Developing a Nursing Care Plan for Preoperative Patient Martha Myles

This assignment presents a detailed nursing care plan for Martha Myles, a 40-year-old female admitted to the emergency department following a high-speed car crash with unstable bilateral pelvic fractures. The care plan addresses two key nursing diagnoses: acute preoperative pain and deficit knowledge with potential for anxiety related to the surgical procedure. The plan outlines specific goals, such as controlling pain and providing relevant knowledge about the surgery to reduce anxiety. Interventions include pharmacological and non-pharmacological pain management techniques, such as systemic analgesia, acupressure, Jacobson relaxation, and nerve blocking. Additionally, the plan incorporates preoperative education, including explaining the surgical procedure, discussing potential concerns, and informing Martha about the nurse's role during surgery. The rationale behind each intervention is provided, emphasizing the importance of patient education, reassurance, and the development of trust to improve patient outcomes and obtain informed consent. The plan references several scholarly articles to support the interventions.

Answer 2
Nursing diagnosis one- Preoperative acute pain due to pelvic fracture.
Goal- The goal is to control pain adequately after the fracture.
Intervention 1
First intervention would be to use pharmacological interventions as indicated. It will include
systemic analgesia and medications which may be narcotics and non-narcotics
(Abdolrazaghnejad, et al., 2018). Nurse will administer appropriate dose, on time through the
suitable route of administration.
Intervention 2
Another significant intervention for pain control would be using non-pharmacological practices.
Acupressure and Jacobson relaxation technique are two of the effective techniques that can be
used for people who had hip fractures (Sanzone, 2016). Bilateral auricular acupressure will be
done in Martha’s case to reduce pain and anxiety. Jacobson relaxation technique is a two-step
process which involves contraction and relaxation of particular muscles. Nurse will learn which
muscles are the cause of pain and will help in its relaxation.
Intervention 3
Nerve blocking is another technique used for pain management (Abou-Setta, Beaupre, Rashiq, &
Dryden, 2011). In this technique, nerve impulses are blocked from reaching the sensory cortex.
Intervention 4

Preoperative skin traction is another technique that can be used for pain management. Skin
traction is also utilized to stable the fractured leg and to reduce pain and the risk of operative
complications before any surgical procedure (Handoll, Queally, & Parker, 2011).
Nursing diagnosis two- Deficit knowledge and potential for anxiety related to surgical procedure.
Goal- The goal is to provide Martha with relevant knowledge about the surgical procedure. The
rationale behind the goal is to calm and reassure Martha about the need and procedure of
surgery. It will be helpful in not only relaxing her but also obtaining her consent.
Intervention 1
Nurse will implement interventions to improve Martha’s understanding level by explaining her
the procedure of surgery. Rationale behind this intervention is that the information gained
through this assessment can be used for developing preoperative educational plan by identifying
the content requirements and breaking myths, if any (MALLEY, KENNER, KIM, &
BLAKENEY, 2015).
Intervention 2
Nurse must offer preoperative education to Martha. Preoperative teaching may include visit with
OR person prior to surgery if possible. Nurse must discuss the expected factor which may be
worrying Martha such as masks, IVs, BP cuff, electrodes, cannula, hospital environment. etc.
Rationale behind this intervention is to give reassurance to Martha and minimize her anxiety. In
addition, nurse provides information for developing intraoperative care (Mitchell, 2017).
Intervention 3

Nurse will inform Martha about nurse’s intraoperative role. This would help in developing trust
and rapport between nurse and Martha which will ultimately reduce fear of loss of control felt by
Martha in an unfamiliar environment.
Intervention 4
Nurse will evaluate the pathology and the impending surgical procedure (Tohidi, Lung, & Yen,
2018). She will review that suitable consent has been obtained. This intervention will give
knowledge base from which Martha can make informed treatment choices and consent for
surgery and is also given the chance to clear her misconceptions.
Reference
Abdolrazaghnejad, A., Banaie, M., Tavakoli, N., Safdari, M., & Rajabpour-Sanati, A. (2018).
Pain management in the emergency department: a review article on options and
methods. Advanced journal of emergency medicine, 2(4).
Abou-Setta, A. M., Beaupre, L., Rashiq, S., & Dryden, D. M. (2011). Comparative Effectiveness
of Pain Management Interventions for Hip Fracture: A Systematic Review. Annals of
internal medicine, 155(4), 234-45.
Handoll, H. H., Queally, J. M., & Parker, M. J. (2011). Pre‐operative traction for hip fractures in
adults. Cochrane Database of Systematic Reviews, (12).
BIBLIOGRAPHY
MALLEY, A., KENNER, C., KIM, T., & BLAKENEY, B. (2015). The Role of the Nurse and
the Preoperative Assessment in Patient Transitions. AORN J, 102(2), 181.e1–181.e9.

Mitchell, M. (2017). Day surgery nurses' selection of patient preoperative information. Journal
of Clinical Nursing, 26(1-2), 225-237.
Sanzone, A. G. (2016). Current Challenges in Pain Management in Hip Fracture Patients. J
Orthop Trauma, 30(5).
Tohidi, M., Lung, T., & Yen, D. (2018). Routine perioperative practices and postoperative
outcomes for elective lumbar laminectomies. J Spine Surg, 4(3), 588-593.