Introduction
After undergoing a wisdom teeth removal procedure, Jaime had some problems, a thing that is quite common in nursing due to the high expectancy of development of complications after such an operation. It is important to emphasize that the main complications arose due to the Penicillin doze the patient received in the course of the operation concerning the wisdom tooth removal. This study investigates the patient to understand her condition and the risks she faces, as well as provides an intervention strategy for her health condition (Watson, 2010; ACU, 2010; Joshi, 2011).
Data collection
The patient complained of different symptoms of post-surgery complications of the wisdom teeth removal procedure. She was subjected to a number of tests so as to determine her condition, which, according to her complaints, became considerably worse. The results obtained from the test on the basic conditions were as follows: the HR= 98, BP= 135/85, RR=28, T=37.2, O2 Sats= 89%. Further tests on the patient through blood gas procedure provided the following results: pH – 7.31, PCO2 – 55mmHg, HCO3 – 30MMEq/L, PO2 – 70 mmHg. Other noted complications included vomiting, nausea as well as being dyspneic. According to the results of the inspection, the patient’s condition demands urgent treatment. As auscultation shows, the patient cannot get her breath.
Nursing Diagnosis within 2hrs
According to a 2-hour diagnosis strategy results, the patient is at the risk of lack of enough oxygen within the body due to her respiratory depression. She has a lot of difficulty breathing and her oxygen circulation is at 89% and the PO2 Rate is at 70mmHg (Nair & Peate, 2009).
The patient is also at risk of dehydration due to her constant vomiting which could cause high loss of blood fluids resulting in panic, low blood circulation as well as high alkalosis resulting from an imbalance in the level of acid/base content in the body (Hayes et al., 2008; Kendall, 2011).
It is also worth mentioning that the patient is at risk of poor metabolism in the organism and has general body weakness due to the presence of a very high metabolic alkalosis, at the rate of 30MMEq/L compared to the normal range of 22-26MMEq/L.
Finally, the patient is at risk of developing digestive depression due to the high levels of alkalinity in the body as well as the high carbon dioxide partial pressure above the normal range of 35-45mmHg.
It is also important to note that the patient is subject to the risk of aspiration because of vomiting.
The Three Highest Priority Nursing Diagnoses
According to the results of the observations made on the patient, there were three medical conditions that required immediate attention and intervention. The first condition was the poor oxygen circulation as well as the hypoxemic condition of the patient, which is extremely dangerous (Ajani et al., 2005; American Psychiatric Association, 2000). It may also result in other complications that may affect vital organs such as the brain and the heart. The nurse may use an oxygen mask as a quick way of aiding the patient to breathe more easily and less painfully even as it encourages oxygen circulation within the body, checking the rate of breathing (Labarthe, Dai, & Harrist, 2010; O’Connor, 2010). Alternatively, oxygen therapy can be used to produce a better effect (Kent, Mitchell & McNicolas, 2011). Another way to treat the current condition is oxygen enrichment with the help of oxygen concentrators, as Kent, Mitchell & McNicolas (2011) offer.
The second condition that was of high priority and required a nursing intervention was the risk of dehydration due to vomiting. Due to the nature of the complication that may lead to death or generate other health complications, the administration of fluids into the bloodstream was necessary to compensate for the fluids lost during vomiting. The nurse could have introduced an intravenous line which could have been used to administer fluids and basic nutrients lost during vomiting into the patient’s bloodstream. This intervention could have been evaluated by checking at the reduction in the paleness of the eyes and the skin of the patient as well as the reduced feeling of nausea (Cornell et al., 2009; Rimmer & Gennaria, 2008; American Psychiatric Association, 2000).
As an alternative to the intravenous intervention, drinking large amounts of fluid can also be offered as an effective intervention of the organism dehydration. However, it is necessary to keep in mind that the excessive amount of water can enhance the feeling of nausea, as Colletti et al. (2010) mark.
However, in case the patient is unable to consume large amounts of water due to the reinforcement of the vomiting effect and more effective intervention is required, there is another way to resort to. Using Maxalon 10 mg IM per nausea will help to cease the vomiting, improve the patient’s state and at the same time eliminate the negative effect of the dehydration.
The third most prioritized risk that the patient faces is high metabolic alkalosis, a condition resulting from a high rate of alkalinity due to the presence of acid/base imbalance within the bloodstream, which is highly dangerous. The patient should immediately be attended through intervention to lower the alkalinity hence bringing the acid/base balance to a normal. Te balance can be achieved through the establishment of an intravenous line that may be used for administration of the required medication, starting with a base solution treatment which gradually reduces the alkalinity and brings the acid/base balance to a normal condition. This intervention could be evaluated to determine its effectiveness through measurement of the level of alkalinity so as to determine if it has declined. This may be done by testing the composition of urine so as to determine if the kidney, which is one of the most sensitive organs in the body to such an imbalance, is operating normally (Luxford, Safran & Delbanco, 2011; Steele, Elkin & Roberts, 2007).
Speaking of another way of decreasing the alkalinity rate, one must mention the necessity for the patient to maintain low-salt diet. However, in case the alkalosis is chloride-resistant, the patient is supposed to be treated with the help of HCl infusion and the increase of K+. In the given case, it is important to block aldosterone as well (Faisy et al., 2010).
Conclusion
In the situation that Jaime was in, caused by her previous surgery and resulting to some post-surgery complications, immediate nursing intervention is required before a long-term solution is found by the doctor. With the help of special care and attention and through the use of nursing intervention strategies, Jaime’s post-surgery complications are dealt with so as to ensure she does not suffer any pain and is not facing a health risk (Kendall, 2011; Groene, 2011).
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