A 25-year-old Arab American man is one day post op following an appendectomy.
There have been no post-surgical complications. He tells his family that he is in terrible
pain, yet he reports ratings of 2 to 3 on 0-10 numeric rating scale to the nursing staff. He
requests pain medication every two to three hours, and will not get out of bed or ambulate.
A 60-year-old African American woman with metastatic ovarian cancer is
experiencing chronic pain. Her pain ratings have been between 3 and 7 on the 0-10 numeric
rating scale. Her vital signs remain within normal ranges. She is fully able to participate in
her daily care. She describes herself as the matriarch of her family, and looks forward to
daily visits from her family even when her pain rating is high. Her church pastor calls and
visits her several times per week. She anticipates discharge in a few days
Initial Discussion Post:
For your assigned scenario, address the following:
Identify and state a priority nursing diagnosis label for your assigned patient related to
Develop and state three (3) nursing interventions for this nursing diagnosis label or patient
problem. When planning individualized nursing interventions, consider the patient’s type
of pain and cultural perspective.
Provide your rationale or reasoning for each intervention chosen.
Health care providers are charged with the responsibility of ensuring that patients who
have gone through surgical procedures have a faster return to their normal activities. To achieve
this, the clinicians should have a clear outline of the priorities required for patient management.
For patients that have been through an appendectomy such as the 25- year old Arab American
presented in the case study, their care priorities include prevention of complications that are arise
after surgical procedure such as infections, ensuring that they are comfortable through pain
management, and providing them with essential information regarding the surgical procedure its
prognosis, treatment as well as the potential complications that may come about.
One of the nursing intervention that should be tailored for the patient presented in the
case study is management of the postsurgical pain. This intervention will involve assessing the
PATIENT CARE 2
patient’s pain, its location, and its severity on a scale of 0-10 (Pantaleao et al., 2015). Abdominal
pain should be managed through periodic placement of an ice bag on the abdomen for the first
24-48 hours after the procedure. This aids in soothing and relieving pain through nerve
desensitization. Opioid analgesics such as morphine or codeine should also be administered to
the patient. These are effective agent for pain management although the patient should be
monitored closely so that he does not develop tolerance or dependence of the drugs.
Patients who have gone through appendectomy are also at the risk of developing deficient
fluid volume. Pantaleao et al., (2015) enlighten that this arises mainly due to peritoneal
inflammation which tends to sequester fluid. As an intervention, clinicians should provide the
patient with clear liquids in small amounts after he has resumed his oral intake and also progress
diet as tolerated. This is indicated in order to minimize the risk of gastric irritation and vomiting
that cause fluid loss. In severe cases, the patient can be administered with IV fluids as well as
electrolytes. This is recommended since it promotes rehydration and electrolyte balance.
The other intervention for postsurgical patients is prevention of infections which they are
usually prone to. This can be done through monitoring of vital signs such as chills, fever,
mentation changes, and patient reports on increased pain in the abdomen. This is an essential
procedure because it provides an indication on the presence of abscess, sepsis, or peritonitis
which is then managed accordingly in the right time.
PATIENT CARE 3
Pantaleao, A., Karamessinis, L., Cooper, J., & Manworren, R. (2015). (108) Monitoring home
pain management after laparoscopic appendectomy. The Journal of Pain, 16(4), S3.