Question

1. Pearl Richards, 69 years of age, is a female patient who is in the operating room for a repair of an abdominal aortic aneurysm. The patient has a history of hypertension controlled with medications, osteoporosis, chronic obstructive pulmonary disease, and has smoked two packs of cigarettes per day for 40 years. a. What nursing interventions are instituted to reduce the surgical risk factors related to the patient's age? b. Explain the role of the nurse in providing patient safety measures during the intraoperative period.

Answer 1

Pearl Richardsen is a chronic smoker, hypertensive controlled on medication, osteoporosis, COPD, and is of 69 year of age was undergoing abdominal aortic aneurysm. The nursing intervention which can be reduce the risk factors can be to make the patient was adequate saturation with oxygen, blood pressure on control, not taken any cigarettes in the morning etc can reduce the surgical risk. If the patient having any breathing difficulty such as any cough in the chest the nursing intervention such as chest physiotherapy can be carried out to reduce the same.

In the intraoperative period also, the vitals should have been watched properly, especially the blood pressure and the saturation, if there is any fall on these things it has to be explained to the surgeon. Make sure that client is prepare for the surgery and explained clearly about the procedure, because the new environment and new people can increase the tension. So, the proper education and introducing to the team etc can be done.

Malignant hyperthermia is a rare inherited disease that causes rapid onset of extremely high body temperature with muscle rigidity and muscle injury in people exposed to certain types of anaesthesia. It is a genetic predisposing disorder so may have family history of the same can act as risk factor.

It usually manifesting in the operating room when exposed to certain anaesthesia, muscle rigidity and muscle injury with increase in temperature.

The anaesthesia gas is the trigger for the malignant hyperthermia, so it has to be stopped and thus stopped the surgical procedure, 100% oxygen was started because the respiratory muscle may not be functioning well because the rigidity so, to maintain the saturation oxygen was given, apart muscle relaxant was given to reduce the rigidity of muscle and sodium bicarbonate to treat the metabolic acidosis as there will be accumulation of CO2 in the blood.