Discuss the nursing responsibilities with associated rationales in relation to administering Morphine

Assessment 2 : Short Answer Test (SAT)/ In class closed book assessment based on the case study of Brian Jones.

The purpose of this short answer test in class assessment is to enable the student to demonstrate:

– An understanding of the principles of perioperative nursing care (Learning outcome 1).

– An understanding of the role of the nurse in the perioperative period (Learning outcome 2).

– An understanding of the relationships between pathophysiology and cancer control initiatives (Learning outcome 5)

– How safe and effective administration of pharmacological agents support people in perioperative care (Learning outcome 1, 6 & 7).

– An evaluation of relevant literature to support an understanding of the pathophysiology, pharmacological and nursing management of a person experiencing the effects of bowel cancer and is able to express this in a clear and succinct writing style (Learning outcome 9).

Details

Brian Jones (aged 50) presented to his GP with a nine month (9/12) history of a change in his bowel habits, abdominal pain and fatigue. His GP ordered Faecal Occult Blood testing which confirmed the presence of blood in Brian’s stool. Following this, Brian’s GP referred him to a gastrointestinal specialist. The specialist recommended Brian have a colonoscopy. During the colonoscopy, a biopsy was taken of a lesion located in Brian’s rectum. The biopsy results confirmed a Stage IIA rectal carcinoma. Brian was admitted to hospital for an abdomino-perineal resection and the formation of a colostomy.

Brian returned to the surgical ward postoperatively. On his return, Brian has

a patient controlled analgesia (PCA) infusion of 50mgs of Morphine in 50ml NaCl running at 4mL/hr,

0.9% NaCl (Sodium Chloride) IVI running at 125mL/hr via an IVC in his left arm,

a sigmoid colostomy with a small amount of haemoserous fluid evident,

2 x Haemovac drains in situ on suction with 100mls frank blood in total,

a nasogastric (NG) tube in situ on free drainage with 4/24 aspirations,

an indwelling urinary catheter (IDC) with 50mls of urine output,

regular medications ordered

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