Tap to ChatGet instant assignment help

Assignment- Clinical case study

Assignment- Clinical case study

Assignment- Clinical case study

Case scenario

The patient in the given clinical scenario can be observed to be returning to the post-operative care ward, after undergoing his surgery of open cholecystectomy. During the surgery the patient was managed on three main general anesthetic drugs. These included Rocuronium, Fentanyl and Propofol. The drug Rocuronium is mainly used to cease the functioning of the muscles of the body. It brings about a paralytic effect in the body the means of blocking the secretion of the neurotransmitters. Whereas, the other two drugs viz. Fentanyl and Propofol are two of the most common choice of drug given during surgical procedures, in order to attain an unconscious state for the person, throughout the procedure. This state of unconsciousness is very crucial to be maintained in order to keep the patient relaxed and free from any suffering during major surgical interventions. The administration of general anesthesia is usually given in high doses in complicated surgeries. While it is an imperative step of the surgical procedure, it might leave the patient with some commonly observed complication post- administration. During surgery the patient is kept on artificial ventilation in order to provide them with respiratory support. However, during major surgeries like cholecystectomy, the patient might be kept on ventilation a little longer than anticipated. This could have been possible in our given case study as well. After surgery these patients might experience respiratory depression or might not be able to have a normal respiratory pattern all together. The administration of Rocuronium is mainly done as a neuromuscular block form. This can have several detrimental effect on the individual such as insufficient lung expansion, inefficient working of respiratory muscles and so on. This can lead to accumulation of secretions in the chest cavity after surgery and also due to underlying respiratory insufficiency as well. This neuromuscular block can also bring about a partial loss of the involuntary movement in the body and thus, reduced expiration as well. The cumulative effect of the same, tagged along with impaired respiratory muscle functioning can bring about an impaired airway clearance. This is also difficult for the patient to manage on his own in voluntary manner, as he might be having a severe pain due to surgery, restricting his overall functioning. The other main complication that can be observed in this case scenario is patient having hypertension as well as gastric oesophageal reflux. This can also be attributed to his life style choices such as sedentary life style, smoking, drinking and him having a high BMI of obese category. Obesity in itself is a major risk factor that might give rise to not only many other complications but might also be a hindrance in managing the clinical condition of the patient. The patient is at a risk of developing multiple complications such as deep vein thrombosis, due to prolonged bed rest, reduced urine output leading to acute kidney injury, developing atelectasis due to reduced and inefficient airway clearance. The paper will focus on goals setting and nursing interventions for managing the patient’s condition in a holistic manner.

                                                                    Goal setting

The main goal is to ensure patient’s comfort and help him in maintaining an efficient airway conduction. This can be attained through the following methods:

  1. Vitals monitoring- The patient is having a history of hypertension and smoking. He is at a high risk of developing further complications from the same. The patient should thus, be closely monitored for vitals like blood pressure, heart rate, pulse rate, respiratory rate and so on. Post any surgery, it is imperative that patients are observed for any fluctuation in vitals every hourly basis. Noting for outputs such as blood output in the drain and urine output is also very crucial to manage any early signs of complications in the beginning only. Close monitoring will be helpful in evaluating the patient for his speedy recovery as well.
  2. Positioning of the patient- It is also very vital from the point of view of promoting ventilation as well as reducing the patient’s discomfort. However, strong are the medications, the patients are having generally very severe intensity pain after surgery, mainly at the surgical incision site. The semi-fowler position however, is found to be relaxing position for the patient. The patient is asked to sit in a 30 degree flexed position, with their head end raise and knees bent 90 degree as well. This helps in approximating the incisional site and is thus, useful in reducing the pain by multiple folds. This position makes the patient to sit in slightly upright position as well, which can be very helpful in maintain the ventilation capacity of the patient and helping him to not develop atelectasis. However, the positioning of the patient should be changed at every two to three hours to put him at ease.
  3. Promotion of ventilation- The patient can be provided with steam inhalation. It will help in relaxing the air passages and will also help in diluting the thick secretion, which can be otherwise difficult to expel out. The patient can also be taught deep breathing and pursed lip breathing techniques, as it will be helpful in promoting active ventilation for the patient and will reduce the chances of development of further complications. The patient can also be promoted for splinted coughing, by keeping hands on the incisional sites, while doing so. This can be helpful in coughing out the secretions and can also act as a stimulus for promoting active coughing in the patient. By placing hands on incisions will help in securing the stiches of the patient and will also be helpful in reducing his pain while trying to cough actively.  


The interventions suggested for the Darren’s case have to be evaluated as well, to examine whether they are apt for the given case scenario or not. The interventions plan for Darren can be evaluated as follow:

