Non-Obstetric Surgery during Pregnancy – Pregnancy Example

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"Non-Obstetric Surgery during Pregnancy" is a decent example of a paper on pregnancy. Non-obstetric surgery is a clinical practice issue, which may be required during pregnancy and poses a challenge for the obstetrician. Non-obstetric surgery that occurs during pregnancy mostly includes the emergent appendectomy that accounts for almost two-thirds of all gastrointestinal surgery done during pregnancy. In this case study, an examination of positioning, as well as airway issues in the anesthetic and parturient choice for the well-being of the fetus, will be considered (Godden, 2004). A twenty-year-old woman in her 23rd pregnancy week named Mercy (not her real name), went to the emergency department after experiencing pain in the right quadrant, persistent nausea, anorexia, and vomiting for three days.

Upon presenting her symptoms, acute appendicitis diagnosis was made, which is often complicated during pregnancy since it involves that displacement of the appendix upwards, as well as laterally as the uterus expands (Godden, 2004). The young woman denied having any health problems before such as cardiac, renal, respiratory, and hepatic health problems. She had visited an obstetrician two weeks ago during her twenty weeks checkup, and the only medication she had taken was prenatal multivitamins, iron sulfate, and folate.

In addition, she denied having any surgical operations in the past, but her parents had several surgical procedures without the use of any anesthetic. The physical examination was unremarkable except for abdominal tenderness and pain, which Mercy experienced when she moved her right lower quadrant. Other vital signs such as temperature, blood pressure, heart rate, respiratory rate, and other physical appearances were normally based on her pregnancy. Also, the airway assessment was reassuring. A preoperative test done on Mercy involved cell count examination in which she showed slight leukocytosis with a 12,000/mm3 white blood Cell count, among others (Godden, 2004).

Thus, during the non-obstetric surgery, a general anesthetic was chosen for Mercy using a rapid sequence induction technique, as well as cricoid pressure because she was at a high risk of aspiration due to her pregnancy, vomiting, and nausea (Godden, 2004). The use of anesthesia in non-obstetric surgery is stressful not only for anesthesia providers but also for the patients. The main concerns include making the right choice of anesthetic agent, care of the unborn baby through maintaining maternal blood pressure and oxygenation.

For this reason, it is essential for nurses to make the right decisions before using any anesthetic agent in non-obstetric surgery. The ethical decision-making model for nurses is used to describe ethical issues faced by nurses during their clinical practice. It consists of six steps, which must be followed so as to make the best decisions. Step one involves the identification of an ethical issue, which in this case is the use of anesthesia in non-obstetric surgery.

The second step involves the collection of information so as to identify the issue and come up with solutions for the ethical issue. The third step consists of the development of alternatives that can be used to compare and analyze the ethical issue. Step four requires the selection of the best justification and alternatives while step five analysis different ways of implementing the ethical decisions relating to the issue. The final step involves the evaluation of effects, as well as the development of strategies so as to prevent such issues.

Through the use of this model, nurses are able to make confident decisions on ethical issues in their clinical practices.

References

Godden, D. R. (2004). Case Study: General Anesthesia for acute appendectomy in a pregnant woman. Clinical Residency in Nurse Anesthesia II. Vol. 1, pp. 1-6.
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