Published Mar 3, 2014
I have most of it done i coppied the whole thing to give all of the background.
Im struggling with ...
6. R.O. undergoes an appendectomy; the appendix has ruptured. The peritoneum is inflamed, and abscesses are seen near the colon and small intestine. R.O. is admitted to the surgical unit; she is NPO, has a nasogastric tube (NGT), foley catheter, IV, abdominal dressing, and penrose drain. Identify 5 priority nursing considerations.
7. R.O. is 4 days postoperative. Assessment shows that R.O. is pale and listless; bowel sounds are absent; abdomen is distended and tender to the touch; the NGT is draining an increased amount of dark, greenish black fluid. Also her lung sounds are moist bilaterally, her temperature has spiked to 40.2 degrees Celsius, and she rates her pain at 10/10 )she has been rating her pain from 5 to 7 on a scale of 1 to 10 for the past two days.) R.O. has difficulty taking deep breaths because of the pain, which she says "hurts over my whole stomach." What should your priority nursing care include?
8. What information, if any, should you relate to her surgeon? What is your rational for relating this information?
missmollie, ADN, BSN, RN
I could answer all these questions for you. Here's what you need to do:
1. Read that huge med-surg textbook. Specifically, the chapter on either Lower GI dysfunction, Upper GI dysfunction, or Liver, Pancreas, and Biliary Tract problems.
2. Once you read about appendicitis, you will be able to answer these questions.
3. As a nice hint, make sure you read the paragraphs over peritonitis.
Rose_Queen, BSN, MSN, RN
We are willing to help (key word- help) with homework. However, we will not do your homework for you. You have shown absolutely no work of your own; you have simply cut and pasted your assignment (and if your instructor posts here, they know that- bad idea). Tell us what you are struggling with, show us your work, and we can help you.
psu_213, BSN, RN
I want to second (and third? :)) what has been said by the two posters before me. I do hope you come back and tell us your thoughts--we will be glad to help then!
I have most of it done but i have never used this site and i thought you needed all of the background information. i am only struggling with the three questions that relate to the disease progression into something else.
cac1213, it's great you've narrowed down what parts you're struggling with. However, you still haven't told us your thoughts and precisely what you're struggling with. Those questions are rather broad. Tell us what you think and we can tell you if you're headed in the right direction or redirect you as needed.
Lev, MSN, RN, NP
You have to read up some more on appendicitis and post op complications. As you are reading, review the following questions..
What happens when an inflamed appendix ruptures? If something ruptured there had to have been something putting pressure from the inside out. What would that be? What can happen next?
What are some potential post op complications than can arise, particularly after abdominal surgery?
What does your assessment tell you? What can a temp of 40.3 come from? Why would lungs sound moist? What do absent bowel sounds mean? What does the color of the fluid coming out of the NG tube tell you?
6: With the nursing priority diagnosis, think Maslow's and ABC's. She is NPO, she has a NG tube. Why? What kind of problems could those present to the patient.
Foley catheter and abdominal dressing: What would be your biggest concern with these?
IV: Why is it there? What's it's purpose, and what would you be on the lookout for?
Penrose drain: Why is the drain there?
When you answer those questions, post it. I will help to the best of my ability. Also, don't be afraid to look in a nursing care plan book!
NRSKarenRN, BSN, RN
Thread closed as OP found answers to case study.
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