Question

                                 Case study: Care of the patient with Atelectasis

mildred north is admitted with acute cholecytittis, elvate white blood cell count and a fever of 102 degrees. she has undergone a cholecytectomy and has been transferred to your unit. its is her second day postoperatively. she has a nasogastric tube to continuous low wall suction, one peripheral iv in her left hand, and a large abdominal dressing. her orders are as follows:

• progress diet to low fat diet
• d5 in ½ normal saline with 40 meq potssium to at 125 ml per hour
• turn, cough and deep breathing every 2 hours while awake
• dangle in am; ambulate in pm
• morphine sulfate 10 mg im every 4 hours pm for pain
• ampicillin (omnipen) gm 2 ivpb every 6 hours
• tyrnol 325 mg rectal suppository every four hours for temperature above 100.4
• chest x-ray in am

5.explain the differences in suction between a levine tube and salem sump

6.explain the rationale why this patient would have gastrointestinal suction

7.Identify the specific electrolytes complications and acide-base balance destrubances when the patient has gastric suction and defend your answer

you know that Mrs. North is at risk for atelectasis and /or pnemonia

8.Discuss the pathophysiology of atelectasis is and why this patient is at risk

9.Discuss the differences (s) between pnemonai and atelectasis

After morning report, you do an assessment and auscultate decreased breath sounds and crackles in the posterior right lower lung base,her right middle lobe and right lower lobe percuss dull.

She splints her right side whe taking a deep breath. You suspect she is developing atelectasis.

10.Identify what most likely accounts for the patient’s inspiratory related behavior

11.List five (5) nursing interventions that might be used to prevent pulmonary complications postoperatively

12.Identigy four (4) positive outcomes that you would expect for this patient as a result of your interventions and her increased activity.

Mrs. North sister questions you saying “I don/t understand. she came in here with a bad gallbladder. what has happened to her lungs?’

13.Explain how you would respond to the question.

14.Discuss patient teaching about a low fat diet and why this is imporant for this patient.

15.Develop a 24-hour sample low fat diet for this patient

Answer 1

Q. No. 5. Answer :

Differences In suction between Salem sump and Levine tube is, the Salem sump is having double lumen tube, one is for suction and drainage and one is small tube it is for ventilation, it allows the atmospheric air enters into the patients stomach so that tube floats freely and does not cause damage to the stomach or gastric mucosa.

But Levine tube has not have two lumens, so it may leads to damage to the stomach mucosa , it is the difference inbetween that.

Q. No. 6. Answer :

Patient is having gastrointestinal suction, because patient is undergone to cholecystectomy so the drain will be there.

Q. No. 7. Answer :