Acute Nursing

As a result Mrs. Porter has to undergo rip replacement surgery, however, different conditions completes such as hypertension, type 2 diabetes, and hyperlipidemia threatens to worsen her condition. She requires specialized nursing to manage her condition before and after operation. The aim of this assignment is to develop a plan of nursing for a person like Mrs. Porter suffering from acute illness. Porter include cardiovascular monitoring, respiratory assessment, hypertension assessment, and diabetes control (blood sugar level). Cardiovascular monitoring is a significant post-operative complication common among patients especially those who have undergone major operations. Mrs. Porter will fall into category of patients who have major operation;therefore, it is prudent to ensure her cardiovascular performance is stable. According to Akhtar et al (2013) after a major operation, it is important to assess patient’s heart rate and blood pressure to ensure that they are stable because heart rate determines how the blood will be pumped through the body.

Similarly, the case of blood sugar or diabetes should be monitored closely since she has poorly managed type 2 diabetes that is susceptible and can occur after surgery. In the case, there are signs of diabetes; hypoglycemic should be administered to manage the blood sugar level. Two nursing priorities to meet nursing care In this post-operative assessment, the priority will be on two aspects i. e. post-operative wound infection, and hypertension. Given close relationship between post-operative wound infection and hypertension, it is important that I prioritize on these aspects. Comprehensive care plan to address the identified priorities Regardless to mechanism used to aid healing of wound, the objective of post-operative wound care is to ensure that the wound heals rapidly without bringing complications, and heals with required aesthetic. According to Harrison, Wade & Gore (2016) all wounds in patient’s body should be kept clean to prevent development of different complications.

The postoperative wounds should always be cleaned using aesthetics, dressing and debriding. For the case of Mrs. The inflammatory phase of wound healing is usually characterized by swelling and redness accompanied by heat and pain. At this stage, nursing care should concentrate on ensuring that there is minimum disturbance in the surgical area. Wound healing process enters a stage of reconstruction and proliferation. At this stage, new blood vessels and tissues start to grow (Yao, Bae & Yew, 2013). During this stage it is prudent to concentrate on preventing bacterial infection on the wound through undertaking simple and low adherent dressing. Increase comfort will reduce tension and anxiety. In case the patient develops hypertension, it is advisable to administer medication such as thiazide diuretics reduce blood pressure, and incidents of stroke and heart failure.

Such medication reduces hypertension and stabilizes patient’s heart rate. Gibb’s reflective cycle Description: This assignment involved demonstrating understanding evidenced-based and person centered care for Mrs. Porter with acute rheumatoid arthritis. Porter who have undergone hip replacement surgery to cure acute rheumatoid arthritis. During the care process, I prioritized in post-operative wound infections and hypertension. I administered thiazide diuretics to reduce hypertension. I felt that prioritizing on wound infections would ensure faster healing process, and mitigate complications associated with wound infections. In addition, managing hypertension would reduce bleeding and bring about stability. L. Matteson, E. L. Perioperative management of the patient with rheumatoid arthritis.  World journal of orthopedics, 5(3), 283. A. Heine, R. P. Risk factors for post-operative wound infection in the setting of chorioamnionitis and cesarean delivery.  The Journal of Maternal-Fetal & Neonatal Medicine, 29(10), 1541-1545.

Bae, L. Yew, W. P. Post-operative wound management.  Australian family physician, 42(12), 867.