NRSG258: Post-Surgical Care - A Case Study of Ted Williams
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Case Study
AI Summary
This surgical nursing case study focuses on the post-operative care of Ted Williams, an elderly patient with multiple comorbidities who underwent bowel resection surgery. The analysis identifies key issues such as shortness of breath, post-operative pain, sluggish bowel function, and fever. It prioritizes interventions including respiratory support, pain management, bowel function improvement, and fever reduction. Pharmacological and non-pharmacological approaches are discussed, including medication administration, breathing exercises, pain relief techniques, and nutritional support. The case study also emphasizes the importance of culturally competent care, involving the patient's partner, and addressing the biopsychosocial aspects of his health. The solution provides rationale for drug usage, potential side effects and implications for nursing practice. Desklib provides access to similar solved assignments and study resources for students.
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Running head: SURGICAL NURSING
SURGICAL NURSING
Name of Student
Name of University
Author note
SURGICAL NURSING
Name of Student
Name of University
Author note
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1SURGICAL NURSING
RESPONSE TO QUESTION 1
Ted Williams is an aged person who has been admitted to the hospital for a bowel
resection surgery and it has been four days that the subject is in a post-operative care and is
being treated with different medications for different conditions. It is highly important to note
that as per the present situation of the subject, there are breathing issues which is the most
critical problem. His heart rate is 98 beats per minutes and his respiratory rate is 26 beats per
minute that is indicative of tachypnoea and shortness of breath. The subject has crackles on
inspiration and moist, productive type of cough. There is severe post-operative pain and the
intensity of pain was recorded to be 7 upon 10. The subject has problems passing flatus and
bowel is sluggish in nature. The body temperature is raised and about 38.1 degree centigrade.
Oxygen saturation is 94 percent. The subject is also comorbid with obesity, heart failure, gout
and type two diabetes mellitus for which he has been taking the medications. The subject
lives alone with a 78 year old partner in the same village. His wife died years ago and his
children lives with their respective families abroad and in the same city. Given his age, the
illnesses and the surgical experience of trauma can impact not only on his physical condition
but also on his social isolation and spiritual state very much (Deasey, Kable & Jeong 2018).
The biopsychosoical aspects of his health are impacted greatly by the surgery and he is aged,
there can identity shift and self-concept crisis, spiritual detachment following the surgery.
Lack of family and culture support would impact as well.
RESPONSE TO QUESTION 2
Processing the information
As first it is to critical noted that the normal range of respiratory rate is 12 to 18
breaths per minute and the respiratory rate of the subject is already 26 breaths per minute
which is considerably high, indicating shortness of breath. The subject also has increased
RESPONSE TO QUESTION 1
Ted Williams is an aged person who has been admitted to the hospital for a bowel
resection surgery and it has been four days that the subject is in a post-operative care and is
being treated with different medications for different conditions. It is highly important to note
that as per the present situation of the subject, there are breathing issues which is the most
critical problem. His heart rate is 98 beats per minutes and his respiratory rate is 26 beats per
minute that is indicative of tachypnoea and shortness of breath. The subject has crackles on
inspiration and moist, productive type of cough. There is severe post-operative pain and the
intensity of pain was recorded to be 7 upon 10. The subject has problems passing flatus and
bowel is sluggish in nature. The body temperature is raised and about 38.1 degree centigrade.
Oxygen saturation is 94 percent. The subject is also comorbid with obesity, heart failure, gout
and type two diabetes mellitus for which he has been taking the medications. The subject
lives alone with a 78 year old partner in the same village. His wife died years ago and his
children lives with their respective families abroad and in the same city. Given his age, the
illnesses and the surgical experience of trauma can impact not only on his physical condition
but also on his social isolation and spiritual state very much (Deasey, Kable & Jeong 2018).
The biopsychosoical aspects of his health are impacted greatly by the surgery and he is aged,
there can identity shift and self-concept crisis, spiritual detachment following the surgery.
Lack of family and culture support would impact as well.
