The Psychosocial Impact

Question One

The psychosocial impact exhibited by the emergency admissions and the surgical intervention are so adverse to persons of low income because they will not receive the actual medication that is needed for their problems. This will affect the family and family relations will go down due to lack of the family basic needs. Emergency admissions are not planned for hence they make the family budget go down and the problems in the family increases due to unplanned contingencies (High, 2010). As per the study Adam has two wives and four children who are looking up to him for survival therefore he need to work hard to cater for them.

 When this crucial pillar of the family is unwell there will be nothing to look up to hence suffering will not be avoided. The hospital bills required for the family head will not get someone to cater for them hence there will be huge hospital debts into the same family. The children will suffer due to lack of their basic needs and most importantly they will lack education due to lack of school fees (High, 2010). More problems are very prompt due to the medical expenses of the medicine that are being administered to him. He is to receive some judicial pressure for the child support payments schemes for the children of the first wife which will be lacking for a long period of time.

The weakness in the body will be too high that it can not support him to work in contraction company .This results to a very enormous tragedy in life of the patient and family due to lack of finances to support the family (High, 2010). As patient is admitted in the hospital more calamities are yet to be discovered. When he is admitted for eight (8) hours there is discovered a problem with his urinary tract. It is not evidential how a man eating and drinking can deny going for either a short or a long call but the patient denies to pass urine and three liters of saline introduced into the body and he is still eating and drinking, that means he has a major problem with his urinary system which means more medication.

Therapy is also required for him which is the most important exercise required for him to recover the hand so that after he is well he resume work to earn a living. All these problems will adversely affect the social life of the patient and the family. The family issues will lack control due to lack of money and these entire problem will give a psychological torture to the patient (High, 2010).

Question Two

The airway breathing is a very important factor in the survival of a human being. The breathing system of a person is the most important factor that without any life can continue. Breathing is very important for blood oxygenation which the heart is involved (High, 2010). The patient needs improved breathing systems that will reduce the difficulty experienced during breathing. This can be achieved through clearing the airways for enhanced and normal breathing. For quick recovery of the patient there should be strategies employed to quicken the recovery.

Tracheal intubation is carried for patients in critical conditions which facilitates the open up of the lungs. It is also carried for patients suffering from asphyxia. This is very crucial for these types of patients because this helps administer drugs to the patient. Ventilation in the room and the patient’s airways are also important for enhanced making the breathing easy and consistence in the respiratory of the patient. Checking if there are any particles blocking the airways are also very important because if they are cleared there will be no harm to the patient. If the patient had suffered a spinal injury the jaw –thrust maneuvers is done. In this one uses the thumb to push the mandible up. Before all these are performed one is advised to use the artificial first aid measures to get the real seriousness of the matter (High, 2010).    

Question 3

In order to identify whether the patient is in pain, there is need to assess the patient’s movements and how he reacts to medication. According to the case study, one of the ways of assessing the patient is observing the behaviour of the patient. Adam is positioned in such a way that the hand is hanging on an immobile sling. This is meant to ensure that there is free flow of blood through the blood and the pain is eased in that the muscles of the hand are relaxed. Another way of addressing the pain of a patient is through inducing him or her to sleep. This mostly happens when the patient is incapable of staying mobile (High, 2010). The sleep is induced through the administering of Morphine IVI.

 Another way of addressing the pain is through administering of pain relief medication or the pain killers. Pain relief medication can be in the form of the pain killers or through injection. Injection reduces the nerve effect. Some of the medication that is administered includes P0 paracetamol and PO/IV metoclopramide. The nerve effect reduced however lasts for a short time. This is evident from the case study. Adam firsts complains of tightness in his hand then complains again of the needles and pins in his fingers. Assessment is done to determine the blood circulation in his hand after which he complains again of the pain. Physiotherapy is also recommended so as to help reduce the pain that comes with stiffness of the body or lack of exercise to relax muscles (High, 2010).

Question 4

Once a patient is operated on, he or she is moved in the post anesthetic care unit .the extent of time that the patient will spend in this unit will be dependent on the type of the surgery done, the length of time the surgery took, the level of the consciousness of the patient. In the post anesthesia care unit, the nurse makes a report on the condition of the patient as well as the type of the surgery that was carried. The nurses also indicate the type of anesthesia administered and the estimated amount of blood that was lost. The nurse should be made aware of any complications that may have developed (Wojahn, 2013).

The patient is discharged from the PACU whenever he or she meets the criterion which is measured by a scale. The score that the scale develops is what determines whether the patient is fit to be discharged. Some of the areas or factors that are assessed include the openness of the airways, the level of consciousness, the body temperature, the pain status, and the patency of the drainage tubes. In the first 24 hours after discharge from the PACU, it is recommended that the nurse assess the patient again using the same methods articulated in the PACU (Wojahn, 2013).

 A number of signs should be monitored every one or two hours in the first eight hours after the discharge. These include the vital signs, the pain status, the respiratory status and the drainage pipes or tubes. It is essential to measure and monitor the body temperature regularly since the surgery leaves the patient hypothermic. The patient may be required to be provided with a warm blanket or fluids that may warm the body. There should be thorough and frequent assessment of the sounds produced in the lungs and the movement of the chest muscles as well as presence or absence of adequate cough (Wojahn, 2013).

The rate of fluid intake and output require monitoring at least every two hours. Incase the urine output is not adequate; it is recommended that the bladder be assessed and the patient be monitored to prove whether he or she has the inability to urinate. Once the assessment is done, it is recommended that the physician be informed incase the patient is unable to urinate between six to eight hours after undergoing the surgery. The patient is also due to receive medication for vomiting or nausea or pain. The patient also has to be taught on the various measures to take after the surgery. This includes performing of the respiratory exercise as a way of preventing pneumonia (Wojahn, 2013).

Also the patient has to be taught on the need for movement since it helps to prevent clotting of the blood. In order to determine the patients’ acceptable level of the pain, it is essential that he or she rates the pain level on the pain level scale. The advantage of controlling pain is to enable the patient to perform other activities like coughing, turning in bed, breathing exercises and later walking (Wojahn, 2013). Movement also enables the patient to keep the lungs clear as well as encouraging the circulation of oxygen or blood even to the extreme ends. Exercises pertaining to the respiratory system should be carried out. These may include coughing, incentive spirometry and adequate coughing.

 It is also recommended to turn the patients at least every two hours. The patient is supposed to be sitting on the bed after eight hours unless the surgery affected the sitting style. Those unable to sit on the bed need to have the compression devices attached to the leg at least until the patients are able to move about the hospital. Incase of any chest or abdominal incisions, the patient are recommended to splint the incisions with pillow to help curb the pain that is caused by the coughing or movement. If the surgeon recommends that nothing be eaten by the patient, the nurses should ensure the same is applied. A major outcome of the surgery is dry mouth. In order to help the patient feel comfortable, the nurses should relieve the patient using the oral sponges that are dipped in lemon mouth swabs or the ice water (Wojahn, 2013).