Perioperative Nursing: An unfolding Case study in Patient Safety by Gerry Altmiller,EdD, APRN, ACNS-BC, FAAN

Perioperative Nursing: An unfolding Case study in Patient Safety by Gerry Altmiller,EdD, APRN, ACNS-BC, FAAN The Case: John Egan, 53. Hx of Type 1 diabetes mellitus, cigarette smoking 40 pack years, CAD, and PVD. Six weeks ago, he developed a wound of his left heel which measured 4cm by 2cm when he discovered it. Despite IV antibiotics and chemical debridement, the wound developed a gangrene infection. He is scheduled for a BKA of the left lower extremity tomorrow at 10:00am. His meds include daily insulin, aspirin 325mg/day, Pletal 100mg BID. He has an advanced directive and NKDA. Identify the priority nursing care for Mr. Egan: Identify what he needs done before he can go to surgery safely. Priority Care to maintain patient safety Complete preoperative testing/preparation Maintain normal glucose levels Ensure informed consent Ensure correct surgical site Prevent postoperative infection Complete preoperative teaching to prevent complications Address psychological comfort What preoperative testing is appropriate for Mr. Egan? Pre-surgical Screening Tests 1. Chest x-ray 2. Electrocardiogram for 40 yrs 3. Complete blood count 4. Electrolyte levels 5. Urinalysis ...............................................continued..................................................