Scenario Exam - Essay Example

Download file to see previous pages It is noted that Meredith Parker is a 36 year old woman who is a supervisor in a large department store. She works full time, leaving little time to spend with her two small children aged 4 and 2. Over the last two months, Meredith has lost 10kg and has now begun to experience episodes of right sided pain under her ribs, radiating through to her shoulder blade. These have become more frequent, lasting for several hours with episodes of nausea and vomiting. Following a GP referral and investigations she has been admitted to the ward for a laparoscopic cholecystectomy. She stopped taking the combined oral contraceptive pill one year ago and smokes 15 cigarettes per day. In pre-admission clinic her observations were: BP 140/84 mmHg; pulse rate 74 beats/min and regular; respiratory rate 17 breaths/min; temperature 36.8 o C, oxygen saturation 98%.Her waist circumference is 92cm. It is certain that with Meredith Parker’s case there are numerous foreseeable consequences that she is likely to encounter if appropriate professional procedure is not impressed. As clearly highlighted in the history of the patient, she is a smoker. Research indicate that smoking often rob the patient’s body of oxygen and significantly interferes with the body of the patient from recovering properly. As widely cited, there is need to impress exercise prior to any surgical procedure. Arguably, exercising increases the level of fitness of a patient and it also promotes quick recovery. However, this are limited to some period of time before hospital admission. Research suggests that before any surgery, a patient needs to be subjected to various diagnostic tests. These might include chest x-ray, CT Scan, biopsies, bone scan, ventilation studies, bronchoscopy, and perhaps blood work. These constitute the prospective assessment. However, one thing to content with is that these processes have to follow a particular protocol commonly referred to as ABCDEF. Certainly Meredith Parker has to adhere to the ABCDEF process. This way, she would be provided with A- Antibiotics shot/Anaesthetistconsulation, followed by B — Blood tests and Bowel for purposes of monitoring proper urinary output, then C — Consent from the patient in order to get be allowed to conduct a Chest X-ray (CXR). It is after this that Meridith Parker shall receive D — Drug chart, which would concern any previous medication/DVT prophylaxis treatment, she would then undergo E — Echocardiography (ECG) followed by F — Fluid monitoring and Food intake, in which she would be kept on nothing per oral (NPO) for at least 12 hours before surgery. In a rather practical approach to Meredith Parker, it is worth noting that there are various steps towards surgery that involve all these procedures in a very specific way and cover the details of management even in six hours post operatively. The first step is to take a detailed history about the symptoms. This includes presenting complaints, history of presenting complaints, social, family, personal and drug history. It is essential that all the associated symptoms should be checked. It is important to note if there has been any change in symptoms or if there is any doubt in diagnosis so that they can be checked again. After that, a detail examination is required. In our patient, we should especially ...Download file to see next pagesRead More