RESPONSE TO QUESTION 2
Processing the information
As first it is to critical noted that the normal range of respiratory rate is 12 to 18
breaths per minute and the respiratory rate of the subject is already 26 breaths per minute
which is considerably high, indicating shortness of breath. The subject also has increased
2SURGICAL NURSING
cough production that is productive and also very moist in nature. In addition, on auscultation
it was found that the subject has crackles that are coarse in nature and that was heard during
inspiration and that is also on the right side of the chest and it is important to check the color
of the sputum in order to understand that there is an underlying chance of infection. More
chest fillings and increased body temperature as the subject has the symptoms of fever is also
indicative of an infection in the aged patient. As the crackles were heard during the
inspiratory phase of the respiration, it is important to understand that the respiratory distress
in the subject is due to an acute respiratory distress syndrome which is restrictive in nature,
which means the problem is with inspiration. Moreover, the oxygen saturation of the patient
is 94 per cent while the normal physiological range is 95 to 100 percent and this signifies as
decreased ventilation-perfusion ratio that can lead to various other complications as well. As
the subject is old and obese, the associated cardiovascular problems can be correlated and it is
important to note that the oxygen saturation that is low in the patient can be correlated to the
weight of the patient as well. The subject has acute post-operative pain symptom, increasing
on palpation and when the abdomen gets distended. Following a bowel resection surgery, the
issues with the bowel passage is common and it is to be noted that post-surgical pain is a
common complain as the surgery but as the subject is a very old aged person, the vitals and
the pain symptoms has to be noted particularly in the post-surgical conditions, to prevent the
chances of the complication that can then be life-threatening. Post the surgery - the subject
did not pass flatus which has accumulated in the abdominal area, causing more distention of
the abdominal area and more pain symptoms as well, increasing and attributing to acute post-
operative pain in the patient. The bowel of the subject is sluggish and that is because the
subject was on a nil diet after the surgery for about 48 hours and then was given just the
liquid and the semi-liquid diet that has attributed to formation of sluggish bowel in the aged
subject. The subject is nauseated and has vomited as well and this is due to the side effects of
cough production that is productive and also very moist in nature. In addition, on auscultation
it was found that the subject has crackles that are coarse in nature and that was heard during
inspiration and that is also on the right side of the chest and it is important to check the color
of the sputum in order to understand that there is an underlying chance of infection. More
chest fillings and increased body temperature as the subject has the symptoms of fever is also
indicative of an infection in the aged patient. As the crackles were heard during the
inspiratory phase of the respiration, it is important to understand that the respiratory distress
in the subject is due to an acute respiratory distress syndrome which is restrictive in nature,
which means the problem is with inspiration. Moreover, the oxygen saturation of the patient
is 94 per cent while the normal physiological range is 95 to 100 percent and this signifies as
decreased ventilation-perfusion ratio that can lead to various other complications as well. As
the subject is old and obese, the associated cardiovascular problems can be correlated and it is
important to note that the oxygen saturation that is low in the patient can be correlated to the
weight of the patient as well. The subject has acute post-operative pain symptom, increasing
on palpation and when the abdomen gets distended. Following a bowel resection surgery, the
issues with the bowel passage is common and it is to be noted that post-surgical pain is a
common complain as the surgery but as the subject is a very old aged person, the vitals and
the pain symptoms has to be noted particularly in the post-surgical conditions, to prevent the
chances of the complication that can then be life-threatening. Post the surgery - the subject
did not pass flatus which has accumulated in the abdominal area, causing more distention of
the abdominal area and more pain symptoms as well, increasing and attributing to acute post-
operative pain in the patient. The bowel of the subject is sluggish and that is because the
subject was on a nil diet after the surgery for about 48 hours and then was given just the
liquid and the semi-liquid diet that has attributed to formation of sluggish bowel in the aged
subject. The subject is nauseated and has vomited as well and this is due to the side effects of
3SURGICAL NURSING
the antipyretic medications that are being administered to the patient (Santosaputri, Laver &
To 2019). It is important to note that the blood pressure of the subject is borderline high and
not very high as the subject is on an antihypertensive medication. The blood pressure of the
subject is 135/85. The stoma is healthy and also minimal ooze is present which means the
healing is occurring appropriately.
