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Week 6, Trigger 2

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by

Joseph Ashmead

on 3 September 2014

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Transcript of Week 6, Trigger 2

Justin Smith
You accept Justin from the PARU and take him back to the colorectal ward. After completing your routine post anaesthetic observations and assessments, you double check Justin’s Patient Controlled Analgesia (PCA) with another nurse prior to giving Justin the button, and then commence the narcotic infusion observations. You note that Justin is becoming increasingly drowsy; however at this stage you determine that no intervention is required
Learning outcomes
1. What are the routine assessments completed in the first 24 hours post general anaesthesia? (Provide rationale for assessments)

2. What are the nurse’s responsibilities in relation to monitoring someone with patient controlled analgesia?

1. What are the routine assessments completed in the first 24 hours post general anaesthesia? (Provide rationale for assessments)
• ASSESS RESPIRATORY ADEQUACY
To recognise early signs of respiratory complications and ensure return to normal function.

• ASSESS CARDIOVASCULAR STATE
To determine the return of the Justin’s normal CV function.

• ASSESS LEVEL OF CONSCIOUSNESS
To determine if any neurological complications has occurred postoperatively.

• PAIN ASSESSMENT
To Identify the location and level of any pain to assist in its management.


2. What are the nurse’s responsibilities in relation to monitoring someone with patient controlled analgesia?
References
Brown, D., Edwards, H., Lewis, S. L., Dirksen, S. R.,
Heitkemper, M. M., O'Brien, P. G., Bucher, L., Camera, I. (2012). Lewis's medical-surgical nursing : Assessment and management of clinical problems (3rd ed.). Chatswood, N.S.W: Mosby/Elsevier.

Grissinger, M. (2008). Safety and Patient-Controlled Analgesia. Pharmacy and Therapeutics, 33(1), 8-9.
Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730066/

Pca-pump [image].n.d.retrieved from http://ppahs.files.wordpress.com/2012/06/pca-
pump.jpg



Week 6, Trigger 2,
Justin Smith part 2

Joseph Ashmead
Henry Bullin
Georgina Belzacki
Markus Contarino
Kabita Dhungana
Kevin Isaac

Pca-pump [image].n.d.retrieved from http://ppahs.files.wordpress.com/2012/06/pca-pump.jpg
......Continued
Brown, et.al (2012)
Brown, et.al (2012)
Brown, et.al (2012)
Grissinger, (2008)
NAUSEA AND VOMITING ASSESSMENT
To avoid respiratory obstructions and relieve discomfort. Any vomitus needs to be assessed to identify source and possible complications.

URINE OUTPUT
To maintain fluid balance and avoid hypovolaemia.

WOUND & DRAIN ASSESSMENT
To ensure surgical wound has been sealed effectively and haemorrhaging is within expected limits.

Provide education on usage and medication type and its effects.

Pain assessment to ensure dosing and drug type is effective.

Vital sign and LOC monitoring to avoid overdosage / toxicity.
Full transcript