DOCTORS / NURSES CASE STUDY QUESTIOn?!


Question: DOCTORS / NURSES CASE STUDY QUESTIOn!?
I have a case study situation:
Patient: 75 y/o male with laryngeal SCC -POD #14 s/p awake trach !. Admitted to ICU from OR s/p total laryngectomy!.
POD#2 s/p salvage total laryngectomy, b/l selective neck dissection, right pectoralis flap
History of hypothyroidism, likely h/o radiation to neck!. Thyroid lobes left in place in order to preserve parathyroid glands!.

on Fentanyl 125 mcg/hr and dilaudid 4 mg/ peg tube q4hr
BP: 97/91, HR: 85

1) So how would you deal with pain that was uncontrolled by the Fentanyl drip that he is on!? What would you do!? what should i monitor and look out for!?

2) What should i keep an eye out for since he has hypothyroidism!? What does hypothyroidism do to his parathyroid glands!?Www@Answer-Health@Com


Answers:
Hey I just graduated nursing school so maybe I can help!? Fetanyl and dilaudid are heavy medications, watch for respiratory depression, urinary retention and lethargy; check your drug book!.
Did you mean he has hx of HYPERthyroidism!?
They preserve the parathyroid glands because they help in part to regulate calcium in the body!.
I would definitley use risk for aspiration on this guy because he has had previous radiation and now has throat surgery again make sure you keep a trach at bedside and monitor O2 stats hold food until u check his gag reflex!. Would need more info to answer the rest!. Good luck!.Www@Answer-Health@Com





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