Identifying the problem
The first priority problem in the subject is shortness of breath. The subject has
crackles on inspiration on the right side and acute respiratory distress. The oxygen saturation
of the subject is 94 percent. There is productive and moist type of cough that is present in the
subject.
The second priority problem is the acute post-operative pain in the abdominal region.
The intensity of the pain is 7 upon ten which is quite high and severe, given the age of the
patient.
The third priority problem is the issue with the bowel of the patient. The patient has
sluggish type of bowel and not having passed the flatus, has increased the abdominal tension,
causing more pain (Mohammmed Iddrisu et al. 2018).
Fever is a major problem in the subject which can be used to a psychogenic cause of
anxiety and stress and also due to infection.
RESPONSE TO QUESTION 3
The first goal is to improve the respiration of the patient as the subject has shortness
of breath. In the pharmacological management, the subject should start with the
administration of the appropriate decongestant medications to relieve the coughing and the
address the distress of respiration arising from the same. The cough content of the subject
the antipyretic medications that are being administered to the patient (Santosaputri, Laver &
To 2019). It is important to note that the blood pressure of the subject is borderline high and
not very high as the subject is on an antihypertensive medication. The blood pressure of the
subject is 135/85. The stoma is healthy and also minimal ooze is present which means the
healing is occurring appropriately.
Identifying the problem
The first priority problem in the subject is shortness of breath. The subject has
crackles on inspiration on the right side and acute respiratory distress. The oxygen saturation
of the subject is 94 percent. There is productive and moist type of cough that is present in the
subject.
The second priority problem is the acute post-operative pain in the abdominal region.
The intensity of the pain is 7 upon ten which is quite high and severe, given the age of the
patient.
The third priority problem is the issue with the bowel of the patient. The patient has
sluggish type of bowel and not having passed the flatus, has increased the abdominal tension,
causing more pain (Mohammmed Iddrisu et al. 2018).
Fever is a major problem in the subject which can be used to a psychogenic cause of
anxiety and stress and also due to infection.
RESPONSE TO QUESTION 3
The first goal is to improve the respiration of the patient as the subject has shortness
of breath. In the pharmacological management, the subject should start with the
administration of the appropriate decongestant medications to relieve the coughing and the
address the distress of respiration arising from the same. The cough content of the subject
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4SURGICAL NURSING
should be sent for an immunological examination to check the present of any infection and if
infection is present in the subject, then the antibiotic therapy should be immediately started in
the subject. The oxygen saturation of the subject is low and is ninety four percent and in case
of presenting respiratory distress, ventilation and oxygen therapy should be started by the
attending nurse (Jain et al. 2018). The non-pharmacological management will include the
breathing exercises such as pursed lip breathing, diaphragmatic breathing, assisted breathing
and thoracic expansion exercises that will increase the tidal volume of the patient and
improve ventilation (Jangland, Kitson & Muntlin Athlin 2016).. Chest fillings will be
clearing by chest percussion exercises and here, the nurse should collaborate with a physical
therapist. The right positioning with head and body level is important that assists coughing
and drainage of the chest fillings. The breathing exercises will improve the pattern and
rhythm of the breathing (Borrott et al. 2017). Sleep and relaxation should be promoted in the
aged subject in order to relieve the feelings of distress, discomfort and nausea that can
deteriorate the respiration. Proper ventilation of the room is important and shifting the subject
to window side facing a green landscape, is effective.
