Question

Pre oprative Care

Veronica Mattel is a 57 y. o. female. She is divorced and her ex-husband is a real estate developer in Malibu, CA. Veronica has been evaluated for significant uterine bleeding and is scheduled for an abdominal hysterectomy. She lives alone in a townhouse in Woodbury, but her daughters both live within the Twin Cities area. She has recently retired as a flight attendant and moved from California to be closer to her daughters. Up to this point, Veronica has been quite healthy except for prehypertension and treatment for atrial fibrillation 5 years ago. Her only previous surgery was an appendectomy in her late 30s. Besides her two daughters, she also had a daughter who died of cancer two years ago.

She has been taking St. John’s Wort for some mild depression and melatonin to help her sleep. Up until the bleeding became a problem, she had been taking one low dose aspirin daily. She is on a diuretic/ACE inhibitor for her hypertension.

VS: BP: 140/90; P: 88; R: 16; T: 98.4; 5’9”; 122 #; Allergic to nickel, kiwi, contrast dye, and Zoloft.

Other preoperative labs:

Hgb: 11.1 g/dL;

Na: 125 mEq/L;

K: 3.2 mEq/L

BUN: 25 mg/dL

Creatinine: 1.6 mg/dL

After your intervention, Veronica states she feels better and her anxiety is reduced. After the teaching has been done, the patient prep has been completed, and the consent is obtained, Veronica is moved to the surgical area.

1. How will you promote safety during her transfer to the surgical gurney/cart?

2. What information should be documented? What priorities would you have for a verbal report?

Answer 1

Abnormal Uterine bleeding is when the bleeding occurs between the monthly menstruation. The most common causes for abnormal uterine bleeding are uterine /cervical cancer,fibroids,polyps,blood thinners used to treat blood clots,hormonal changes, polycystic ovarian syndrome. Abdominal hysterectomy a surgical procedure involves in removal of uterus.

To ensure safe transfer of the patient from the bed to surgical cart it is responsible for the nurses to select the method of transfer that includes proper securing of IV lines,mobility level of the patient, size and age of the patient to determine the strength needed to transfer the patient.

Before transporting the patients lock the wheels of the cart,apply safety straps, ability to use patient transfer devices. Arrange for adequate number of people to transfer the patient. For the conscious,mobile patient two personnel are need to shift the patient. Elevate the side rails of the bed,ensure head,arms and legs of patients are adequately protected to prevent injury. Use smooth,unjerky movement to move non mobile patient. Should consider the dignity of the patient during the transfer process by ensuring proper covering of the patient. Instruct patient to move as per the command.

Information to be recorded are preoperative preparation done like obtaining consent part preparation, preoperative drug administration, anesthesia fitness, health teaching,preoperative anxiety assessment and anxiolytic drug administration.

Verbal report includes

She has been taking St. John’s Wort for some mild depression and melatonin to help her sleep. Up until the bleeding became a problem, she had been taking one low dose aspirin daily. She is on a diuretic/ACE inhibitor for her hypertension.

VS: BP: 140/90; P: 88; R: 16; T: 98.4; 5’9”; 122 #; Allergic to nickel, kiwi, contrast dye, and Zoloft.