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    Management of a patient following an operation

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    We keep getting these pre-lab discussion questions before we even talked about it in lecture and I'm having a really hard time breaking this down. Can someone please help?
    Not sure what D5 is..
    Her blood glucose seems to be high after surgery but as for what physical assessment data I will need to plan for her care, Im still trying to figure out how to recognize that. These are 3 of the questions that I am stuck on

    Mrs. Space has returned from the short procedure unit as she underwent excision of her tonsils.

    Orders are as follows:
    Nothing by mouth (NPO) except for ice chips
    Bathroom Privileges (BRP)
    Ancef 1 (cefazolin) gram IV every 6 hours
    Intake & Output (I&O) q shift
    D5 ½ NS + 40 mEq KCL @ 125mL/hr

    Na = 130 mEq/L Cr = 0.7 mg/dl
    K = 5.0 mEq/L Glucose = 222 mg/dl
    Cl = 100 mEq/L CO2 = 25 mEq/L
    BUN = 11 mg/dL

    Operating Room Report:
    Intake: Crystalloid- 2050 mL
    Output: Urine- 150 mL, Estimated blood loss (EBL) - 500 mL

    15. Based on the information provided, identify physical assessment data needed to plan for her care and information will you share with the provider caring for this patient?

    16. Based upon your discussion, what changes to Mrs. Space's orders should you expect and why?

    17. How will you evaluate the effect of your interventions and what do you expect to find?

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    Solution Preview

    Management of a patient following operation
    What is D5?
    This is a short form for Dextrose 5 % IV fluid.
    1. Physical assessment data
    Key points to use to guide on what to assess are:
    Infection may cause dehydration
    Infection may precipitate Ketoacidosis in diabetic patients
    Diabetic Ketoacidosis may lead to dehydration, loss of sodium and potassium in the body
    Dehydration may cause low urine output, electrolyte imbalances, high blood glucose levels, faster breathing, low blood pressure, change in urine colour, presence of ketones in urine,

    1.1. Physical Assessment information
    1.1.1. Temperature changes occur when a patient is dehydrated. Should you check Mrs Space's temperature?
    1.1.2. Level of dehydration can be determined by checking the skin texture. Guess the physical test you would do on the skin
    1.1.3. Dehydration causes urine to be concentrated turning yellow or deeply amber. How would you physically check this aspect on this patient
    1.1.4. Dehydration causes a drop in blood pressure-how would you physically check this?
    1.1.5. Guess the physical assessment to check for breathing rate
    1.1.6. How would you physically assess the improvement in urine output as treatment ...

    Solution Summary

    Following operation there are vital parameters to monitor and critical management interventions to take in order to adequately manage such a patient in a critical care environment. These notes serve as a guide on what physical examinations to perform, what to look out for, precautions to take and what to expect.