Question

Mildred North is ad PN 200 Fundamentals of Nursing II Case Study: Care of the Patient with Atelectasis this admitted with acute cholecystitis, elevate white blood cell count and a Srees. She has under cholecystectomy and has been transferred to your day postoperatively. She has a nasogastric tube to continuous low wall Meral IV in her left hand, and a large abdominal dressing. Her orders are as unit. It is her second day posto follows: Progress diet to low fat diet DS in normal saline with 40 mi: 4 normal saline with 40 mEq potassium to run at 125 ml per hour urn, cough and deep breathe every 2 hours while awake Incentive spirometry every 2 hours while awake Dangle in AM; ambulate in PM Morphine sulfate 10 mg IM every 4 hours prn for pain Ampicillin (Omnipen) Gm 2 IVPB every 6 hours Tylenol 325mg rectal suppository every four hours for temperature above 100.4 Chest X-ray in AM 1. Explain the rationale for the use of incentive spirometry for this patient 2. Explain why you would need to turn off the suction when assessing bowel sounds 3. Identify the GI complication that may result from one of the medications the patient is receiving postoperatively 4. State the two (2) most common respiratory related complications for patients with abdominal or respiratory surgery 5. Explain the differences in suction between a Levine tube and a Salem sump. 6. Explain the rationale why this patient would have gastrointestinal suction 7. Identify the specific electrolytes complications and acid-base balance disturbances when the patient has gastric suctioning and defend your answer You know that Mrs. North is at risk for atelectasis and/or pneumonia 8. Discuss the pathophysiology of telectasis is and why this patient is at risk. 9. Discuss the difference(s) between pneumonia and atelectasis

Answer 1

1.The risk for infection especially the respiratory infection are very common due to secretion after an abdominal surgery.It also helps to expand the lung volume and reduce fluid accumulation in the lungs.

2. When assessing the bowel sounds ,a suction which is on can interrupt from hearing it clearly.There are chances for error,in order to prevent this it is turned off.

3. The prescription containing the antibiotic ampicillin can cause the following gastrointestinal complications like

• Nausea vomiting
• Diarrhea with blood
• Abdominal pain
• Glossitis
• Gastrointestinal bleeding

4.The common respiratory problem after an abdominal or respiratory surgery are

• Pneumonia
• Pulmonary edema
• Pulmonary thromboembolism