Three nursing interventions for a post-operative patient
The three nursing interventions that can be offered to a post-operative patient include the diagnosis for acute pain, diagnosis for nausea and diagnosis for risk levels for infection (Heater, Becker, & Olson, 2008). Acute pain that is related to reflex muscle and surgical incision are diagnosed by complaints of restlessness, pain, irritability and facial grimacing. This type of pain can be corrected by assessing the location of the patient’s pain and giving him or her appropriate analgesic and teaching and then assessing their correct usage of the same. Other than drugs, other methods such as massage, distraction and imagery may be used to reinforce drug effects.
Nausea which comes about as a result of medication, anesthesia and gastrointestinal distension manifests itself in form of complaints which are observed or even reported as nausea together with refusal to ingest food. It can be corrected by identifying and if possible eliminating factors that may trigger vomiting, assess bowel sound to determine their frequency and characteristic, prevent the buildup of gastric secretions by maintaining patency of nasal-gastric tube and administration of antiemetic as prescribed (Heater, Becker, & Olson, 2008).
Another intervention is checking the risk levels for infection related to the surgery, low fluid and nutrient intake, immobility and germs in the environment. These infections can be minimized by reporting any signs and symptoms that may point towards infection such as fever, increased pulse and swollen and itchy area surrounding the point of incision. In addition to that, the strict antiseptic technique should be used while taking care of the wound to avoid contamination. The correct dosage should be followed in administering antibiotics and the patient should be turned regularly and assisted in breathing and coughing to clear the air passage thus preventing respiratory infections.
Patient findings that can be noticed on patients experiencing immobility issues
Generally, the effects of immobility issues causes the following noticeable findings to patients; muscle weaknesses, spinal disorders such as neck pain and cervical spine, leg weaknesses, skin swellings among others.
Muscle weaknesses are clearly noticed with patients experiencing immobility complications since they practically struggle to perform whatever they wish using their muscles. In these instances, their muscles become abnormal. In essence, the muscle become floppier than usual thus reduces its bulkiness. Again, muscle tiredness, which is often referred to as asthenia may also be noticed. Here, the muscle is not actually weaker but it takes a lot of effort to perform its job. Also, muscle fatigability may be realized due to immobility issues. In this case, the muscle begins like in normal situations but tires off very fast and it requires more time for it to recover (Allman, Goode, Patrick, Burst & Bartolucci, 2015).
Damaged skin is another noticeable finding for those patients suffering from immobility issues. The fact that the skin takes part in excretion processes, failure to eliminate wastes makes the skin susceptible to damages and swellings. During instances of immobility, the patient normally tends to overlie or sit on certain body parts subjecting the skin cover at such area to constant pressure resulting from the body weight. In the process, blood vessels which supply the skin are compressed thus limiting the supply of nutrients and oxygen. Therefore, skin areas may break down causing pressure ulcers especially over areas considered bony like sacrum, heels and hips.
Complications occurring due to immobility for all body systems
Respiratory complications: Immobility results to the chest muscles becoming weak thus decreasing expansion of the lungs hence causing shallow breathing. Coughing which is fundamental in clearing of lungs becomes less efficient and weak, and this causes secretions to accumulate in the lungs increasing the risk of pneumonia and collapse of alveoli by blocking small airways. As a result, there is reduced the supply of oxygen to the body resulting to short breaths and overworking the heart.
Cardiovascular complications: The heart being a muscle decreases when mobility decrease. As a result, circulation slows down resulting in short breaths and fainting when normal activities in the body resume. The sensitivity of nerves regulating the blood pressure slows down increasing the risk to postural hypotension. Slow circulation also causes blood clots in lungs or legs and also dependent edema, swelling of the lower part of the body (Allman, Goode, Patrick, Burst & Bartolucci, 2015).
Neurologic complications: Immobility impacts negatively on the nerves that control key functions of the body resulting in low blood pressure on standing, lack of coordination and increased risk of falling.
Metabolic problems: Due to immobility the patient’s appetite reduces as not much calories are burnt. It leads to weight loss and consequently malnutrition if enough attention is not paid to the patient’s food intake.
Skin problems: Because the elimination of wastes and oxygenation are affected, the skin becomes prone to damage and takes longer time to heal. The skin on which the patient is resting on becomes damaged due to the constant body pressure it is subjected to leading to pressure ulcers, especially on bony areas like the hips and sacrum (Allman, Goode, Patrick, Burst & Bartolucci, 2015).
Gastrointestinal complications: the GI system slows done hence the fecal matter also moves slowly, giving water more time to be reabsorbed into the body. Consequently, the fecal mass hardens and this causes constipation.
Immobility also causes urinary complexity as it results in accumulation of urine in the kidney due to poor drainage. This not only causes kidney stones due to changes in calcium balance but also increases chances of urinary tract infections.
References
Heater, B. S., Becker, A. M., & Olson, R. K. (2008). Nursing interventions and patient outcomes: A meta-analysis of studies. Nursing Research, 37(5), 303-307.
Allman, R. M., Goode, P. S., Patrick, M. M., Burst, N., & Bartolucci, A. A. (2015). Pressure ulcer risk factors among hospitalized patients with activity limitation. Jama, 273(11), 865-870.
