Same Day Surgery
During same day surgery, I shadowed Nurse Laura, BSN, RN. We prepared four patients for their procedures. The first patient was an 81 year old, white male. He was a patient of Dr. Workman in for a medi-port placement. A medi-port is one type of a central venous access device. This port can remain in place for years and is often inserted for patients who receive long term IV medications and who require frequent blood draws causing less discomfort for the patient. The port is surgically inserted under the skin. The catheter runs form the portal and is surgically inserted into a vein, either the jugular or subclavian. This allows medications to be spread throughout the body quickly and efficiently (Treas 794). This patient was receiving the medi-port because it would be more beneficial during his chemotherapy treatments. I was not able to observe nurse care for this patient due to time of arrival; however, I introduced myself to Mr. C.F and got a brief background history. He was diagnosed with adenocarcinoma esophageal cancer. The esophagus is the tube that allows food travels from the mouth to the stomach. What happens in adenocarcinoma is the cancer cells start replacing the normal lining of the lower esophagus (Lewis 937). He has a history of smoking and GERD. I would not see him post-operatively because they were taking him to the oncology wing to start chemotherapy. My next patient was Mr. F.T. He was a 77year old, white male scheduled for a computed tomography (CT) guided tunneled abdominal drain placement. He was not currently receiving dialysis but is in renal failure. His creatinine was 3.4mg/dL and BUN was 28mg/dL, which both are elevated and the GFR decreased at 30 ml/min. The catheter was going to be placed in the peritoneal cavity to filter wastes and extra fluid. Mr. F.T was a pleasure to have and was not able to have his procedure during my service. Mr. F.T.’s bloodwork showed a significant decrease in platelets, red blood cells, hemoglobin, hematocrit, and white blood cells. He had bruising all over his face and body. Two weeks ago, Mr. F.T had a platelet count of ten. The day of surgery, his platelet count was five. Normal platelet counts are between 150,000 and 400,000/µL. Counts below 100,000µL are considered thrombocytopenia (Lewis 627). The function of the platelets is to initiate the clotting process; thus, putting him at a major risk of hemorrhage if he was to have the surgery (Lewis 616). Dr. Workman ordered a platelet transfusion. I took his vital signs before transfusion, at the start of transfusion, and fifteen minutes after transfusion. The lab came down and did all of his blood work. Dr. Workman refused to do the surgery until consulting with the patient’s primary doctor about the patient’s current and previous condition. His primary doctor no longer would do procedures at JRMC. I kept Mr. F.T and his wife comfortable …show more content…
Mr. M.J. was not on any medication and was receiving the colonoscopy for screening due to age. I took his vitals and Mrs. Laura inserted his I.V. He left within five minutes of us working him up. The last pre-operative patient I was able to assist with was 77 year old, R.W, a white female in for a sonography. Ms. R.W. was receiving a sonography because she had a wound underneath her stomach that will open and gush blood at random times and then close back up. The sonography was going to try and determine what might be causing the wound to open. A sonography is a diagnostic procedure that visualizes body tissue structures or wave-form analysis. This ultrasound can detect tissue abnormalities such as masses, cysts, edema, and stones (Kee 620). I was able to go get a wheelchair and get Ms. R.W. from the waiting room by myself. I weighed her, began her vitals, and assisted her with a clothing change. We received Ms. R.W. around the time Mr. F.T.’s platelet transfusion, so Ms. Laura had me watching Mr. F.T for the majority time of Ms. R.W.’s work up. I did get to observe the wound. It was located on the left side under the abdominal skin fold. The wound was tunneled with no edema, erythema, or drainage. It was
During same day surgery, I shadowed Nurse Laura, BSN, RN. We prepared four patients for their procedures. The first patient was an 81 year old, white male. He was a patient of Dr. Workman in for a medi-port placement. A medi-port is one type of a central venous access device. This port can remain in place for years and is often inserted for patients who receive long term IV medications and who require frequent blood draws causing less discomfort for the patient. The port is surgically inserted under the skin. The catheter runs form the portal and is surgically inserted into a vein, either the jugular or subclavian. This allows medications to be spread throughout the body quickly and efficiently (Treas 794). This patient was receiving the medi-port because it would be more beneficial during his chemotherapy treatments. I was not able to observe nurse care for this patient due to time of arrival; however, I introduced myself to Mr. C.F and got a brief background history. He was diagnosed with adenocarcinoma esophageal cancer. The esophagus is the tube that allows food travels from the mouth to the stomach. What happens in adenocarcinoma is the cancer cells start replacing the normal lining of the lower esophagus (Lewis 937). He has a history of smoking and GERD. I would not see him post-operatively because they were taking him to the oncology wing to start chemotherapy. My next patient was Mr. F.T. He was a 77year old, white male scheduled for a computed tomography (CT) guided tunneled abdominal drain placement. He was not currently receiving dialysis but is in renal failure. His creatinine was 3.4mg/dL and BUN was 28mg/dL, which both are elevated and the GFR decreased at 30 ml/min. The catheter was going to be placed in the peritoneal cavity to filter wastes and extra fluid. Mr. F.T was a pleasure to have and was not able to have his procedure during my service. Mr. F.T.’s bloodwork showed a significant decrease in platelets, red blood cells, hemoglobin, hematocrit, and white blood cells. He had bruising all over his face and body. Two weeks ago, Mr. F.T had a platelet count of ten. The day of surgery, his platelet count was five. Normal platelet counts are between 150,000 and 400,000/µL. Counts below 100,000µL are considered thrombocytopenia (Lewis 627). The function of the platelets is to initiate the clotting process; thus, putting him at a major risk of hemorrhage if he was to have the surgery (Lewis 616). Dr. Workman ordered a platelet transfusion. I took his vital signs before transfusion, at the start of transfusion, and fifteen minutes after transfusion. The lab came down and did all of his blood work. Dr. Workman refused to do the surgery until consulting with the patient’s primary doctor about the patient’s current and previous condition. His primary doctor no longer would do procedures at JRMC. I kept Mr. F.T and his wife comfortable …show more content…
Mr. M.J. was not on any medication and was receiving the colonoscopy for screening due to age. I took his vitals and Mrs. Laura inserted his I.V. He left within five minutes of us working him up. The last pre-operative patient I was able to assist with was 77 year old, R.W, a white female in for a sonography. Ms. R.W. was receiving a sonography because she had a wound underneath her stomach that will open and gush blood at random times and then close back up. The sonography was going to try and determine what might be causing the wound to open. A sonography is a diagnostic procedure that visualizes body tissue structures or wave-form analysis. This ultrasound can detect tissue abnormalities such as masses, cysts, edema, and stones (Kee 620). I was able to go get a wheelchair and get Ms. R.W. from the waiting room by myself. I weighed her, began her vitals, and assisted her with a clothing change. We received Ms. R.W. around the time Mr. F.T.’s platelet transfusion, so Ms. Laura had me watching Mr. F.T for the majority time of Ms. R.W.’s work up. I did get to observe the wound. It was located on the left side under the abdominal skin fold. The wound was tunneled with no edema, erythema, or drainage. It was