You are a nurse preparing a 56-year-old
You are a nurse preparing a 56-year-old telephone linesman for surgery to repair a torn left rotator cuff. He has an unremarkable medical history, and denies smoking or consuming alcohol. He has never been hospitalized and asks many questions regarding what to expect from his first surgical experience. His wife is continually at his bedside and is very supportive. (Learning Objectives 1, 3, and 5) What preoperative tasks would be important in your nurse-patient relationship? Outline general teaching topics to be included for any patient undergoing surgery. During your discussions of his undergoing general anesthesia, what major risks would you describe? Your patient indicates serious concern regarding medications used perioperatively. How would you outline the uses of various medications? After a complete description of the surgery, your patient indicates that he is ready to sign consent forms. How would you respond? Which conditions would invalidate this patient’s ability to sign consent? Develop appropriate postoperative patient goals that you might include in this patient’s care plan. You are a nurse preparing a 79-year-old retired firefighter for surgery to repair a torn right rotator cuff. He has a 40-pack-year history of smoking and reports social drinking. He has been a widower for 10 years and has two daughters who live in his community—they accompanied him at admission. He lives alone, is athletic, and enjoys hunting, fishing, and backpacking. He reports, “This bum shoulder is stopping me from doing what I want to do—can’t wait to get it fixed and go camping next week!” (Learning Objectives 2 and 4) Considering his history, what postoperative teaching would be important? During your discussions of his undergoing general anesthesia, what major risks would you be sure to include? What component of his health history might affect his physical response to general anesthesia? How might this patient’s age affect his recovery? What is his statement indicates the need for additional perioperative teaching? How might that issue be addressed?
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