Case Study Preoperative Research Based Journal Order Instructions: Hello writer sir, how are you today
Thank you so much for helping for this perioperative case study assignment. Topic is mentioned below.
• APA Referencing
• At least 25 genuine references from 2010 to 2016 study based,
• 90 % references has to be research based Journal article AND books
• Australian and New Zealand based study articles are preferable.
• Please have a look Rubric guideline for given topic, I need good grades in this assignment so please do me a favour and try to make a good reflection using
Case Study
Peri-operative:
Candace Evans 42 years old , Caesarean Section
Candace is a 42 year woman admitted to the maternity ward, for an elective caesarean section for the birth of her second child the following day. Candace has a past history of gestational diabetes with her first pregnancy, 5 years ago, which resolved following the birth with no recurrence in this pregnancy. Candace also has a past history of depression and anxiety and was treated for post-natal depression following the birth of her first child. She is first on the list for an elective caesarean section under spinal anaesthesia. You are working in the PACU on a morning shift and will receive Candace following her caesarean section. Candace arrives in the PACU, following the uneventful birth of a male infant via LUSCS with APGARS of 8 at 1minute and 10 at 5 minutes following birth. She has a dressing insitu which is dry and intact, IDC insitu with minimal drainage and IVT of CSL at 84mls/hour via an IV pump. She is still experiencing the effects of the spinal anaesthesia under which she had the LUSCS. Candace had a total blood loss of 150 mls during the procedure. She is alert and her vital signs are T 36.6oC, HR 88, BP 104/76, O2 sats 97% RA.
Case Study Preoperative Research Based Journal and Case study instructions
Utilize the Clinical Reasoning Cycle (Levett-Jones, 2013) (a clinical decision-making framework) to plan and evaluate person-centered care:
• Considering the person’s situation, collect, process and present related health information
• Identify and prioritize at least three (3) nursing problems/issues based on the health assessment data that you have identified for the person at the center of care.
• Establish goals for priority of nursing care as related to the nursing problem/issues identified
• Discuss the nursing care of the person; link it to assessment data and history.
• Evaluate your nursing care strategies to justify the nursing care provided
• Reflect on the person’s outcomes
Dear Writer sir
Please draft this essay in giving order please use the clinical reasoning cycle framework and the evidence. I included clinical reasoning cycle resource for your kind consideration.
Introduction
Nursing issue 1 :-
• Establish goals for priority of nursing care as related to the nursing issues identified
• Discuss the nursing care of the person; link it to assessment data and history.
• Evaluate your nursing care strategies to justify the nursing care provided
• Reflect on the person’s outcomes
Nursing issue 2
• Establish goals for priority of nursing care as related to the nursing issues identified
• Discuss the nursing care of the person; link it to assessment data and history.
• Evaluate your nursing care strategies to justify the nursing care provided
• Reflect on the person’s outcomes
Nursing issue 3
• Establish goals for priority of nursing care as related to the nursing issues identified
• Discuss the nursing care of the person; link it to assessment data and history.
• Evaluate your nursing care strategies to justify the nursing care provided
• Reflect on the person’s outcomes
Case Study Preoperative Research Based Journal Conclusion
Please give me heading in this essay such as
Nursing issue 1:- ………………………………………………
Established goal:-…………………………………………
Discussion of Nursing care:-…………………………………..
Evaluation of nursing care strategies:-……………………………
Person outcome:- ……………………………………..
Nursing issue 2:- ………………………………………………
Established goal:-…………………………………………
Discussion of Nursing care:-…………………………………..
Evaluation of nursing care strategies:-……………………………
Person outcome:- ……………………………………..
Nursing issue 3:- ………………………………………………
Established goal:-…………………………………………
Discussion of Nursing care:-…………………………………..
Evaluation of nursing care strategies:-……………………………
Person outcome:- ……………………………………..
