Perioperative Nursing Theory, Case Study of Jessica 2
Perioperative Nursing Theory, Case Study of Jessica
Surgery is among the sensitive nursing care practices which must be handled with a lot of
care for the end results to be positive. It is commonly believed to be a matter of life and death
practice which can easily cause sleepless nights for victims. For that matter, before patients
undergo surgery, they must be prepared both physically and psychologically. Also, when it
comes to surgery, doctors must strictly follow the stipulated procedures to avoid complications
associated with the practice. After the operation, the patient must continue to be supported so as
to ensure systematic and fast healing. This nursing care has been summarized as perioperative
nursing care. Perioperative nursing care is described in three phases: preoperative phase,
intraoperative phase, and postoperative phase.
Preoperative phase describes the preparation procedure done to a patient before
undergoing the ideal operation. Intraoperative phase, on the other hand, describes the procedure
followed by a doctor when performing the operation while the postoperative phase entails the
support given to a patient after undergoing operation until full recovery (Qing et al, 2016, p.149).
This paper considers the case study of Jessica, a 40-year old in her journey from the time her
appendicitis became worse, through appendectomy to recovery. The paper will be divided into
four sections; the first section will describe the case of Jessica in her journey of appendicitis, the
second section will be the preoperative phase, the third section will be the intraoperative phase
and finally the postoperative phase, all in consideration to the case of Jessica.
Appendicitis is a health condition characterized by an inflamed appendix. Appendix, on
the other hand, is the finger-like a pouch that projects from the cecum or the start of the colon.
Mainly, the appendix becomes inflamed because of bacterial infections on its tissues which is

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signaled by the development of pus within the lumen. Bacterial infections in the appendix are as
a result of mechanical blockage of the appendix by foreign substances or thick mucus (Berman,
Snyder and Frandsen, 2016).
As an orphan, Jessica had been raised by a guardian who cared less about her wellbeing
in the environment. For that matter, as an infant, Jessica would consume everything on her site,
right from soil particles, fruit seeds to chewing plants. This had continued for a while until she
was grown up enough to differentiate between consumable and non-consumable things. At the
age of 14 years, Jessica started to complain of aching pain between her umbilicus and the lower
right abdomen. Her pain was sharp and could increase with her movements such as joking,
walking or running (Shih and Meldrum, 2018, p.20). According to her testimony, the pain would
be accompanied by nausea, fever, loss of appetite, vomiting and abdominal swelling. Jessica’s
condition had been linked with her adolescent as it had started at the time when her adolescent
symptoms started. She did not seek medical attention for that case because she expected her
condition to disappear with time. Unfortunately, her condition continued to worsen. At the age of
20 years, she visited a clinic where she was diagnosed with appendicitis.
Following her diagnosis with appendicitis, the doctor prescribed some medication to her
because he believed that her condition was not extreme to demand an operation. The doctor had
prescribed prophylactic antibiotics on her which was expected to eradicate the infections which
were affecting her appendix and prevent more complications. After the eradication of the
infections and prevention of further complications, it was expected that her appendix would
recover and carry its work normally (Arakelian et al, 2017, p.2530). The doctor had prescribed
piperacillin and zosyn, an agent which acted as a beta-lactamase inhibitor with piperacillin.

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These two antibiotics were really helpful on Jessica because they reduced the severity of the
symptoms. For twenty years she kept using the antibiotics. However, at the age of 40 years, her
condition became worse because her body had developed resistance for the two antibiotics. On
admission, the doctor confirmed that Jessica’s appendix was almost rupturing. Rupturing of the
appendix would release bacteria into the rest of her abdomen which would lead to a potentially
life-threatening infection. Jessica was supposed to undergo appendectomy because it was the
only option to control her condition (White and Spruce, 2015, p.50).
Before Jessica could be allowed to sign a consent form which would render her
dependent on the skill, integrity, and knowledge of the surgeon who would operate her in the
next five days, she was prepared physically and psychologically. The scope of activities during
this phase included the establishment of a baseline assessment in the clinical setting, being taken
through a preoperative interview and then being prepared for the anesthetic which would be
given before the surgery (Sweeney et al, 2017, p.10). During this phase, the nurse in charge of
her assessed and corrected all the physiological and psychological problems which would
increase the surgical risk on Jessica, instructed and demonstrated the exercises that would benefit
Jessica postoperatively and then planning for discharge and the projected changes in lifestyle due
to the surgery was done.
Through the physiologic assessment, the health history of Jessica was obtained through
physical examinations where vital signs were noted and a database established for future
comparisons. Among the assessments which were done included: nutritional status needs, fluid,
and electrolyte imbalance, drug and alcohol use, respiratory status, cardiovascular status, hepatic
and renal function, endocrine function, presence of trauma, immunologic function and previous