Question

PN 200 Fundamentals of Nursing II Concept Map - Care of the Operative Patient A health 14-year-old boy, Robert Kipling, is admitted to the emergency room. Approximately four (4) hours ago, he was rollerblading and fell while (4) hours ago, he was rollerblading and fell while jumping over som obstacles. His left arm was caught under him as he et arm was caught under him as he fell. He had a very sudden sharp pain in LUQ immediately after the fall. The pain "eased brought him to the emergency room because he fainted every time he tried nausea and vomiting twice. Robert appears somewhat pale and sig wang twice. Robert appears somewhat male and slightly diaphoretic. He denis shortness of breath or dizzy when lying down. VS are 104/52, (supine) P. 92, R but now is returning. His mother led every time he tried to stand up. He C/O Sare 104/52, (supine) P. 92, R. 24 and afebrile. 1. List the key symptoms Robert is presenting with The local emergency room is a Level 2 and cannot appropriately care for the patient. patient is transported to your emergency department which is five (5) miles away. You are the nurse receiving the patient. 2. State what your first step would be. Robert does not have complaints of dizziness, shortness of breath or nausea or vomiting while lying down. A CT scan is completed revealing a ruptured spleen. He needs to have surgery immediately. 3. Identify additional information that is required prior to sending the patient to the operating room 4. List the laboratory tests that need to be completed before the patient is taken to the operating room Robert is taken to the operating room and undergoes an exploratory laparotomy and a splenorhaphy. 5. State why a splenorrhaphy rather than a splenectomy would be done. Robert is 14 years old and heals rapidly. He is discharged home on the 5th postoperative day after having his sutures removed. 6. State five (5) factors that were in favor of his wound healing quickly Reviewed 10/19

Answer 1

1. list key symptoms Robert presenting with

sudden sharp pain, fainting when try to stand up, nausea, vomiting, pale, diaphoresis, shortness of breath.

2.Insert a large bore cannula and administer IV fluid prescribed by the doctor and collect the blood for investigation.

3.The last time has taken food.

4.Laboratory test are the following

• Complete blood count
• Liver function test
• kidney function test
• blood sugar
• APTT, PT INR
• BT, CT
• Viral markers
• grouping and cross matching

​​​​​​​5.It is a traumatic splenic injury and is safety procedure. If spleen shattered splenectomy is advised.

6. Adequate nutrition ie protein and vitamin c

sleep help cells multiply more rapidly

Age ie children heal more rapidly than older people

lack of infection

Adequate blood supply

lack of stress ie stress increase adrenaline and steroid which impaired healing.

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