Author Question: A patient underwent a thoracotomy 12 hours ago The patient currently has an epidural catheter in ... (Read 60 times)

fox · **on:** Jun 25, 2018

A patient underwent a thoracotomy 12 hours ago

The patient currently has an epidural catheter in place and is receiving continuous epidural analgesia with morphine. In addition to respiratory depression, the patient should be monitored for which of the following complications?

a. Urinary retention, undue somnolence, itching, nausea, and vomiting
b. Urinary incontinence, photophobia, headache, and skin rash
c. Apprehension, anxiety, restlessness, sadness, anger, and myoclonus
d. Gastric bleeding, nasal discharge, cerebrospinal fluid leak, and calf pain

Question 2

Because the nature of the environment, _____ is a serious concern in the critical care environment.

a. family involvement
b. use of complementary therapies
c. sleep deprivation
d. calm environment

ynlevi · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

A
Epidural analgesia is commonly used in critical care units after major abdominal surgery, nephrectomy, thoracotomy, and major orthopedic procedures. Monitor for adverse reactions, including respiratory depression, urinary retention, undue somnolence, itching, seizures, nausea, and vomiting.

Answer to Question 2

C
Sleep deprivation is a serious concern in critical care environments. Including patients and family members in critical care interdisciplinary rounds has been shown to improve perceptions of accessibility and communication. Alterations in the physical environment of critical care units can provide a sense of calm, enhance patient coping, and facilitate healing. The type of complementary or integrative therapies used depends on a patient's preferences, coping style, physical capabilities, and personality type. Music therapy, relaxation, guided imagery, therapeutic massage, visualization, prayer, biofeedback, and mindfulness meditation are potentially useful for critically ill patients.