Question

Mrs. Campana has just been transported to your surgical nursing division from the PACU. She is 80 years old had a right colectomy (right-sided large bowel resection) for removal of tumor. Her vital signs were stable in the PACU, and her temperature was 36.8 degrees Celsius. She has an IV line in her right arm, a Foley catheter, a nasogastric tube, and oxygen a 4L/min. per nasal cannula. She received a total of 5 mg of morphine sulfate IV in the PACU and now has morphine patient-controlled analgesia with a demand dose of 1mg every 10 minutes connected to her IV line. When you assess her, she is slow to respond?

1. why may Mrs. Campana be slow to respond?

2. what are your priority assessments at the time considering Mrs. Campana’s current decreased responsiveness? What do you need to do if you discover any unexpected or abnormal assessment findings?

3. Mrs. Campana’s daughter enters the room and is very concerned about her mother’s slowness to awaken. What do you tell her?

Answer 1

#The medication Morphine Sulfate can be the reason for Mrs. Campana to respond slowly.

The priority assessment at this time for the patient are

• Monitoring vital signs :Respiratory rate , Oxygen saturation (due to respiratory supression )
• Neurological assessments (glascocoma scale) to rule out the level of consciousness in the patient

In case of abnormal assessment finding

• Stop the patient controlled analgesia to prevent any fatal events because if the medication
• Monitor vitals
• Report and call the provider immediately for getting new order forms the assessment made and initiate on emergency basis .

The daughter can be informed the following

• First reassure the daughter by explaining about the anesthesia and its effects on patients after surgery .
• The elderly population are very sensitive and they resume responsiveness gradually