Reference no: EM133342042
Case Study: You are the surgical pre-op nurse preparing a patient for cosmetic repair of scarring related to self-mutilation cutting. Your patient, Miranda< is a 15 year old patient who is being admitted pre-op for surgical repair related to a multiple episodes of cutting over the last 2 years. Significant medical history includes depression being treated with Elavil 100 mg po q HS.
Miranda tells you that she "more than doubled up" on her Elavil last night because she was
nervous about her pending surgery. She is 157 cm tall and weighs 45 kg. T: 37.0 P: 136 R: 18 BP:
114/56. Her Lungs are clear. Her abdomen is slightly distended, hypoactive bowel sounds. She
says that she feels a "bit bloated" from the pepperoni pizza that she ate last night. You instruct
the patient that a pre-op urinalysis is needed. When she gets up to go into the bathroom she
complains of feeling "woozy." She attempts, but is unable to void. One of the preoperative
orders includes administering atropine 0.9 mg IM. You realize that the atropine order may not
be appropriate.
Questions: Now reflect on the following queries
· Share your thoughts on Miranda's readiness for surgery.
· What aspect of her vital signs, or assessments are of greatest concern?
· What has caused these abnormal findings?
· If you were to give the atropine (as ordered), what problems could occur?
· What information will you report to the surgeon?
· Why were the medications in this scenario prescribed?
· Were the doses taken / prescribed appropriate?
· Discuss any safety concerns and nursing implications of Miranda's situation.
· Is there an antidote for the medication effects that Miranda is experiencing?
· What specific patient teaching is needed in this scenario?
· Were there any ethical issues presented in this scenario?