Reflection Section 1 My practice area is the surgical ward area, specifically, in the Ear, Nose, and Throat specialization. This practice area primarily admits patients who are about to or who have undergone surgery. Most of the patients in this ward are ENT surgical patients, about to be scheduled for surgery or undergoing pre-operative procedures, including medical tests prior to surgery…
Postoperative anxiety is to be expected for these patients, and nurses and other health practitioners within the surgical ward are tasked with educating the patient about the surgery, providing emotional support, and reducing the emotional impact of the surgical procedure. Some of the other patients in the surgical ward are also undergoing postoperative care. Postoperative care for these patients include pain management, monitoring of vital signs, monitoring for bleeding, and monitoring for infection. In the case of the patient subject of this reflection, the patient is a 55 year old female patient who has recently undergone thyroidectomy. She is married, with 3 children, and has worked as a school teacher for 35 years. Six months ago she first noticed that there was a lump at her throat area. She ignored it at first, but four months prior to the surgery, the lump seemed to get bigger. Upon seeking medical consult, she was diagnosed with hyperthyroidism. This caused her goitre. After a month of treatment, her goitre continued to enlarge. Hence the thyroidectomy was scheduled. Post-operative pain medications were ordered for the patient by his attending surgeon. In this case, the controlled drug morphine was ordered. The patient registered pain levels on the scale of 1-10 (with 10 being the most severe) at 9/10. The pain was localized at the incision site at her throat area and she described it as a throbbing and persistent pain. She also registered pain when she would move. The administration of the morphine managed to reduce the pain levels to 3/10. Additional pain management included guided imagery where the patient was asked to picture pleasant scenarios as a means of distracting herself from the pain that she was feeling. I also checked the incision site for signs of bleeding and infection. I also monitored her blood pressure and vital signs. Her blood pressure as well as vital signs remained within normal levels within the postoperative period. The administration of the morphine Oramorph SR was orally through a tablet every 12 hours. Based on hospital policy, no more than 2 tablets were administered to the patient within a 24 hour period. Morphine was also not administered when necessary as per hospital policy. An order by the attending physician was necessary before morphine could be administered. The nurses are required to instruct patients not to chew the tablets before swallowing because it can cause the release of the drug into the body all at once, possibly causing serious health issues, in some cases, death. The patient’s mouth was also washed after each administration. I was also asked to check for side or adverse effects of the drug, including: dizziness, lightheadedness, nausea, vomiting, diarrhoea, weight loss, dry mouth, headache, confusion, stiff muscles, mood changes, chills, and flu symptoms. More serious symptoms requiring immediate medical care included slow or irregular breathing, bluish coloration to the skin, fast or slow heartbeat, seizures, hallucinations, blurred vision, hives, and rashes. Section 2 While caring for this patient, I was able to learn more about the protocols in the administration of the controlled drug morphine. The learning was able to emphasize the importance of understanding the application and use of controlled drugs, especially those used for pain relief (Hardwick, 2009). The ...
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