Chapter 7, Problem 34R

A 48 year old patient is post-op 24 hours from a traditional hysterectomy with left salpingo-oophorectomy. The client had a history of uterine fibroids and an enlarged left ovary. Traditional approach was chosen over laparoscopy because of the client's history of obesity, and DM type 2. She was recovered in the PACU and transferred to the surgical unit. The nurse taking care of her had these findings: Temp - 99.7 oral, P102, iR18, BP 92/50 supine, SPO2 95% on room air Pain 9/10 to incision site Noted abdominal surgical dressing, intact, with serosanguinous drainage. moderate abdominal distension bowel sounds audible in all 4quadrants Patient with reports of nausea, nut no vomiting. Questions: 1. What signs and symptoms are of concern in this patient's presentation? 2. What could these be telling you is happening to the patient? 3. Of the concerning symptoms, which of these is a priority? Please explain your answer. 4. What can we do to stabilize this patient? Why?

Write a description below of the surgical procedures: Reference required. Type of surgery Description Tonsillectomy Cataract extraction Laparotomy Amputation Prostatectomy Craniotomy Hysterectomy Open reduction and internal fixation Hip replacement Appendectomy Reference:

Women’s Health Prescribing Case   Ann is a 57 y/o female who presents today with c/o vaginal dryness and dyspareunia.  She says that this has been an issue for the last 2 years or so, but it has gotten worse.  She went through natural menopause at the age of 53—and did not take any oral estrogens—she said it was her preference not to, and that she really did not have any systemic signs/symptoms of menopause—just the vaginal dryness for the last 2 years or so. She says that she has used OTC products without benefit—and she uses Astroglide or some type of lubricant when she is sexually active with her husband—but it is still uncomfortable because she just thinks her tissue are so dry.  Ann tells you that she usually does not have any itching or discharge but has in the last few days—which she attributes to a recent round of Amoxicillin for a tooth infection.  So she thinks she may need something for that also—she has not used any OTC meds for the discharge.  Ann is healthy—she takes…