Assessment From Outpatient Surgery
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Continued assessment from outpatient Surgery (LAW)
.Jessica Adams
C. Evaluate the effects of the hospitalization and surgical intervention on the growth and developmental level of the patient.
Textbook p.59
Psychosocial
Trust vs. Mistrust-Erikson, This is the first developmental task, the establishment of trust. If an infants physical and emotional needs are met in a timely manner through warm and nurturing interactions with a consistent caregiver, the infant begins to sense that the world is trustworthy. The infant begins to develop trust in others and a sense of being worthy of love.
According to Erikson, unsuccessful resolution of this first developmental task results in a sense of mistrust. If needs are consistently unmet, acute tension begins to appear in children. S/S of unmet needs is restlessness, fretfulness, whining, crying, clinging, and physical tenseness.
A trustworthy child may exhibit these symptoms, though, from time to time.
Evaluation
I observed the pt. as being restless, whiny, crying and clingy. You really had to critical think in this situation because just going by the textbook would lead you to believe that this child was not meeting the developmental task. But on further evaluation of this pt. you came to the conclusion that he could be well established and trustworthy.
The only reason he may be acting this way may include:
NPO all morning
woke up early
different environment
unfamiliar people
The nurse would have to have several encounters with this pt. to come to a complete conclusion of his psychosocial well being.
Textbook p.56
Cognitive and Sensory Development
Sensorimotor-Piagot, during this period of development, infant thinking seems to involve the entire body. Reflexive behavior is gradually replaced by more complex activities. The world becomes increasingly sold through the development of the concept of object permanence, which is the awareness that objects continue to exist even when they disappear from sight. By the end of this stage, the infant shows some evidence of reasoning.
Evaluation
The pt. was very anxious before surgery. He seemed to be irritated at his mother for holding him but he also did not want to get down. I also observed the pt. looking for the nurse to come back and he got a little fussy every time they entered the cubical. Even though the nurses wasnt objects he new they still were there and was very observant of the people that passed by. When the nurses took him for surgery, he was a little reluctant but gave in without a fuss. I thought he was going to put up a big fight. By reading the textbook on sensorimotor and the end of this stage will show evidence of some reasoning, I therefore came to the conclusion that he did somewhat reason with the nurses and give in to what was happening.
Briefly evaluate the express surgery experience regarding:
Use and effectiveness of nursing process
The use of the nursing process for the nurses was the short version (if there is one). The assessment was very short with just the vital signs taken. I do not think they gathered enough information to analyze, other than the vital signs. Planning was done way before the surgery day so some of the planning involved in clinic teaching, which I didnt observe. The nurse as well as the anesthesiologist discussed the plan of care and the expected outcome for the patient. They also discussed the unexpected outcomes that could happen but where very unlikely. The evaluation of the expected outcomes was proficient for the nurses and they followed through with the plan of care after surgery.
This was very routine for them. I was looking for