Critically discuss four (4) components of the PACU discharge criteria outlined in the Aldrete Scale. Utilize the scale provided on LEO as a resource in your case study.
Case Study 3: John Wong (Transurethral Resection of the Prostate).
John Wong is an 80 year old male of Chinese origin. John’s medical history includeshypothyroidism and osteoporosis and he smokes 10 cigarettes per day. His gait hasrecently been increasingly unstable and he has difficulty with simple tasks, such asgetting up his house stairs and getting up from chairs.In the last 4 weeks, he has noticed that he has been having difficulty passing urine andsome abdominal discomfort. His GP referred him to a urologist and a prostate biopsywas taken. This showed BPH (benign prostate hyperplasia) and it was recommendedthat he undergo a Transurethral Resection of the Prostate (TURP).While conducting John’s pre-admission assessment it is noted that John is slightlyhypertensive and is fidgeting and moving around the waiting room. After some educationJohn states that he is pleased to have the surgery as he hopes it will relieve some of thediscomfort he has been experiencing. John tells the nurse that he currently lives alone.John’s surgery is uneventful during the intra-operative stage. On arrival to PACU John isplaced in a supine position. He is drowsy and restless and oxygenated through afacemask on 02 at 5l/min. A wheeze and non-productive cough is noted. John has anIDC insitu with continuous bladder irrigation with output noted to be a reddish pink. Anumber of blankets are placed on top of him as he is shivering. His observations are T36.5c, HR 90, RR 30, BP 150/90 and SpO2 91%.John is transferred to the surgical ward after a 65 minute stay in PACU. John remainsdrowsy but easily rousable. He is oxygenated via intra-nasal cannulae at 2l/min and hestates his pain is 3/10. He has 0.9% sodium chloride infusion running at 125ml/hr. Postoperativeorders include IVF, analgesia (PRN Endone, 5mg 6hrly and Paracetamol, 1g4-6hourly), strict FBC and continuous bladder irrigation for 24 hours, with an aim of roseurine output.Four hours after John’s return to the ward he is observed to be in pain and distressed.He is diaphoretic and restless and states that his bladder feels full and he feels the urgeto urinate. At this time, vital signs are noted to be: T 36.9c, HR 91, RR 28, BP 146/91 &SPO2 98%. On review of his documentation it is found that his fluid status has a positive500ml balance and his urine is of red colour. There are blood clots in his urine.QUESTIONSPlease refer to the rubric on page 14 on the Unit Outline for full marking criteria1. In relation to your chosen patient, discuss the pathophysiology of theircondition and using evidence based practice explore current treatment optionsfor your patient’s condition, include any pharmacological and nonpharmacologicalconsiderations.2. Critically discuss four (4) components of the PACU discharge criteriaoutlined in the Aldrete Scale. Utilize the scale provided on LEO as a resource inyour case study.3. Develop a discharge plan to support your patient on discharge. Includeany education you deem relevant, any referrals to allied health professional/srequired, and discuss your rationale.
NRSG258 Acute Care Nursing 1, Semester 1 2015 Page 12 of 19;
Assessment Task 1: Case StudyDescription: Students are to choose one (1) of the case studies available (seeLEO) and answer the associated questions. The assignment is tobe presented in a question/answer format, and not as an essay(i.e. no introduction or conclusion). Each answer has a word limit;each answer must be supported with citations. Students shouldfollow the recommended formatting for academic papershttp://students.acu.edu.au/308971 Students must provide in-textreferencing and a reference list must be provided at the end ofthe assignment.Due date: Friday 27th March: Midnight (Week 5)Weighting: 40%Length and/or format: 1500 wordsPurpose: Facilitate the development of critical thinking in relation to nursingmanagement along the perioperative continuum includingeffective care, safety and evaluation.Learning outcomes assessed: 1, 2, 3, 5 & 6How to submit: Students are to submit the following via Turnitin Case Studysubmission folder as one document:?? Assignment?? Reference List (adhering to APA style)Return of assignment: Case Study submissions will be returned to students online viaLEO.Assessment criteria: This assessment task will be graded against a standardisedcriterion referenced rubric. Please follow these criteria closelyduring the planning and development of your assignment.For more comprehensive information on this assessment task, including the available case studies andthe Aldrete resource required for this assignment, please refer to the Case Study Folder in LEO under‘My Assessments’.
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