  1. Evaluation for vitals monitoring- The vitals measured and noted for Darren can be compared with their normal ranges in order to assess for any fluctuation in them. A difference of +/- 10 can be avoided, as comparison will be done with a healthy person vitals. Due to presence of medication and major surgical intervention the patient can be having a slight increase in the body temperature. However, a temperature range of above normal can be suggestive of the patient having an active infection. Developed secondary to the post-operative complications. The extremities can also be monitored for any temperature fluctuation in order to note for abnormal clinical signs in the body. Reduced warmth in the extremities can also be a direct indicator of reduced blood supply to the region.
  2. Evaluation for positioning of the patient- It can be done by closely monitoring the patient for any discomfort or pain. The patient’s drain tubes can also be observed for any kinking as it might cause obstruction in the body output, required from the same. The patient can also be noted for any signs of cyanosis, accessory muscles breathing and so on, to detect any complication he might be developing beforehand basis.
  3. Evaluation for ventilation promotion- The patient can be provided with a sputum box, which can be observed for cough output every time patient coughs actively. The patient can also be observed for chest wall movement and the pattern of breathing as well. Other clinical signs such as measuring for patient’s pulse rate, respiratory rate and saturation rate can also be dully noted for any sins of abnormality. The lung fields can also be regularly auscultated for checking the air entry in the lung passages in adequate amount. Reduced of absent breath sounds can be an indicator for post-operative consolidation formation due to impaired respiratory regulation in the body. Presence of adventitious breath sounds can also be done, as it will be helpful in indicating the presence of secretion in the particular lobe. This will be helpful in draining out the secretions, by targeting on that particular lobe by the means of postural drainage. Taking chest x-rays will also be helpful in providing with a visual feedback on which segment of the lung to concentrate on, for further management interventions.

Students Speak About Our Assignment- Clinical case study

Oscar Saunders

I tried using many assignment writers from various affiliations, yet all of them were temperamental and they acted outlandishly. Numerous expert associations deluded me by passing on copied content. I was extremely stressed about who will do my assignment on psychology given by my teacher with several guidelines. And when I have encountered my assignment question I realized tha..


I viewed assignments as a reason for stress rather than a shortcut to earn top grades until I started seeking The Student Helpline to do my assignment. From the first encounter with these professionals, I experienced confidence and relief- things I never get usually when assigned to a topic. Just like it is mentioned on the website, they possess qualified write..


1What Makes You Better than Other Student Assigment Writing Services?

Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for 'lorem ipsum' will uncover many web sites still in their infancy. Various versions have evolved over the years, sometimes by accident, sometimes on purpose (injected humour and the like).

2Who Are Your Writers?

Contrary to popular belief, Lorem Ipsum is not simply random text. It has roots in a piece of classical Latin literature from 45 BC, making it over 2000 years old.

3Can I Communicate with My Writer?

Yes, you can send an e-mail along with your assignment code and our coordinator will send your assignment to an assigned writer who will respond you back as soon as possible.

4How Do You Guarantee That You Will Follow My Instructions?

Our online expert writers follow your instructions while conducting the research and write your paper from scratch so that the completed assignment is 100% original and tailored to university’s requirements. All the resources used by the writers are duly referenced to avoid plagiarism.

5How Is the Price Calculated?

Our writers offer the right prices after thoroughly checking your requirements. We are aware of the financial situation of the students and are ready to work in their budget. We provide the highest quality of service at the lowest price possible.

Meet our Respectable Specialist

If writing tasks related to Physics are causing you trouble then here we have our expert all set to give you perfect guidance. Feel free to chat with him and discuss your problems anytime.

Higher Degree Holder

Expert in All Majors

Focus on your Success

Creative in Writing

David Will



Mr.Will is our leading Physics expert who has completed a Master's in Physics from Edinburgh University and acquired three years of experience as a high school physics teacher and two years as a research analyst. He is a savior to students who encounter difficulties with Physics-related scholarly writing as he posses great skills in drawing a guide to quick study and the best academic preparation for dissertation and thesis.

Need more details about Writing services?

High Quality Custom Content Writing Fast Service. #1 Copywriting Agency. Unlimited Revisions. SEO Friendly. 100% Original Content. Free Meta Details. Within 1 - 3 Days. Highlights: Live Chat Option Available, Delivering Creative Content Solutions.

Get It Done! Today

  • 1,212,718Orders

  • 4.9/5Rating

  • 5,063Experts


“My wound healing efficacy dissertation turned out just excellent with the extreme level of proficiency. I did not expect online writers to do such a scrupulous job. The content was precise, scientific, and thoughtful. Likewise, the sources were cited according to APA standards. I could not have been happier. I entrust my success to the dissertation professionals of Thestudenthelpline and recommend everyone for the same.” - Evelyn

Assignment writing-
"I never expected my first year to be that hard, and I panicked when I saw so many papers assigned to me. In spite of being a diligent student, I ordered this one assignment due to a lack of time to 'Thestudenthelpline'. I got my essay written according to almost all the instructions directed to the website. The writer did it well. Moreover, the price was not expensive either. I will use this service again if necessary." - Harper, a psychology freshman

Essay writing
"I ordered a 3-page essay on comparative analysis from Thestudenthelpline. Though the comparative analysis is not easy, it did not count as complex. The essay writers are very patient and open to customer views. Because of the cooperative writers, I was able to deliver my essay way before the deadline. The essay was structured with the proper sentence skills and had all the necessary sources, cited according to the rules. You can definitely place your order here if you need qualified assistance." - Aubrey



  • 21 Step Quality Check
  • 2000+ Ph.D Experts
  • Live Expert Sessions
  • Dedicated App
  • Earn while you Learn with us
  • Confidentiality Agreement
  • Money Back Guarantee
  • Customer Feedback

Just Pay for your Assignment

  • Turnitin Report

  • Proofreading and Editing

    $9.00Per Page
  • Consultation with Expert

    $35.00Per Hour
  • Live Session 1-on-1

    $40.00Per 30 min.
  • Quality Check

  • Total

  • Let's Start