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Reflection: Hypovolaemia - Essay Example

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Reflection: Hypovolaemia This reflection evaluates the case of a postoperative appendectomy patient suffering from hypovolaemia due to postoperative bleeding. This reflection will focus on the postoperative care administered to the patient and the nursing actions carried out when the deterioration of the patient’s condition was noted…
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Download file to see previous pages The patient subject of this reflection is a 38 year old male who had no significant medical history, was not alcoholic, and was not a smoker. He was wheeled into recovery after an appendectomy. When he was admitted to the recovery room, he was drowsy but rousable and his observations were within normal levels. After 15 minutes however, the patient’s condition started to deteriorate. His blood pressure dropped to 90/60 mmHg, his heart rate increased, and he was experiencing shortness of breath. He was also groggy and becoming increasingly unresponsive to our attempts to rouse him. I immediately checked his incision site and noted some moderate oozing of blood which partly soaked his surgical dressing. I also noted that his surgical drain had some blood. His urine output also decreased. There was also some haematoma or bruising in his pelvic area. I immediately informed his attending physician and surgeon about the deterioration of the patient’s condition. I also marked the area soaked with the blood on his surgical dressing. A blood transfusion was immediately ordered and I assisted in the transfusion. The patient was also placed on oxygen therapy. I continued to monitor the patient’s vital signs until his attending physician and surgeon decided to wheel him again into the OR, suspecting hypovolaemia due to postoperative bleeding. My concerns for the patient were related to his decreasing blood pressure and his elevated heart rate which were strong indicators of bleeding. I was concerned that the surgeons might not be able to find and stop the bleeding immediately. I was concerned about myself not adequately carrying out my duties as a nurse in the recovery room. I felt that I had the relevant knowledge at the time. I was adequately knowledgeable about postoperative nursing care, about the signs of bleeding, surgical complications, and appendectomy. I also had adequate skills in managing postoperative patients, mostly in monitoring their vital signs, blood pressure, signs of bleeding, and other surgical complications. I was also skilled in managing postoperative bleeding, especially in assisting surgeons and other health professionals for related interventions. I also felt confident at the time because I believed that I was doing the necessary tasks to assist the patient and the surgeons in their decisions for the patient. I however felt that I needed to have more knowledge and skills in order to deal with a similar situation, including actually participating in surgical and nursing measures to manage postoperative bleeding. I also feel that I needed to enhance my skills in postoperative monitoring in order to detect patients for early signs of postoperative complications. The professional/legal implications refer to the operative team who may been negligent during the surgery, thereby causing the postoperative bleeding. I carried out my postoperative duties adequately and appropriately, so there are no adverse legal or ethical implications from my actions. The standards of postoperative care were applied, mostly based on the patient safety first checklist as laid out by the National Health Services and the World Health Organization. The standards for this checklist include vital signs monitoring (blood pressure, heart rate, respiratory rate, and temperature), pain, responsiveness, signs of bleeding at incision site, nausea, vomiting, drainage ...Download file to see next pagesRead More
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