1. Rita Schmidt, 74 years of age, is a female patient who was admitted to the surgical unit after undergoing removal of a section of the colon for colorectal cancer. The patient does not have a colostomy. The patient has several small abdominal incisions and a clear dressing over each site. The incisions are well approximated and the staples are dry and intact. There is a Jackson-Pratt drain intact with minimal serous sanguineous drainage present. The patient has a Salem sump tube connected to low continuous wall suction that is draining a small amount of brown liquid. The patient has no bowel sounds. The Foley catheter has a small amount of dark amber-colored urine without sediments. The patient has sequential compression device (SCD) in place. The nurse performs an assessment and notes that the patient’s breath sounds are decreased bilaterally in the bases and the patient has inspiratory crackles. The patient’s cardiac assessment is within normal limits. The patient is receiving O2 at 2 L per nasal cannula with a pulse oximetry reading of 95%. The vital signs include: blood pressure, 100/50 mm Hg; heart rate 110 bpm; respiratory rate 16 breaths/min; and the patient is afebrile. The patient is confused as to place and time.

1. Explain the assessment parameters used to provide clues to detect postoperative problems early and the interventions needed.
2. What gerontological postoperative considerations should the nurse make?

2. Mr. John Smith is admitted to the hospital for surgical incision and drainage (I&D) of an abscess on his right calf, which resulted from a farm machinery accident. The right calf has an area 3 cm × 2.5 cm, which is red, warm and hard to touch, and edematous.

1. Explain the wound healing process according to the phase of Mr. Smith’s wound?
2. The surgeon orders for wet-to-dry sterile saline dressing twice a day with iodoform gauze to the wound, covered with the wet-to-dry dressing. Explain how to perform this dressing change.

Prepare a 3–4-page report on nurse-patient communication in which you address types of communication, factors that influence the communication experience, and how the patient experience affects health outcomes. Recommend evidence-based strategies to improve nurse-patient communication and explain how the strategies consider patient demographics.

Nursing professionals do not only communicate with others within their organizations—often, they are also the first point of contact with patients. Thus, nursing professionals need superior communication skills to explain procedures and medication instructions, as well as to listen to what patients need to say.

Show Less

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• Competency 2: Describe the concepts, processes, and tools required to conduct comprehensive health assessments for individuals, families, communities, and populations.
  • Recommend evidence-based strategies to improve nurse-client/patient communication.
  • Explain how nurse-client/patient communication strategies consider individual demographics.
• Competency 3: Explain the internal and external factors that can affect the health of individuals, families, communities, and populations.
  • Describe the types of communication that occur between nurses and clients/patients.
  • Explain the factors that influence the communication experience between nurses and clients/patients.
  • Explain how the client/patient communication experience can impact health care outcomes.