Saunders Medical Center OR: Preceptor Day Six This is my sixth clinical shift with my preceptor at Saunders Medical Center in Wahoo, NE, and it was on May 11, 2018 (Friday). Today, I had the chance to work in the OR, following nurse Mikayla. My duties for the day were to practice my IV skills on all surgical patients (15 of them) and check them all into their preoperative rooms. The patient census that I cared for includes: W. K. a 67-year-old male scheduled for a colonoscopy; A. J. a 77-year-old female scheduled for a colonoscopy; L. P. a 74-year-old female scheduled for a colonoscopy; D. F. a 53-year-old male scheduled for a colonoscopy; C. L. a 52-year-old male scheduled for a colonoscopy; K. M. a 21-year-old female scheduled for an …show more content…
F. a 53-year-old male scheduled for a colonoscopy. Indication for the procedure is for a screening because the last colonoscopy done was in 2005. Vital signs included: temperature 98.6, respiration rate 18, heart rate 80, blood pressure 137/88, and oxygen 99% on room air. Lungs were clear bilaterally upon auscultation. I gave myself a pep-talk before entering the patient’s room and told myself to breathe/relax and focus on the IV angle and placement of the site I choose. I chose to place the IV in the patient’s left hand and I was successful on the first try! I was so excited and happy to place the IV, finally I said to myself (in my head, not out loud). What I did differently was raising the bed to my comfortable level, positioned the hand across the patient’s stomach, went flush with the skin when I poked, and once I got flash return, I advanced the needle a little further and pushed the catheter off. I occluded the catheter and attached it to the fluids, then covered the site with a transparent dressing over the insertion site, and then taped up the tubing around the site. This concluded my visit with this patient.
Patient Five C. L. a 52-year-old male scheduled for a colonoscopy. Indication was for an initial screening. The patient is allergic to the pertussis vaccine. Vital signs included: temperature 97.1, respiration rate 20, heart rate 98, blood pressure 137/98, and oxygen 98% on room air. Lungs clear bilaterally upon auscultation. The IV attempt was successful on the first try made by me. I placed the IV in the patient’s left hand. This concluded my visit with this patient.
Patient
HPI: MR is a 70 y.o. male patient who presents to ER with constant, dull and RUQ abdominal pain onset yesterday that irradiate to the back of right shoulder. Client also c/o nauseas, vomiting and black stool x2 this morning. He reports that currently resides in an ALF; they called the ambulance after his second episodes of black stool. Pt reports he drank Pepto-Bismol yesterday evening without relief. Pt states that he never experienced similar symptoms in the past. Denies any CP, emesis, hematochezia or any other associated symptoms at this time. Client was found with past history gallbladder problems years ago.
I am now reporting to you from the patient’s femoral vein. I am headed north to her right lung. The femoral vein is one of the largest veins in the body. The ride has been smooth so far. I have been seeing many different types of cells go by my submarine window. I just saw an army of white blood cells headed the same way that I am. They most likely are headed towards the bacteria infestation in the right lung. I am also hearing the heart beat; it is making a LUB- DUB sound. I can also hear the blood flow; it is making sort of a swooshing noise. That noise is reminding me of the ocean! The right femoral vein is now turning into the external iliac vein; I am now by the urinary system and reproductive system. This is also known has the pelvic region. As we continue north the eternal iliac vein is now called the common iliac vein. As we continue on, the common iliac vein is now called the inferior vena cava. We are getting closer to the heart! We are in the abdomen of the body. There are diff...
On Tuesday September 8, 2015 I had my first OR/PACU experience, and it was amazing! I witness an infant go through surgery. The surgical procedures I observed were a bronchoscopy, laryngoscopy, esophagoscopy, and an adenoidectomy. The infant was having these surgeries for chronic cough and runny nose. During my OR experience, I really enjoyed watching the teamwork the nurses and doctors displayed. I was also pleased to see how nice the doctors were to the nurses, based on past experiences of my own surgeries, this has not always been the case. The doctor was really helpful at explaining the procedure and the nurse answered all of my questions. I was surprised by how fast the surgery went, especially with the removal of the adenoids. My PACU
Goldman, M. A. (2008). Pocket Guide to the Operating Room. Philadelphia, PA: F.A. Davis Company.
