Perioperative
Nursing:
An unfolding
case study in
Patient Safety
by
Gerry Altmiller,EdD, APRN,
ACNS-BC, FAAN
,The Case:
John Egan, 53.
Hx of Type 1 diabetes mellitus, cigarette
smoking 40 pack years, CAD, and PVD.
Six weeks ago, he developed a wound
of his left heel which measured 4cm by
2cm when he discovered it. Despite IV
antibiotics and chemical debridement,
the wound developed a gangrene
infection. He is scheduled for a Below
Knee Amputation (BKA) of the left lower
extremity tomorrow at 10:00am.
His meds include daily insulin,
aspirin 325mg/day, Pletal 100mg BID.
He has an advanced directive and
NKDA.
,Pre-
operative
, Identify the priority nursing care for
Mr. Egan. Identify what he needs done
before he can go to surgery safely.
Complete pre-operative testing (labs: CBC, CMP,
CXR, EKG, UA, XR of LLE) and preparation.
Complete baseline assessment/vitals. Ensure
informed consent has been signed. Assess glucose
levels and maintain glucose levels in normal
range. Assess all medications including any herbal
medications. Assess for any allergies. Complete
pre-op teaching to prevent complications. Address
any psychological problems pertaining to
procedure. Comfort patient.
Nursing:
An unfolding
case study in
Patient Safety
by
Gerry Altmiller,EdD, APRN,
ACNS-BC, FAAN
,The Case:
John Egan, 53.
Hx of Type 1 diabetes mellitus, cigarette
smoking 40 pack years, CAD, and PVD.
Six weeks ago, he developed a wound
of his left heel which measured 4cm by
2cm when he discovered it. Despite IV
antibiotics and chemical debridement,
the wound developed a gangrene
infection. He is scheduled for a Below
Knee Amputation (BKA) of the left lower
extremity tomorrow at 10:00am.
His meds include daily insulin,
aspirin 325mg/day, Pletal 100mg BID.
He has an advanced directive and
NKDA.
,Pre-
operative
, Identify the priority nursing care for
Mr. Egan. Identify what he needs done
before he can go to surgery safely.
Complete pre-operative testing (labs: CBC, CMP,
CXR, EKG, UA, XR of LLE) and preparation.
Complete baseline assessment/vitals. Ensure
informed consent has been signed. Assess glucose
levels and maintain glucose levels in normal
range. Assess all medications including any herbal
medications. Assess for any allergies. Complete
pre-op teaching to prevent complications. Address
any psychological problems pertaining to
procedure. Comfort patient.
