الاثنين، 27 أغسطس 2018

205-Splenectomy

About
Surgical removal of the spleen usually due to trauma, history of blood disorders, or ruptured spleen.
Assess
Abdomen, bowels sounds, incision ( redness, drainage, bleeding, bruising), vital signs, pulse oximetry, pain levels, lung sounds
Complications
Pneumonia, atelectasis, abscess, blood clots, infection
Diagnosis
  • Acute pain related to actual tissue damage
  • Risk for infection related to surgical procedure
  • Deficient knowledge related to post surgical treatment regimen
  • Impaired skin integrity related to surgical intervention.
Goals
  • The client will understand pre-, intra-, and post-operative instructions.
  • The client will remain free from post-operative complications.
  • The client will have incision closed, well approximated without evidence of bruising or bleeding.
  • The client will perform coughing and deep breathing exercises at least ten times an hour while awake.
Interventions
  • Monitor vital signs every 15 minutes X 2, 30 minutes X2, one hour X2, than every 4 hours ( may have different guidelines for each clinical agency).
  • Monitor for signs and symptoms of infection.
  • Assess lung sounds, pulse oximetry, bowel sounds, circulation frequently.
  • Implement incentive spirometry pre-operatively.
  • Encourage to do IS post-operatively at least ten times an hour.
  • Teach abdominal splinting.
  • Apply elastic compression stockings and/or sequential compression device as ordered.
  • Maintain NPO prior to surgery and start with clear liquids after surgery.
  • Encourage early ambulation to avoid complications.
  • Teach client signs and symptoms requiring immediate follow-up by a health care provider.
  • Monitor for signs/ symptoms of complications.

ليست هناك تعليقات:

إرسال تعليق