Assessment Description You are part of a surgical team and your role is postoperative management of thoracic surgery. In your role, you are required to determine the course of action for the patient before you call surgeon. A right lower-lobe resection occurred due to adenocarcinoma. The nurse has called at the 12-hour interval from surgery concerned with the amount of drainage within the chest tube. Support your summary and recommendations plan with a minimum of two APRN approved scholarly resources.

Introduction

Postoperative management of thoracic surgery is a critical aspect of patient care. In cases where a right lower-lobe resection has been performed due to adenocarcinoma, it is important to closely monitor the patient’s condition and address any concerns or complications that may arise. This assessment focuses on the scenario where the nurse has called at the 12-hour interval from surgery expressing concerns about the amount of drainage within the chest tube. This paper will provide a summary of the situation and outline a recommended plan of action based on evidence from APRN approved scholarly resources.

Summary of the Situation

In the case of a right lower-lobe resection, the chest tube is inserted to facilitate the removal of excess air, fluid, or blood from the pleural space. The nurse’s concern regarding the amount of drainage within the chest tube at the 12-hour interval post-surgery is valid. Excessive or abnormal drainage can indicate potential complications such as bleeding, infection, or persistent air leak. It is crucial to assess the patient’s vital signs, drainage characteristics, and overall clinical condition to determine the appropriate course of action.

Recommended Plan of Action

To determine the most suitable course of action for the patient, a systematic approach must be taken, considering the underlying pathology, the patient’s clinical status, and the available evidence from APRN approved scholarly resources. The following plan of action is proposed:

1. Assessment of the patient’s vital signs and general condition

The first step is to assess the patient’s vital signs, including blood pressure, heart rate, respiratory rate, and temperature. Any signs of hemodynamic instability or changes in the patient’s condition may indicate a serious complication. Additionally, a thorough physical examination should be performed to evaluate the patient’s respiratory status, including auscultation of the lung sounds and assessment of oxygen saturation levels. Any abnormal findings should be documented and communicated to the surgical team.

2. Evaluation of the drainage characteristics

The next step is to assess the characteristics of the drainage within the chest tube. This includes measuring the volume of drainage over a specific time period and evaluating the color, consistency, and odor of the fluid. Excessive or frank bleeding, an increase in the amount of drainage, or a change in color (e.g., from serous to sanguineous) may indicate a potential problem. Additionally, the presence of purulent or foul-smelling drainage may suggest an infection. Comparing these findings with the expected postoperative drainage patterns can help guide further management.

3. Analysis of the patient’s laboratory results

Laboratory tests, including complete blood counts and coagulation profiles, should be reviewed to assess for any abnormalities that may contribute to the increased drainage. Anemia or coagulopathy may predispose the patient to bleeding complications, while an elevated white blood cell count may suggest infection. These results should be correlated with the patient’s clinical condition and used to inform the plan of action.

4. Review of APRN approved scholarly resources

To support the plan of action, a review of APRN approved scholarly resources is necessary. These resources provide evidence-based guidelines and recommendations for the management of postoperative drainage in thoracic surgery patients. They may address topics such as expected drainage volumes, criteria for reinsertion of chest tubes, the role of antibiotics in postoperative infections, and strategies for managing persistent air leaks. By consulting these sources, the surgical team can ensure that their decisions are informed by the latest evidence and best practices in thoracic surgery.

Conclusion

In the postoperative management of thoracic surgery, it is essential to promptly address any concerns or complications that may arise. When faced with a patient who has undergone a right lower-lobe resection and is exhibiting abnormal drainage within the chest tube at the 12-hour interval post-surgery, a systematic approach should be taken. This includes assessing the patient’s vital signs and general condition, evaluating the characteristics of the drainage, analyzing the laboratory results, and reviewing APRN approved scholarly resources. By following this recommended plan of action, the surgical team can ensure that the patient receives appropriate care based on the best available evidence.