Care Plans

[ljbutler]

Can anyone tell me what I might can use for 2 care plans for a patient in preop? She had a LAVH with left salpingo-oophorectomy due to uterine prolapse. Only other medical problems are HTN and Hyperlipidemia. My instructor tells me I am not picking priority diagnosis for patients in preop????

[Daytonite, BSN, RN]

a care plan is always based upon the symptoms of a problem that a patient is going to have. in this case, the patient is preop and being prepared for surgery. read your textbook on what teaching and preparation preop patient needs. much of this care plan will be anticipatory problems. preop patients get a good amount of teaching. never assume that the patient knows what the surgical and anesthetic experience is going to be like. that will be the major focus of the preop plan.

you can find information about these surgeries on these websites:

• http://www.surgeryencyclopedia.com/index.html
  
• http://www.upmc.com/healthmanagement...ce/procedures/
  
• http://adam.about.com/surgery/maindex.htm

you should also look up lavh (laparoscopically assisted lady partsl hysterectomy) and salpingo-oophorectomy so you can talk to the patient about what the surgery is and what she can expect in the postop period. you also need to keep in mind the complications of general anesthesia:

• breathing problems (atelectasis, hypoxia, pneumonia, pulmonary embolism)
  
• hypotension (shock, hemorrhage)
  
• thrombophlebitis in the lower extremity
  
• elevated or depressed temperature
  
• any number of problems with the incision/wound (dehiscence, evisceration, infection)
  
• fluid and electrolyte imbalances
  
• urinary retention
  
• constipation
  
• surgical pain
  
• nausea/vomiting (paralytic ileus)
  

and teach the patient how they can be avoided.

medical problems of hypertension and hyperlipidemia are of no interest in a care plan unless they have some influence on the nursing care or the symptoms the patient will have.

i have a 2-page preoperative care plan for a surgical patient in a pdf file that i can send to you, but i would need your e-mail address to do it. if you want to see this care plan send me your e-mail address in a pm (private message) and i will send it as an attachment to a return e-mail. i also have general intraoperative and postanesthesia care plans. these care plans were originally posted on the internet at a surgical nursing site but have since been removed. good thing i downloaded and saved them on my computer.

[manofcare]

Consider the area that the surgery was performed on. The bladder and urinary elimination could be impaied or stopped. It could interupt the other elimination (fecal) as well, because of swelling. Even though it was a lap procedure she will most likely suffer form acute pain. Also, how old is your pt? Is this surgery going to interrupt her desire to have children? Or is she done? Also, this will have an impact on her sexuality. In some cultures a uterus is the sign of feminity. Without a uterus they are viewed by other women as less than women.

[susanbeaver]

a care plan is always based upon the symptoms of a problem that a patient is going to have. in this case, the patient is preop and being prepared for surgery. read your textbook on what teaching and preparation preop patient needs. much of this care plan will be anticipatory problems. preop patients get a good amount of teaching. never assume that the patient knows what the surgical and anesthetic experience is going to be like. that will be the major focus of the preop plan.

you can find information about these surgeries on these websites:

• http://www.surgeryencyclopedia.com/index.html
  
• http://www.upmc.com/healthmanagement...ce/procedures/
  
• http://adam.about.com/surgery/maindex.htm

you should also look up lavh (laparoscopically assisted lady partsl hysterectomy) and salpingo-oophorectomy so you can talk to the patient about what the surgery is and what she can expect in the postop period. you also need to keep in mind the complications of general anesthesia:

• breathing problems (atelectasis, hypoxia, pneumonia, pulmonary embolism)
  
• hypotension (shock, hemorrhage)
  
• thrombophlebitis in the lower extremity
  
• elevated or depressed temperature
  
• any number of problems with the incision/wound (dehiscence, evisceration, infection)
  
• fluid and electrolyte imbalances
  
• urinary retention
  
• constipation
  
• surgical pain
  
• nausea/vomiting (paralytic ileus)

and teach the patient how they can be avoided.

medical problems of hypertension and hyperlipidemia are of no interest in a care plan unless they have some influence on the nursing care or the symptoms the patient will have.

i have a 2-page preoperative care plan for a surgical patient in a pdf file that i can send to you, but i would need your e-mail address to do it. if you want to see this care plan send me your e-mail address in a pm (private message) and i will send it as an attachment to a return e-mail. i also have general intraoperative and postanesthesia care plans. these care plans were originally posted on the internet at a surgical nursing site but have since been removed. good thing i downloaded and saved them on my computer.

i would love to see the pdf files. can't find how to send a pm

[Daytonite, BSN, RN]

I would love to see the pdf files. Can't find how to send a PM

What PDF files are you referring to. No PDF files above.

[susanbeaver]

Thank you for getting back to me. I was wanting the PDF Files for Preop care plan for surgical patient and post anaesthesia care plan. Thankyou I really like reading your suggestions and sharing your knowledge.