Monday, February 10, 2020
Care of the highly dependent postoperative patient Essay
Care of the highly dependent postoperative patient - Essay Example He had a bloc resection of rectal cancer and had been treated with sigmoid colectomy. Right hemicolectomy fallowed by HIPES (treated intra peritoney chemotherapy) solitary liver metastasis. The patient came into recovery room breathing spontaneously. His blood pressure was110/60. His pulse 82, resps 9, SpO2 with oxygen 40% via face mask. Right Jugular CVP line left hand arterial line, intercostals x2, bupivacain 0.25%. Silicon drain and abovac plasma lite 1000. I.V. continued. CVP and arterial line has been attached to monitor. First 1/2 hour patient observation was done every 5 min.-ABCDE was administered. After 15 min. BP-high, puls-100, RR-normal. On question are u in pain, patient answer severe pain. Morphine PCA attached and explained how to use, continued with boluses of 2.5mg, morphine via PCA pump. After 1/2 hour arterial blood gas sample done, showing respiratory acidosis. Patient is with urinal catheter, urine output monitoring hourly. Fluids maintenance done, fluid balance monitoring hourly for 24 hours. This paper explores the post operative care of this patient. Variables such as the level of debility before surgery, operate complexity and severity of underlying cirrhosis appear to significantly influence the rapidity at which a patient progresses through his or her early postoperative recovery stage (Leaper, & Whitaker, 2010). Most of the key liver resections are attributed to the liverââ¬â¢s regenerative capacity. They are well tolerated by patients and it is rare for patients to experience biochemical abnormalities. Patients having compensated liver cirrhosis and the complications that come with it are more susceptible to intraoperative blood losses that make the organ functions to deteriorate and lead to the loss of its reserve capacity to withstand stress causing life-threatening complications (Leaper, & Whitaker, 2010).
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