The second goal is to relieve the subject from the acute post-operative pain. The
pharmacological management of the patient will be done by morphine but as morphine has
several abuse, addiction and complicating symptoms, a special care has to be taken by the
attending nurse to check for neurological depression that might result from intake or overdose
of morphine. Capnography monitoring has to be done to check for the partial pressure of
carbon dioxide as increase in its level can lead to cyanosis and other complication, that can be
fatal for a 82 year old patient. For non-pharmacological management, cryotherapy and ice
massage on the surrounding area can assist both healing and the decrease the intensity of pain
in the subject (Street et al. 2018). In addition, in collaboration with a physical therapist,
exercise therapy and electrotherapeutic modalities can be used to manage pain but with
should be sent for an immunological examination to check the present of any infection and if
infection is present in the subject, then the antibiotic therapy should be immediately started in
the subject. The oxygen saturation of the subject is low and is ninety four percent and in case
of presenting respiratory distress, ventilation and oxygen therapy should be started by the
attending nurse (Jain et al. 2018). The non-pharmacological management will include the
breathing exercises such as pursed lip breathing, diaphragmatic breathing, assisted breathing
and thoracic expansion exercises that will increase the tidal volume of the patient and
improve ventilation (Jangland, Kitson & Muntlin Athlin 2016).. Chest fillings will be
clearing by chest percussion exercises and here, the nurse should collaborate with a physical
therapist. The right positioning with head and body level is important that assists coughing
and drainage of the chest fillings. The breathing exercises will improve the pattern and
rhythm of the breathing (Borrott et al. 2017). Sleep and relaxation should be promoted in the
aged subject in order to relieve the feelings of distress, discomfort and nausea that can
deteriorate the respiration. Proper ventilation of the room is important and shifting the subject
to window side facing a green landscape, is effective.
The second goal is to relieve the subject from the acute post-operative pain. The
pharmacological management of the patient will be done by morphine but as morphine has
several abuse, addiction and complicating symptoms, a special care has to be taken by the
attending nurse to check for neurological depression that might result from intake or overdose
of morphine. Capnography monitoring has to be done to check for the partial pressure of
carbon dioxide as increase in its level can lead to cyanosis and other complication, that can be
fatal for a 82 year old patient. For non-pharmacological management, cryotherapy and ice
massage on the surrounding area can assist both healing and the decrease the intensity of pain
in the subject (Street et al. 2018). In addition, in collaboration with a physical therapist,
exercise therapy and electrotherapeutic modalities can be used to manage pain but with
5SURGICAL NURSING
proper precautions. For the control of psychogenic aspect of pain, the nurse should consider
modifying the surrounding of the room such as light coloring, reduction of noise from
background, enough ventilation and proper clear lighting levels that can improve the
relaxation of the patient and promote sleep. Guided imagery, visual imagery and progressive
muscle relaxation can add to the relaxation and reduction of pain (Brown et al. 2017).
Improving the bowel function of the subject is an important goal. Proper nutrition and
diet should be given to the patient in collaboration with a dietician and it is important that the
fluid intake of the subject is also managed properly in order to improve the bowel function
(Allen et al. 2018).
Managing the fever of the subject is a critical goal. The pharmacological management
will be done with the antipyretic drugs and in case of infections causing the fever the same
will be managed with antibiotic therapy. Rest, sleep, comfortable clothing and maintain the
ventilation and temperature of the room can improve the fever symptoms (Chan et al. 2018).
As the subject is aged, improving the functioning status of the subject is important. A
culturally competent humanistic care along with a biomedical care should be given by the
nurse. The activities of daily life training and talk therapy in collaboration with a [physical
therapist and a psychologist is critical to improve the overall physical and mental well-being
of the subject. The partner should be involved in the care as well to make the care culturally
and social competent.
RESPONSE TO QUESTION 4
The drugs can be used to manage the pain is hydromorphone as it has less addictive
symptoms than morphine. The drug is indicated for reduction of fast acute pain. The drug
acts by blocking the pain receptors that is the nociceptors at the spinal cord level (Li et al.,
2020). The drug acts by blocking the neuronal transmission of the pain sensation and the drug
proper precautions. For the control of psychogenic aspect of pain, the nurse should consider
modifying the surrounding of the room such as light coloring, reduction of noise from
background, enough ventilation and proper clear lighting levels that can improve the
relaxation of the patient and promote sleep. Guided imagery, visual imagery and progressive
muscle relaxation can add to the relaxation and reduction of pain (Brown et al. 2017).