Hinkle, J., Cheever, K., & , (2012). Textbook of medical-surgical nursing. (13 ed., pp. 586-588). Philadelphia: Wolters Kluwer Health
What? The patient is 65-year-old man Mr. John Douglas who is suffering from dysphagia and have been admitted to the surgical ward for insertion of a percutaneous endoscopic gastrostomy (PEG). Apart from that, he is a Type 1 diabetes patient and has weakness in his right leg and arm because of right-sided hemiplegia. He is thin in appearance and has stage 1 pressure sore on his right heel.
Several skills are beneficial to the nurse and paramedic, but perhaps one of the most important skills is the ability to place an intravenous catheter into a vein. This procedure is most commonly referred to as “starting an IV”. In today’s medical community, intravenous cannulation is necessary for the administration of many antibiotics and other therapeutic drugs. Listed below are the procedures and guidelines for starting a successful IV. Following these instructions will provide a positive experience for the patient and clinician.
Bowers, L., Allan, T., Simpson, A., Nijman, H., & Warren, J. (2007). Adverse Incidents, Patient
Toby-Finn, a 21 year-old Caucasian gentleman, is presented to the Emergency Department with a chief complaint of severe abdominal pain. Toby-Finn, who is a full time college student was just discharged three days ago from the Medical Surgical Unit status post laparoscopy appendectomy. Upon arrival to the Emergency Department, Toby-Finn has a computed tomography of the abdomen, and he is diagnosed with Ischemic Necrosis of Small Bowel, and required to go under another abdominal surgery. Toby-Finn was given a total of four milligrams of Morphine Sulfate intravenously, five milligrams of Reglan intravenously, and one liter of Normal Saline intravenously in the Emergency Department. The admitting physician, Dr. Sophie had contacted the surgeon, Dr. Scarlett for emergency surgery. In the meantime, Dr.Sophie had provided a written order for pain management to keep the patient comfortable.
I followed the RN nurse who was to assist and prep the operating room (OR). She first went into the clean utility room, where she picked up essentials for the surgery. When everything was gathered and prepared, we had to sit and wait for the patient who had arrived late. The RN would check the computer constantly to see if the patient was on file. After the clock hit 9, which was the time for the surgery, the RN nurse decided to go help put the patient on file quicker. When we arrived at the patients room, there was a nurse making the patient fill out papers. The RN nurse took over the papers while the other nurse completed the documents on the computer. While watching all the questions being asked, and the time it took to fill out the paper work, I realized that the paper work process is not easy.
Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2010). Brunner & Suddarth’s textbook of medical-surgical nursing (12th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Patient profile: Heterosexual Muslim Woman who has been in the United Stated for three years. She came from Pakistan. She is 42 forty-two years old, from low socioeconomic standing, English language barrier, and is Muslim rituals and practices. She came to emergency department with her husband due to shortness of breathing, high fever, severe cough. She was dignosed with new onset of pneumonia and currently on antibiotic. she also has history of Vitamin D deficiencies and diabetes mellitus type II. She admitted to medical-surgical floor for observation...
They were often administered at night when his room would be dark and he could not see the bag of packed red blood cells hanging from his intravenous (IV) infusion pump pole. He was receiving narcotic pain medicine resulting in very mild sedation and causing him to sleep more. Jose was also persistently febrile and overall did not feel well so his wakefulness and alertness were decreased. If he questioned what was hanging from his IV pole or why his vital signs needed to be checked again, he was told it was a different type of IV fluid or a different type of medication he needed to
The patient has high temperature-sign of fever, a very fast pulse rate (tachycardia), and chest wheezing when listened to using a stethoscope (Harries, Maher, & Graham, 2004, p.
Although students were not allowed in the recovery unit, I was able to talk to one of the recovery nurses. I learned that a nurse’s duty of care includes monitoring the patient’s vital signs and level of consciousness, and maintaining airway patency. Assessing pain and the effectiveness of pain management is also necessary. Once patients are transferred to the surgical ward, the goal is to assist in the recovery process, as well as providing referral details and education on care required when the patient returns home (Hamlin, 2010).