Case Study, Chapter 17, Preoperative Nursing Management

1. Joan Arnold, 67 years of age, is a female patient who underwent a coronary angiogram that diagnosed severe coronary artery disease in three of her coronary arteries, the left anterior descending, the left circumflex, and the right coronary artery. She is scheduled for a coronary artery bypass graft operation tomorrow. The nurse provides patient education for Mrs. Arnold and her husband, which includes watching a hospital video on the operation, the intensive care environment, what to expect after the surgery, the recovery period, and cardiac rehabilitation. The video also covered the importance of coughing and deep breathing, using an incentive spirometer, splinting, early ambulation, pain medication, and how to position oneself safely. The video stressed the importance of not rolling onto the side that the chest tube may be in place postoperatively. The video also discussed the preoperative preparation. The nurse also provided a booklet on the subject material. The nurse had a session with the patient and her husband to assess their understanding and to answer any questions they may have had. 

1. What specific preoperative nursing measures should the nurse review with the patient to help decrease the risk for postoperative complications?
2. Explain the role of the nurse when implementing the immediate preoperative preparation the day before surgery and the morning of the surgery?

2. The nurse in a gynecology clinic is completing preoperative teaching for a patient scheduled for an abdominal hysterectomy next week. The patient states that she is currently taking 325 mg of aspirin daily for chronic joint pain, along with a multivitamin. The patient has type 2 diabetes; she closely monitors her blood glucose levels. Currently, she is taking an oral hypoglycemic agent. The nurse advises her to ask the anesthesiologist whether she should take this medication the morning of surgery. 

1. The nurse instructs the patient to stop taking the aspirin. What is the rationale for this action?
2. Why is it important to assess the patient for use of herbal products prior to surgery?

c.The patient asks how surgery could affect her blood glucose; how should the nurse respond?

Describe and provide rationale for which design you plan to use in   your DPI project. Be sure to describe how your methodology is in line   with your project questions. 1 page, APA

 This project will use the quantitative methodology with a descriptive research design.

Topic:  Use of Advanced Practice Providers in triage in improving waiting times in Emergency departments? 

Holloway, I., & Galvin, K. (2016). Qualitative research in nursing and healthcare. John Wiley & Sons.

Respond to your colleagues, offering additional/alternative ideas regarding opportunities and risks related to the observations shared.

  At least 2 references in each peer responses!

In my healthcare organization, there are many general healthcare technology trends we use daily. Most frequently, the use of the electronic health record (EHR), which is essentially a digital version of a paper chart (HealthIT.gov, 2018c). These EHR’s contain vital information for assessment and treatment for patients. The medical history, allergies, current medications, and treatment plans are all examples of what can be in the EHR (HealthIT.gov, 2018c). In addition to the chart containing all this information, it makes it accessible for all workers involved in the patient’s care to share information over a secure server. For example, physicians, nurses, laboratories, and pharmacies can all view vital healthcare information as well as share information among each other (HealthIT.gov, 2018c).

One potential drawback to using the EHR is patient perception. The use of the computer is vital to patient care and sometimes distances us from the patient or family members. In the last 30 years, the computer has come between this patient-centered approach to patient care (Sobral, Rosenbaum, & Figueiredo-Braga, 2015). It is widely known that a patient-centered approach brings better compliance, patient outcomes, and better patient satisfaction (Sobral, Rosenbaum, & Figueiredo-Braga, 2015). One benefit is that patients can easily access their lab and test results and communicate with physicians at home through patient portals. In the environment we live in, healthcare providers need to have the knowledge and skills necessary to recommend and navigate these digital tools (Skiba, 2017).

The healthcare trend I think is most promising, is telehealth. Just this week, my husband and I have both utilized these services with the COVID-19 restrictions on leaving the house. If someone is exhibiting symptoms of COVID-19, instead of leaving the house to see a doctor for mild symptoms, a call can be made from home and possibly prevent the spread of disease to others. Medicare has even gone so far as to expand payment for telehealth to ensure people feel comfortable using this type of technology in hopes of preventing the spread of COVID-19.

Write for your organization a 3–5-page impact report regarding the  health concerns of a new immigrant population. Describe the population’s  health concerns and issues, explain current pharmacological treatments,  and explain how culture and traditional practices may affect use of  pharmacology. Identify evidence-based strategies for the organization  and nursing staff to use to educate the population and promote health  and wellness.

Imagine the county health department notifies your organization that a  large number of immigrants are expected to be resettled in your area.  The organization, wanting to be prepared to handle any health concerns  of the population, tasks each department with readying for the influx of  immigrants. Your supervisor asks you to prepare an impact report on the  pharmacological needs of the population that can be shared with other  departments.

Preparation

Complete the following as you prepare for your impact report:

1. Choose one of the global areas below as the area from which the population will be coming.      
   • Sub-Saharan Africa.
   • India.
   • China.
   • Dominican Republic.
   • Guatemala.
   • Jamaica.
   • Bangladesh.
   • Saudi Arabia.
   • Pakistan.
   • Mexico.
2. Research the most common health concerns and issues for  immigrants from your chosen global area, the pharmacological treatments  that will likely be prescribed, and any cultural values or traditional  practices that may impact patient outcomes.

Requirements

Once you have identified the population you will be using for this assessment, include the following in your impact report:

• Describe the health concerns and issues for the population.
• Describe current pharmacological treatment regimens for the main health concerns and issues.
• Explain any traditional beliefs and practices associated with the  health concerns and issues. Does the population engage in culturally  based methods of treating the health concern?
• Explain how cultural values and traditional practices might  affect acceptance and use of prescribed pharmacological treatments. Be  sure to consider the relationship between quality patient outcomes,  patient safety, and the appropriate use of pharmacology.
• Identify evidence-based, culturally sensitive strategies the  organization can use to educate the population about the correct use of  the pharmacology treatments.
• Identify evidence-based, culturally sensitive strategies the  nursing staff can employ with the population to promote health and  wellness.

Write this assessment as an impact report formatted as other  reports of a similar nature in your organization or an organization with  which you are familiar. Include a title page and reference page and  follow APA guidelines for your in-text citations and references.

Additional Requirements

• Number of pages: 3–5
• At least 3 current scholarly or professional resources.
• Times New Roman font, 12 point, double-spaced font.

Create a 8 slide PowerPoint presentation for Mental Health Early Identification and Intervention in the Adolescent Population. Include speaker notes and citations for each slide, and   create a slide at the end for References.

Address the following:

1. Describe the above subject or topic (Mental Health Early Identification and Intervention in the Adolescent Population)  and associated population your     group has selected. Discuss how this topic adversely affects the     population. How does health disparity affect this population?
2. Outline a proposal for health     education that can be used in a family-centered health promotion to     address the issue for the target population. Ensure your proposal is     based on evidence-based practice.

Cite at least three scholarly sources to complete   this assignment. Sources should be published within the last 5 years   and appropriate for the assignment criteria and public health content.