observed for shock. Surgical repair of the foot is necessary and Sergeant Jones must
be prepared for surgery. There is also the need to alleviate his anxiety over the welfare
of his children.
b. The nursing plan is to prepare Sergeant Jones for surgery, scheduled for one
hour later. You will monitor him closely since a change in vital signs could indicate a
change in his stable condition. While the RN begins the pre-operative arrangements for
Sergeant Jones, you will call social services to arrange for someone to help Sergeant
Jones with childcare. These are Sergeant Jones' immediate needs. Several projected
needs have also been identified. As the wound is considered "dirty," there is an
additional danger of infection for Sergeant Jones. The RN decides that it would be best
to isolate Sergeant Jones in a private room post-operatively, and you begin to make the
necessary preparations for the room. Additionally, Sergeant Jones will need the
services of other activities. Physical therapy will be consulted for post-surgical
rehabilitation. Since Sergeant Jones will most likely suffer a sense of loss and
depression caused by the disfigurement of his foot, mental health services will be
consulted.
c. The ward staff now begins to implement the plan. The surgical paperwork is
prepared and placed in Sergeant Jones' chart. The RN accompanies the surgeon to
Sergeant Jones' room to witness the surgical counseling and signing of the operative
permit. Sergeant Jones' vital signs are taken every 15 minutes in order to monitor his
status. Since the RN had assigned you the duty of passing medications for that shift,
you prepare and administer the pre-op medication ordered by the physician. Social
work services has sent a representative to the ward to assist Sergeant Jones and child
care arrangements are made. A patient administration clerk is notifying Sergeant
Jones' unit of his admission and will request that a representative of the unit come in the
hospital to visit Sergeant Jones and assist him with his personal matters.
d. The staff evaluates the plan 45 minutes later and finds that Sergeant Jones'
condition is stable and he is ready for surgery. The appropriate paperwork is completed
and placed in the patient's chart. Social work services have arranged for Sergeant
Jones' neighbor to care for the children until his wife can be notified and return from
TDY. A private room has been prepared for Sergeant Jones to occupy following
surgery. Pre-op blood and urine specimens have been sent to the lab. X-rays have
been obtained from the radiology section and are ready to be sent to the OR with
Sergeant Jones. The RN has completed pre-op counseling and teaching and you have
taken Sergeant Jones through his first coughing and deep breathing exercises. Based
upon this evaluation, it is determined that all of the initial short-term nursing care goals
have been accomplished. As he is transported to the operating room, you are already
preparing for Sergeant Jones' return, when a re-assessment must be done and a new
plan implemented.
MD0910
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