SECOND DAY OF ADMISSION AND DAY OF OPERATION (05-01-10)
Based on the results of the various investigations, it was ordered by a senior doctor on review to prepare the client for urgent surgery (laparotomy).
The client and family were informed about it and they were reassured. This gave the opportunity for the client and family to be educated on the disease condition, the cause, the signs and symptoms, the prevention, and the complications.
Around 5:30 am, the client was allowed to empty the bowel, she was assisted to care for the month, bed bathed, and groomed.
It was explained to the client the need for surgery to be done and she gave her consent by thumb printing on the consent form.
The client was shaved from the nipple line to the middle of the thigh including the genital area and was washed with an antiseptic solution. It was also inspected to find out and remove any dentures to prevent dislodgement or foreign body during procedures.
The client had no rings or prostheses on her. She was assisted to put on a theatre gown and hair cap. Due antibiotics were given and vital signs checked and recorded as follows;
Temperature – 37.4 ºC
Pulse – 106 bpm
Respiration – 22 CPM
Blood pressure- 130/90 mmHg
This was to serve as a baseline data to monitor any deviation during surgery and post-surgery.
All needed particulars, laboratory results, x-ray results, IV fluids, and medication together with the patient on the trolley were taken to the theatre.
The client held my hands and prayed to God to see her through the surgery. She was then handed over to the anesthetist for an anesthetic assessment to be done at the theatre door.
After the surgery, Miss Akosua Naa was sent to the intensive care unit for monitoring until she regained consciousness. Her vital signs were monitored as requested by the surgeon. This is shown in appendix 1, the table I.
She was a nurse in a recumbent position with the head tilted to one side to aid in the secretion of drainage and easy breathing, side rails were raised in support to prevent falling when regaining consciousness from anesthesia.
Resuscitation equipment was assembled at the bedside in readiness for possible emergencies such as asphyxia.
Strict intake and output of fluid and electrolytes were maintained. This was recorded daily as illustrated in appendix 2.
Other nursing cares such as administration of drugs, an inspection of the operation site, emptying of drainage bags were performed. Miss Akosua Naa regained full consciousness at around 5:00 pm and when she was stable she was trans- out to ward C1B for the continuation of care.
Ready in the ward, was a neatly prepared operation bed with all the necessary accessories including temperature tray, blood pressure apparatus, drip stand, resuscitation tray, sanction machine, and oxygen apparatus. This was to arrest any emergencies in case it occurs.
Client pain consent was addressed post-operatively by implementing nursing interventions such as nursing clients on the unaffected side and using a bed cradle to lift the weight of bed linen on the incisional site and checking recording vital signs.
Prescribed analgesics were also given.