Improving the bowel function of the subject is an important goal. Proper nutrition and
diet should be given to the patient in collaboration with a dietician and it is important that the
fluid intake of the subject is also managed properly in order to improve the bowel function
(Allen et al. 2018).
Managing the fever of the subject is a critical goal. The pharmacological management
will be done with the antipyretic drugs and in case of infections causing the fever the same
will be managed with antibiotic therapy. Rest, sleep, comfortable clothing and maintain the
ventilation and temperature of the room can improve the fever symptoms (Chan et al. 2018).
As the subject is aged, improving the functioning status of the subject is important. A
culturally competent humanistic care along with a biomedical care should be given by the
nurse. The activities of daily life training and talk therapy in collaboration with a [physical
therapist and a psychologist is critical to improve the overall physical and mental well-being
of the subject. The partner should be involved in the care as well to make the care culturally
and social competent.
RESPONSE TO QUESTION 4
The drugs can be used to manage the pain is hydromorphone as it has less addictive
symptoms than morphine. The drug is indicated for reduction of fast acute pain. The drug
acts by blocking the pain receptors that is the nociceptors at the spinal cord level (Li et al.,
2020). The drug acts by blocking the neuronal transmission of the pain sensation and the drug
6SURGICAL NURSING
has been reported to block the pain transduction at the spinal cord level itself. The drug has
certain side effects as well starting from respiratory depression, miosis, neurological
depression, decreased heart and respiratory rate, over sedation, delirium, euphoria,
hallucination that can deteriorate the health and prognosis of the patient on a an adverse note.
Intracranial pressure has been increased after the overdose of endomorphone (De et al. 2017).
Overdose can also lead to orthostatic hypotension and nausea that can be very dangerous as
well. Hence, while administering the drug, the implications should be checked by the nurse
and the vitals should be monitored, regularly. Capnography monitoring and arterial blood gas
analysis is very important to understand the partial pressure of carbon dioxide that can cause
cyanosis in the subject.
The other drug that will be used is ibuprofen for the management of fever and pain.
The mechanism of action of the drug is that it acts by blocking the cyclooxygenases that is
closely related to the secretion of prostaglandins. The sides of effects of the drug are nausea
and vomiting that can be severely complicating for the aged patient. Thus, the implications of
the drug have to be considered by the nurse, while administering the same.
has been reported to block the pain transduction at the spinal cord level itself. The drug has
certain side effects as well starting from respiratory depression, miosis, neurological
depression, decreased heart and respiratory rate, over sedation, delirium, euphoria,
hallucination that can deteriorate the health and prognosis of the patient on a an adverse note.
Intracranial pressure has been increased after the overdose of endomorphone (De et al. 2017).
Overdose can also lead to orthostatic hypotension and nausea that can be very dangerous as
well. Hence, while administering the drug, the implications should be checked by the nurse
and the vitals should be monitored, regularly. Capnography monitoring and arterial blood gas
analysis is very important to understand the partial pressure of carbon dioxide that can cause
cyanosis in the subject.
The other drug that will be used is ibuprofen for the management of fever and pain.
The mechanism of action of the drug is that it acts by blocking the cyclooxygenases that is
closely related to the secretion of prostaglandins. The sides of effects of the drug are nausea
and vomiting that can be severely complicating for the aged patient. Thus, the implications of
the drug have to be considered by the nurse, while administering the same.
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References
Allen, E., Williams, A., Jennings, D., Stomski, N., Goucke, R., Toye, C., ... & McCullough,
K. (2018). Revisiting the Pain Resource Nurse Role in Sustaining Evidence‐Based
Practice Changes for Pain Assessment and Management. Worldviews on Evidence‐
Based Nursing, 15(5), 368-376. https://doi.org/10.1111/wvn.12318
Borrott, N., Kinney, S., Newall, F., Williams, A., Cranswick, N., Wong, I., & Manias, E.
