Nursing Student Workbook
Current management: Aleksandra has been admitted by the surgical team on call who suspect that she has cholecystitis. Investigations in the E.D. included: Abdominal US, CXR,
ECG, FBC, U&Es and ABG’s. She has been prescribed and administered I.V ciprofloxacin
400mg (TDS), I.V paracetamol lg, I.V ondansetron 4mg, I.V 0.9% NaCl at a rate of 125mls/hr. A CT scan has been ordered and Aleksandra is aware of same. On arrival to the ward Aleksandra continues to voice complaint of nausea, vomiting and pain.
Informed by the assessment and investigation information a diagnosis acute cholecystitis has been made by the surgical team. The surgical team’s plan is to treat Aleksandra’s cholecystitis conservatively with a view to bringing her back for a cholecystectomy at a later date. You are required, as a group, to:
- Demonstrate the nursing assessment and identify the key priorities of care for Aleksandra during the first 48 hours of her admission.
- Demonstrate knowledge of the nursing management of cholecystitis to include required clinical assessment, continued monitoring, pharmacological treatment, documentation, multidisciplinary team input (including pre-operative work up if appropriate), patient safety and emotional wellbeing considerations in the first 48 hours of care. Include relevant documentation and assessment tools.
Reflection on Practice: Nursing Care Aleksandra Bigus
The purpose of this activity is for you to reflect on practice so that you (and others) can learn from your experiences. We will refer to these reflections in class however you will not be required to hand anything in. You may wish to make a few notes under the following headings to bring with you. All reflective activity should maintain anonymity of patients and settings.
Description
- What have been your experiences to date with caring for patients such as Aleksandra?
- What factors guided your clinical decision making?
- Describe the care of one patient with cholecystitis which you have experienced on clinical placement.
Feelings
- What did you think/ feel? What did you do and why?
- How do you feel about your clinical practice and managing patients with cholecystitis?
Evaluation
What has been good and bad about your experiences to date?