Conclusion
Thank you so much for your kind support
Regards
Case Study Preoperative Research Based Journal Sample Answer
Case Study Perioperative
Introduction
Cesarean delivery remains one of the most effective birth delivery methods especially in cases where vaginal delivery is associated with negative risks (Hofmeyr, Hannah, & Lawrie, 2015). Cesarean delivery is widely used in cases where labour contractions are irregular. It is also considered as one of the less painful methods of birth delivery compared to vaginal delivery due to its use of anesthesia. It is carried out when maternal infection or risk of mother to child transmission is high especially in cases related to herpes and HIV (Hofmeyr et al., 2015). There are several indicators that serve to establish when cesarean delivery should be carried out. The indicators include cephalopelvic disproportion, malpresentation such breaches or traverse lie, multiple pregnancies (White, Lee, & Beckmann, 2016), severe hypertensive diseases in pregnancy, failed induction of labor (Seeho, Nippita, & Roberts, 2016), and signs of pelvic cysts or fibroids in a pregnant woman (Hofmeyr et al., 2015). Nonetheless, before a pregnant woman fully undergoes any form of a cesarean section, important tests have to be conducted. Pre and post-tests aim to address any issue that may arise as a result of carrying out the procedure. The pre-tests collect relevant past medical history of the patient associated with the current condition. The compilation of past medical records provides sufficient information on the condition of the patient and goes further to determine the effectiveness of certain medical procedures (Hofmeyr et al., 2015). The pre-tests ensure that a patient is adequately prepared and suited for a particular test. In the case of pregnant women, the past medical history serves to ensure that the health of the fetus and mother is not in any way threatened by the procedure that to be carried out. Post-tests aim to evaluate the effectiveness of any medical procedure that has been carried out (Scott, 2014). However, each patient case is different and evaluated on an individual basis basing on the clinical evidence and body physiology of an individual (Chervenak & McCullough, 2013). Clinical decisions made before and after surgical procedures such as cesarean deliveries may determine the health outcome of the pregnant mother and unborn child.
Nursing Issue 1: Recovery from Anaesthesia and Pain Management in Case Study Preoperative Research Based Journal
Pain management is a fundamental aspect carried out immediately a patient undergoes any form of cesarean procedure. Cesarean delivery is known to induce pain in patients for the first 48 hours. Pain management is a crucial component in stabilizing any individual’s medical condition.
Goals
Pain relief after C-section remains one of the most effective ways of stabilizing the patient. Any form of induced anesthesia during surgical procedures aim to reduce pain during the procedure (Mostafa Kamal, 2013). However, after the procedure, the patient is supposed to come out of anesthesia so that vital signs could be easily read. The management of an active patient free from the effects of anaesthesia serves as an effective way of ensuring that other management procedures such as cardiorespiratory and air control, as well as management of any condition, is readily dealt with (Bannister-Tyrrell, Ford, Morris, & Roberts, 2014; Butwick, El-Sayed, Blumenfeld, Osmundson, & Weiniger, 2015; Liu, Raju, Boesel, Cyna, & Tan, 2013; Yeoh & Li, 2013). The main goal of carrying out pain management and more so recovery from the effects of anesthesia is to ensure that the patient vital signs have been stabilized and not affected by the effects of anesthesia (Dyer, Butwick, & Carvalho, 2011). Also, a reduction in pain after c- section deliveries will ensure that the patient is comfortable enough to undergo any form of treatment (Joshi, Schug, & Kehlet, 2014).
Nursing Care
The current information that stands out from the patient immediately from coming out of the operating room is the associated effects of spinal anesthesia. The vital signs of the patient have not fully stabilized and range differently from the norm. The blood pressure is currently at 104/76, the heart rate is 88, and the temperature is at 36.600C. The patient has not in any way indicated any form of medical allergy to any of the drugs through the patient has a medical history of gestational diabetes and postnatal depression meaning there is a higher probability of the mentioned effects affecting the recovery process in the patient.
Evaluation of Nursing Strategies
Different forms of drugs have different outcomes basing on the physiology of an individual. The drugs used should not antagonistically affect the management of gestational diabetes or the management of postnatal depression (Shand, Harpham, & Lainchbury, 2016). A synergistic effect is more preferred since it manages different conditions at the same time. Also, the drugs should not have side effects such as raising the body temperature of the patient or significantly reducing the heart rate. Opioid-related drugs with a little form of morphine may be directly applied to the patient to reduce pain management (C Grigg & Tracy, 2014; CP Grigg, Tracy, & Schmied, 2015; Husarova, Macdarby, Dicker, & Malone, 2016; Steel, Adams, Sibbritt, Broom, & Frawley, 2014). Opium-related drugs should be taken systematically or injected intravenously depending on the condition of the patient (Hegde & Raghavendra Rao, 2011; Sharkey, Finnerty, & McDonnell, 2013). Monitoring of all vital signs should be done after every two hours.
Case Study Preoperative Research Based Journal and the Personal Outcomes
Application of opium related drugs would significantly reduce pain and reduce the effects of anesthesia to the patient. It would significantly assist in the management of vital signs.
