Nursing troubles of a Patient

Nursing difficulties of a Patient



Nursing difficulties of a Patient

Introduction

The aim of this assignment is to provide a detailed account of the nursing care for a persevering who is experiencing a breakdown in health. One aspect of their care will be considered in relation to the nursing process. The model utilised to supply an individualised events of care will be considered and critically analysed.

The patient

68 year old builder refers by his GP in the ward, this gentleman has had a left and right sided inguinal hernia for the last two years. Recently the hernia had increased in size and caused him pain on coughing, sneezing and lifting heavy objects. Patient had pain, bloating and vomiting. Patient currently smokes 15-20 cigarettes per day and rarely drinks alcohol. Patient has been examination of his groin region was consistent with the size and tender direct inguinal hernia, and right side was non-tender. Both of testes were normal. Patient had inguinal hernia surgery. Clinic has been explaining patient the risks of recurrence, testicular atrophy, haematoma and infection.

Discussion 3 Nursing Problems of a 68 year old builder Patient

1. Preoperative anxiety

Preoperative anxiety is a demanding notion in the preoperative care of patients. Most patients awaiting elective surgery experience anxiety and it is widely accepted as an expected response. Anxiety is described as an unpleasant state of uneasiness or tension, which may be associated with abnormal hemodynamics as a consequence of sympathetic, parasympathetic, and endocrine stimulation. It begins as soon as the surgical procedure is planned and increases to maximal intensity at the moment of entering the hospital(Shearer, 1998 P47).

68 year old builder patient may see the day of surgery as the biggest and the most intimidating day in their lives. The degree to which each patient manifests anxiety related to future experiences depends on many factors. These include age, gender, type and extent of the proposed surgery, previous surgical experience, and personal susceptibility to stressful situations. Some degree of anxiety is a natural reaction to the unpredictable and potentially threatening circumstances typical of the preoperative period, especially for the patient's first few surgical experiences. Studies have shown that high preoperative anxiety levels can lead to increased postoperative analgesic requirement, prolonged hospital stay, (Diamond 2002, p66) significant contribution to adverse perioperative outcome and 68 year old builder patient poor satisfaction. Interventions to reduce preoperative anxiety include pharmacological therapy, provision of information, distraction, attention focusing, and relaxation prodedures.

2. Post Operative pain

The response of the body to acute pain can impede the return of normal pulmonary function, modify certain aspects of the stress response to injury, and alter cardiovascular function. The systemic response to painful stimuli is partly caused by increased sympathetic tone that will increase cardiac work and oxygen consumption, which, in the cardiac risk 68 year old builder patient, may lead to ischaemic myocardial events and thereby affect postoperative morbidity and mortality(McLellan 2004 P179). Pain-induced peripheral vasoconstriction will decrease subcutaneous perfusion and oxygen tension and may thereby increase the risk of ...