Lucia Alberti Year Explained for Students (Easy Guide)
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Original Question
Lucia Alberti is a 58 year old female who arrived at the orthopaedic ward as a day of surgery admission (DOSA) with her son and husband at 8 am. She is scheduled to have an elective total knee arthroplasty at midday today. She has been fasting from 6 am. Her vital signs: Temperature- 36.8 °C, Blood pressure- 155/84mmHg, Heart rate- 65bpm, Respiratory- 20/minute, spO2- 95% on room air, Nil complaints of pain and Blood glucose level 7.8mmol at the time of admission. An intravenous cannula has been inserted and 5% dextrose intravenous infusion has commenced while Lucia is fasting for operation. The nurse also identified that Lucia is not very clear about the post operative expected outcomes. Past medical history includes type 2 diabetes mellitus, coronary heart disease, angina, hypercholesterolemia and COPD Current medications are listed as below. Aspirin has been withheld for the last 2 weeks. The anesthetist asked a nurse to administer Metoprolol 25mg with sips of water up to 2 hours before the surgery. Her respiratory medications and other topical medications to be given as charted until the procedure. Name of the medication Dose Frequency Route Insulin glargine 36 units mane Subcutaneous Novorapid 12 units Midday Subcutaneous Gliclazide 60mg mane PO Simvastatin 40mg nocte PO Aspirin 100mg mane PO Metoprolol 25mg BD PO Polytear 1 drop TDS Top: Left eye Atropine 1 drop Daily sublingual Seretide MDI 125/25 2 puffs BD Inhale It is now midday, and a nurse in charge has just received a call from the operating room that an emergency trauma surgery must be performed before Lucia’s procedure. A nurse who is looking after Lucia has been asked to advise Lucia and her family of the unexpected delay. When the nurse explains the delay, her son becomes irritated and loudly asks the nurse “What do you mean my mum has to wait for the operation for we don’t know how many more hours?” “Where is the surgeon? Bring the surgeon right now! I need to tell the surgeon that my mum has diabetes and has to eat regularly!” QUESTIONS: a. Describe at least seven (7) immediate pre-operative preparation required for Lucia, and briefly state the rationale for each. b. Construct an admission note entry for Lucia. Ensure the note follows legal requirements. c. Describe the immediate post-operative care that should be performed for Lucia. D. The nurse who admitted Lucia identified that Lucia does not have good understanding in regards to postoperative expected outcomes. Discuss how the nurse should manage this situation. E. Discuss how the nurse should respond to Lucia’s son when he expressed his frustration and verbal aggression.
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