(2017). Medication communication between nurses and doctors for paediatric acute
care: An ethnographic study. Journal of clinical nursing, 26(13-14), 1978-1992.
https://doi.org/10.1111/jocn.13606
Brown, D., Edwards, H., Seaton, L., & Buckley, T. (2017). Lewis's Medical-surgical
Nursing: Assessment and Management of Clinical Problems. Elsevier Health
Sciences. retrieved from https://books.google.co.in/books?
hl=en&lr=&id=Y1QoDwAAQBAJ&oi=fnd&pg=PP1&dq=Lewis%27s+Medical-
surgical+Nursing:
+Assessment+and+Management+of+Clinical+Problems&ots=AEcC-
5BQw6&sig=gSrgel4ukP17Qy3RmW2d0UP5FRo&redir_esc=y#v=onepage&q=Lew
is's%20Medical-surgical%20Nursing%3A%20Assessment%20and%20Management
%20of%20Clinical%20Problems&f=false
Chan, D. K., Liu, F. X., Irwanto, D., Prasetyo, D., Ozorio, G., Li, F., ... & Chen, J. (2018).
Experience of establishing an acute geriatric outreach service versus subacute service
to nursing homes. Internal medicine journal, 48(11), 1396-1399.
https://doi.org/10.1111/imj.14104
De, J., Wand, A. P., Smerdely, P. I., & Hunt, G. E. (2017). Validating the 4A's test in
screening for delirium in a culturally diverse geriatric inpatient
References
Allen, E., Williams, A., Jennings, D., Stomski, N., Goucke, R., Toye, C., ... & McCullough,
K. (2018). Revisiting the Pain Resource Nurse Role in Sustaining Evidence‐Based
Practice Changes for Pain Assessment and Management. Worldviews on Evidence‐
Based Nursing, 15(5), 368-376. https://doi.org/10.1111/wvn.12318
Borrott, N., Kinney, S., Newall, F., Williams, A., Cranswick, N., Wong, I., & Manias, E.
(2017). Medication communication between nurses and doctors for paediatric acute
care: An ethnographic study. Journal of clinical nursing, 26(13-14), 1978-1992.
https://doi.org/10.1111/jocn.13606
Brown, D., Edwards, H., Seaton, L., & Buckley, T. (2017). Lewis's Medical-surgical
Nursing: Assessment and Management of Clinical Problems. Elsevier Health
Sciences. retrieved from https://books.google.co.in/books?
hl=en&lr=&id=Y1QoDwAAQBAJ&oi=fnd&pg=PP1&dq=Lewis%27s+Medical-
surgical+Nursing:
+Assessment+and+Management+of+Clinical+Problems&ots=AEcC-
5BQw6&sig=gSrgel4ukP17Qy3RmW2d0UP5FRo&redir_esc=y#v=onepage&q=Lew
is's%20Medical-surgical%20Nursing%3A%20Assessment%20and%20Management
%20of%20Clinical%20Problems&f=false
Chan, D. K., Liu, F. X., Irwanto, D., Prasetyo, D., Ozorio, G., Li, F., ... & Chen, J. (2018).
Experience of establishing an acute geriatric outreach service versus subacute service
to nursing homes. Internal medicine journal, 48(11), 1396-1399.
https://doi.org/10.1111/imj.14104
De, J., Wand, A. P., Smerdely, P. I., & Hunt, G. E. (2017). Validating the 4A's test in
screening for delirium in a culturally diverse geriatric inpatient
8SURGICAL NURSING
population. International journal of geriatric psychiatry, 32(12), 1322-1329.
