Mr. Jones a 68 year old male with a past medical history of COPD (emphysema), diabetes, hypertension, and congestive hea

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Mr Jones A 68 Year Old Male With A Past Medical History Of Copd Emphysema Diabetes Hypertension And Congestive Hea 1 (48.32 KiB) Viewed 48 times

Mr. Jones a 68 year old male with a past medical history of COPD (emphysema), diabetes, hypertension, and congestive heart failure (left sided). He was admitted on April 21, 2020 through the emergency department with complaints of abdominal discomfort. A CT scan revealed a small bowel obstruction related to a tumor. His home medications include: Metoprolol, Lisinopril, Glucophage. and Atrovent inhaler. You receive him from the post anesthesia care unit (PACU) after his exploratory laparoscopic colon resection PACU report: LOC: AOX3 Vital signs: RR28. HRB6, BP 110/70, 197.5. Pulse Ox 94% on 3L nasal cannula. Lungs: clear but diminished at the bases Gl : no bowel sounds, NG tube in place to low continuous wall Suction with yellow/green drainage GU:indwelling catheter in place to gravity at bedside with clear. yellow urine Est. blood loss in the OR was 750cc. Pain at 12:30 is 2/10 with a PCA running morphine. IV fluids: Dextrose 5 Normal saline (D5W) +20mEq of potassium @ 125ml/hr with an 18 gauge right AC IV Labs: H/H pre op 13.2/38 post op 8.3/30.2 Blood glucose pre op 125 post op 300 Na+ pre op 140 post op 135 K+ pre op 3.9 post op 2.9 Questions: 1. What key assessment parameters are you going to monitor in this patient post operatively? (minimum of 5) 2. What are your nursing priorities going to be fi.e. post- operative interventions) (minimum of 3) 3. What lab values will you closely monitor and why? 4. He is on a beta blocker and an ACE inhibitor. Why? What side effects must you monitor for with these two medications? 5. What are two (2) actual nursing diagnoses and one (1) potential nursing diagnosis for Mr. Jones (written in correct format): 6. Provide one (1) intervention for each actual nursing diagnosis: 7. Based on his hemoglobin and hematocrit levels post operatively, what do you anticipate the physician might want to order? And why? 8. What acid base imbalance should you closely monitor for since Mr. Jones has a NGT placed with low continuous wall Suction? 9. Why might Mr. Jones blood sugar be elevated post- operatively? Based on this patients past medical history: 1. What signs/symptoms would you note or assess for based on Mr. Jones having emphysema? 2. What signs/symptoms would you note or assess for based on Mr. Jones having CHF left sided?