Perioperative Nursing Elective: Case Study 1

Directions: Please answer the following questions related to a patient scenario using your textbook and scholarly resources. Use APA (when applicable) for references. Additional information about this patient may be addressed in class or added as the case study unfolds. Pay attention to the point values as a guide for how much information is expected in each answer. Please submit each set of questions to the designated drop box in eCollege by the due date indicated on the course calendar.

Mary Jones is a 64 year old woman scheduled for a lumbar 4-5 discectomy. She is 5’2” and weighs 210 lbs. She has a history of diabetes mellitus, hypertension, coronary artery disease (CAD) and used to smoke 1 pack of cigarettes per day for 20 years, but quit smoking 25 years ago. She has a past surgical history of a cholecystectomy in 1997 with no complications.

She currently takes the following medications: Insulin 4 units Regular every AM, subcutaneous. Lisiniopril 20 mg every day, PO. Aspirin 325 mg every day, PO.

1) What are the nursing responsibilities of the perioperative nurse in the immediate preoperative period? What items are included on the preoperative checklist? (3 points)

2) Identify the priority nursing care assessments for Ms. Jones prior to her procedure. Explain why these assessments are necessary to her care. (3 points)

3) What are the surgeon and anesthesia provider responsible for obtaining from the patient prior to surgery to ensure informed consent? What must the patient consent to prior to the surgery being done? How would the nurse verify that informed consent has been obtained? (4 points)

4) What does it mean that Ms. Jones has an advance directive? How will it apply to her surgical procedure? (2 points)

5) During the admission assessment, the nurse questions Ms. Jones to determine if there is a latex allergy or sensitivity. Why is this essential to the patient’s safety? What symptoms would the nurse question Ms. Jones about in order to determine an allergy or sensitivity? How should a latex allergy or sensitivity be addressed by the perioperative nurse? (3 points)

6) Which of Ms. Jones’s medications may be concerning to the nurse, and why? Should the patient be instructed to stop taking medications before surgery? (2 points)

7) What preoperative teaching should the perioperative nurse include prior to the patient undergoing surgery? (3 points)

8) Recently, some institutions have shifted their practice to completing the perioperative interview in the OR, rather than the OR holding area in an effort to save time between procedures. Why might this be concerning for the safety of the patient? Do you see a benefit to this this new approach? Please share your opinion. (5 points)