https://doi.org/10.1002/gps.4615
Deasey, D., Kable, A., & Jeong, S. (2018). An exploration of emergency nurses'
understanding of the ageing process and knowledge of their older patient: A
comparison between regional and metropolitan nurses in Australia. International
emergency nursing, 37, 44-51. https://doi.org/10.1016/j.ienj.2016.03.004
Jain, S., Gonski, P. N., Jarick, J., Frese, S., & Gerrard, S. (2018). Southcare Geriatric Flying
Squad: an innovative Australian model providing acute care in residential aged care
facilities. Internal medicine journal, 48(1), 88-91. https://doi.org/10.1111/imj.13672
Jangland, E., Kitson, A., & Muntlin Athlin, Å. (2016). Patients with acute abdominal pain
describe their experiences of fundamental care across the acute care episode: A multi‐
stage qualitative case study. Journal of advanced nursing, 72(4), 791-801.
https://doi.org/10.1111/jan.12880
Li, X., Du, W., Parkinson, A., & Glasgow, N. (2020). Postoperative Delirium Following Joint
Replacement in Patients With Dementia in New South Wales, Australia: A State-
Wide Retrospective Cohort Study. Research in Gerontological Nursing.
https://doi.org/10.3928/19404921-20200214-01
Mohammmed Iddrisu, S., Hutchinson, A. F., Sungkar, Y., & Considine, J. (2018). Nurses'
role in recognising and responding to clinical deterioration in surgical
patients. Journal of clinical nursing, 27(9-10), 1920-1930.
https://doi.org/10.1111/jocn.14331
Santosaputri, E., Laver, K., & To, T. (2019). Efficacy of interventions led by staff with
geriatrics expertise in reducing hospitalisation in nursing home residents: A
population. International journal of geriatric psychiatry, 32(12), 1322-1329.
https://doi.org/10.1002/gps.4615
Deasey, D., Kable, A., & Jeong, S. (2018). An exploration of emergency nurses'
understanding of the ageing process and knowledge of their older patient: A
comparison between regional and metropolitan nurses in Australia. International
emergency nursing, 37, 44-51. https://doi.org/10.1016/j.ienj.2016.03.004
Jain, S., Gonski, P. N., Jarick, J., Frese, S., & Gerrard, S. (2018). Southcare Geriatric Flying
Squad: an innovative Australian model providing acute care in residential aged care
facilities. Internal medicine journal, 48(1), 88-91. https://doi.org/10.1111/imj.13672
Jangland, E., Kitson, A., & Muntlin Athlin, Å. (2016). Patients with acute abdominal pain
describe their experiences of fundamental care across the acute care episode: A multi‐
stage qualitative case study. Journal of advanced nursing, 72(4), 791-801.
https://doi.org/10.1111/jan.12880
Li, X., Du, W., Parkinson, A., & Glasgow, N. (2020). Postoperative Delirium Following Joint
Replacement in Patients With Dementia in New South Wales, Australia: A State-
Wide Retrospective Cohort Study. Research in Gerontological Nursing.
https://doi.org/10.3928/19404921-20200214-01
Mohammmed Iddrisu, S., Hutchinson, A. F., Sungkar, Y., & Considine, J. (2018). Nurses'
role in recognising and responding to clinical deterioration in surgical
patients. Journal of clinical nursing, 27(9-10), 1920-1930.
https://doi.org/10.1111/jocn.14331
Santosaputri, E., Laver, K., & To, T. (2019). Efficacy of interventions led by staff with
geriatrics expertise in reducing hospitalisation in nursing home residents: A
9SURGICAL NURSING
systematic review. Australasian journal on ageing, 38(1), 5-14.
https://doi.org/10.1111/ajag.12593
Street, M., Phillips, N. M., Haesler, E., & Kent, B. (2018). Refining nursing assessment and
management with a new postanaesthetic care discharge tool to minimize surgical
patient risk. Journal of advanced nursing, 74(11), 2566-2576.
https://doi.org/10.1111/jan.13779
systematic review. Australasian journal on ageing, 38(1), 5-14.
https://doi.org/10.1111/ajag.12593
Street, M., Phillips, N. M., Haesler, E., & Kent, B. (2018). Refining nursing assessment and
management with a new postanaesthetic care discharge tool to minimize surgical
patient risk. Journal of advanced nursing, 74(11), 2566-2576.
https://doi.org/10.1111/jan.13779
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