Nursing Issue 2: Regain of Cardiorespiratory and Air Control
Surgical procedures such as C-sections involve the loss of blood. Excessive loss of blood from the mother would directly result in the loss of oxygen in a patient and the subsequent coma and death (Kennedy, Grant, Walton, & Sandall, 2013). Blockage of the respiratory system occurs due to the formation of blood clots in the system blocking the movement of gases and other essential nutrients in the body including the drugs that have been infused to reduce pain management (Seeho et al., 2016).
Goals
The major goal of the management mentioned above practice is to ensure that blood loss is controlled and at the same time, appropriate management practices are carried out to ensure that the airway is opened. The two management practices will ensure blood loss is reduced to negligible levels.
Nursing Care
From the information collected after the surgery, Candace lost 150 milliliters of blood. The in situ dressing is also dry and intact. Since the patient lost blood, it is imperative to carry out blood transfusion. Candace has a history of gestational diabetes which means there are elevated levels of blood glucose in the body that could significantly affect the management of cardiorespiratory outcomes.
Evaluation of Nursing Strategies
Management of cardiorespiratory outcomes is essential in controlling the amount of blood lost by the patient and opening up of respiratory airways. Anticoagulants applied to the patient prevent coagulation of blood after surgery (Scott, 2014). Anticoagulants also act to clear some of the blocked pathways related to the respiratory system (Beucher, Dolley, Lévy-Thissier, Florian, & Dreyfus, 2012). Since the cardiovascular system and respiratory system are intertwined any modification made to the cardiovascular system would directly impact the respiratory system (Seeho et al., 2016). The dry and intact dressing in situ should also be checked occasionally to determine if there is any form of bleeding from the wound. Anticoagulants should only be selectively applied after surgery (Joshi et al., 2014). Immediately the condition of the patient improves, the application of anticoagulants should be stopped immediately (Bannister-Tyrrell et al., 2014). The cardiorespiratory outcomes will also determine the management of vital signs.
Personal Outcomes
The major outcome expected in this case is the reduction of any form of bleeding and the opening of the airway to facilitate air transfer.
Nursing Issue 3: Management of the Patient Condition and Antibiotic Prophylaxis
After stabilizing the condition of the patient, it is important to stabilize the health condition of the patient and check on the health condition of the child. This will ensure that both the child and the mother are doing well and can kick start the recovery period within the set time limits.
Goals
Several important goals are outlined in this management practice. First, the health condition of the unborn baby by evaluating the APGRS scale. Secondly, antibiotic prophylaxis will be carried out to ensure there is no post-operation infection caused by any form of bacteria. Thirdly, management of gestational diabetes and postnatal depression since it has an impact on breastfeeding milk(Yeoh & Li, 2013). When all of the above outcomes have been keenly observed, vital signs will be monitored until they return to normal levels. The patient will also be expected to have enough rest before taking the first step.
Nursing Care
The past medical history reveals cases of gestational diabetes and postnatal depression in the patient. Also, the patient vital signs have not been adequately stabilized and deviate from the normal condition. The blood pressure is currently at 104/76, the heart rate is 88, and the temperature is 36.600C. The patient immune system has not been the subject of any form of investigation though antibiotic treatment is a key element in the management of patients undergoing coming out from any form of surgery (Steel et al., 2014).
Evaluation of Nursing Strategy
Gestational diabetes could either be treated through the use of specific drugs such as Metformin or through other mechanisms such as dietary management (Duran, Sáenz, Torrejón, & Bordiú, 2014; Melamed, Ray, Barrett, & Geary, 2016; Nicklas, Miller, Zera, & Davis, 2013; Spaulonci, Bernardes, & Trindade, 2013; Viana, Gross, & Azevedo, 2014). Alternatively, Candace would choose to improve or change diet for some months when the glucose levels reduce substantially in the body. Candace requires adequate medical treatment when it comes to postnatal depression. In this case, chemotherapy and counseling would serve Candace some good since postnatal depression can affect milk production in women (Woolhouse, Gartland, Perlen, & Donath, 2014). Antibiotic therapy is carried out to ensure that there is a decrease in the levels of bacteremia or any form of microorganism infection is reduced (Steel et al., 2014).
Personal Outcome
Reduction in the amounts of sugar associated with gestational diabetes as well as reduction of microorganism infection and postnatal depression.
Case Study Preoperative Research Based Journal Conclusion
Pre and post-operative procedures carried out in health settings are evaluated based on the health condition of an individual. Each management technique carried out has a specific important role.
Case Study Preoperative Research Based Journal References
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