Which interventions or orders would you anticipate performing or preparing for? Why would you choose these?
The most important things to do for this patient would be to stabilize her and keep her as comfortable as possible. Therefore, the patient will need an analgesic, preferably an opioid to help with the pain and make her comfortable.
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It is also important to keep reassessing her airway, breathing and circulation to monitor for any desaturation. Be ready to resuscitate.
The patient will need to be connected on to a monitor for continuous monitoring of her vital signs, which include the blood pressure, respiratory rate, temperature and the pulse rate also the oxygen saturation levels.
Blood samples for full blood count, electrolytes, urea and creatinine, grouping, and cross matching should be drawn and sent to the laboratory for analysis.
Lastly, according to Fauci et al. (2018), since the patient is mostly complaining of back pain and appears pale, abdominal ultrasound or an abdominal CT scan if available should be done to check for any bleeds.
Your patient needs an immediate surgical intervention. Which interventions or orders would you now anticipate performing, or preparing for? Why would you choose these?
After a leaking abdominal aortic aneurysm was found, a decision to take the patient to the theatre was made. The patient will need to have the following things done for her;
1 The patient will need to be fixed with two wide bore intravenous cannulas and crystalloid fluids given for fluid resuscitation. Urinary catheterization done to monitor input and output.
2. An electrocardiogram should be done to check for any abnormalities.
3. According to the article “Perioperative Management” (2020), the patient will need antibiotics for prophylaxis before the procedure.
4. The patient will also need to be put on nil per oral to reduce the chances of regurgitation and aspiration during surgery
5. She will need to sign a consent to allow the surgery to go ahead and this is where the expected outcomes and the risks are explained.
It is also very important to take care of the psychological needs of the patient by addressing them to alleviate their fear and anxiety (Preoperative Care, 2020). This support should be extended to the family members too.
Which tasks could you delegate to unlicensed assistive personnel (UAP)?
There are a few tasks can be delegated to unlicensed assistive personnel. First, they can help with the patient change from home clothes to the theatre gown. Secondly, they can help with documentation of vital signs. Lastly, they can also help move the patient from one point to the other.
As the RN, what must you be sure of before you delegate to a UAP?
According to the article “Unlicensed assistive personnel (UAP)” (2020), the nurse should ensure that the person being delegated to is competent. The nurse should also supervise the task being done and must be ready to be accountable in the event anything happens.
References
Fauci, A., Braunwald, E., Kasper, D., Hauser, S., Longo, D., Jameson, J., & Loscalzo, J. (2008). Harrison's principles of internal medicine (17th ed.). McGraw-Hill Prof Med/Tech.
Preoperative Care . (2020). Encyclopedia of Surgery. https://www.surgeryencyclopedia.com/Pa-St/Preoperative-Care.html
Pre-operative management . (2020, July 7). TeachMeSurgery. https://teachmesurgery.com/perioperative/preoperative/management/
Unlicensed assistive personnel (UAP) . (2020). Academy of Medical-Surgical Nurses. https://www.amsn.org/practice-resources/position-statements/archive/unlicensed-assistive-personnel-uap
