Question

Mr, Owen is a 62-year-old man underwent a neck dissection yesterday due to cancer of the mouth. You are the nurse assigned to care for Mr. Owens during his first postoperative day. Initial assessment finds Mr. Owens sitting up in bed: he is drowsy, but not appear to be in respiratory distress. His respiratory rate is 16 to 18, and his oxygen saturation is 96% on 40% oxygen via face tent. He has two peripheral IV lines both infusing Lactated Ringer's solution at 75 ml/hr. Two Jackson Pratt drainage tubes are partially filled with serosanguinous drainage, (Learning Objective 5)

a. What is the rational for the patient being placed in Fowler's position after surgery?

b. The nurse notes that there has been 240 ml output in the drainage tubes during the first 24 hours after the surgical procedure. What should the nurse do?

c. Postoperatively, the nurse identifies that the patient is at risk for imbalanced nutrition, less than body requirements related to anorexia and dysphagia. The nurse instructs Mr. Owen to eat soft food and suggests that he tilt his head to the unaffected side to facilitate swallowing. What is the rationale for these instructions?

d.In reviewing Mr Owens medical record, what findings in his health history are associated with development of oral cancer?

Mr, Owen is a 62-year-old man underwent a neck dissection yesterday due to cancer of the mouth. You are the nurse assigned to care for Mr. Owens during his first postoperative day. Initial assessment finds Mr. Owens sitting up in bed: he is drowsy, but not appear to be in respiratory distress. His respiratory rate is 16 to 18, and his oxygen saturation is 96% on 40% oxygen via face tent. He has two peripheral IV lines both infusing Lactated Ringer's solution at 75 ml/hr. Two Jackson Pratt drainage tubes are partially filled with serosanguinous drainage, (Learning Objective 5)

a. What is the rational for the patient being placed in Fowler's position after surgery?

b. The nurse notes that there has been 240 ml output in the drainage tubes during the first 24 hours after the surgical procedure. What should the nurse do?

c. Postoperatively, the nurse identifies that the patient is at risk for imbalanced nutrition, less than body requirements related to anorexia and dysphagia. The nurse instructs Mr. Owen to eat soft food and suggests that he tilt his head to the unaffected side to facilitate swallowing. What is the rationale for these instructions?

d.In reviewing Mr Owens medical record, what findings in his health history are associated with development of oral cancer?

Answer 1

A. The rationale for the patient being placed in Fowler's position is that it will allow the expansion of lungs and easy flow of the drainage by garvity and also to prevent aspiration.

B. First of all the nurse should document the volume of drainage in the input and output chart . Basically the output should be 30ml/hr . So, in 24hrs it should be 24× 30 = 720ml and should inform the physician about the less volume of drainage .

C. The rationale for the instruction is that it will not disturb the healing tissues on the surgery side and hence it will not cause pain .

D. The findings in the medical record of Mr. Owen which are associated with the development of oral cancer are :-

- usage of tobacco

- heavy alcohol intake