Assessment Overview
A patient is undergoing a surgical procedure. Critically analyse the surgical plan, considering their health status. Evaluate the advantages and disadvantages of the surgical plan with consideration to the preoperative preparation, intraoperative procedure, and immediate postoperative recovery.
Part A: Developing your Presentation
To complete Part A, you will need to create and submit your presentation before the Part A Due Date.
- This submission will be used during your presentation
- Use the information provided from the scenario and introduce the patient
- Use a structured tool such as SBAR
Explain what will be presented and key points that will be discussed.
1 Slide Recommended
- Identify and Analyse one (1) legal issue that relates to the patients capacity to consent to medical treatment.
- Identify and Analyse one (1) ethical issue that the anaesthetic nurse must consider as a result of the identified legal issue.
2 Slides Recommended
Briefly provide an overview of the proposed procedure
Evaluate the advantages and disadvantages of the chosen surgical approach and technique with consideration to the following:
- Preoperative Assessment
- Intraoperative Procedure
- Immediate Post operative Care
3 Slides Recommended
Choose and Evaluate one (1) potential environmental risk that is relevant to the scenario from the list below and propose appropriate risk mitigation strategies.
AT3: Scenario Information
Please read the following scenario details that will assist you in completing assessment task 3. This information has been provided a narrative
Summary
Joe Davis (pseudonym) is a 50-year-old male scheduled for an emergency open cholecystectomy at 12:00 on the 14th April 2024. Upon arrived at the hospital at 06:00, Joe presented with fever, hypotension, and delirium. A surgical review was completed at 08:00 and upon recognising that his condition could quickly worsen, the surgical team determined that removing the infected gallbladder within the next four hours was essential to prevent further deterioration.
History
Joe is 180 cm tall and weighing 140 kg, and has a medical history that includes hypertension managed with telmisartan 80 mg daily, as well as a previous pulmonary embolism that required a one-week hospital admission in 2022. As a result, he is prescribed Apixiban 2.5 mg twice daily. Joe lives alone, and although a neighbour brought him to the hospital, no next of kin or guardian could be identified.
On admission at 06:30, his vital signs included a respiratory rate of 24 breaths per minute, oxygen saturation at 95% on 2 L of nasal cannula, heart rate at 110 bpm, blood pressure of 88/50 mmHg, and a tympanic temperature of 38.5°C. A physical examination revealed marked tenderness in the right upper quadrant, along with restlessness and delirium, indicating an altered mental status that prevented him from following commands or giving coherent responses. He also showed signs of poor peripheral perfusion, evidenced by cool extremities and weak pulses.
Bloods and Scan
Investigations confirmed the severity of his condition, with elevated white blood cell count, raised inflammatory markers (CRP), elevated liver enzymes, and a high lactate level consistent with sepsis. A CT scan showed thickening of the gallbladder wall and potential perforation. Blood cultures specimens have been collected; however, results are pending due to the time required for incubation and culture sensitivities.
Surgical Plan
The surgical choice is for an emergency open cholecystectomy under general anaesthesia