Mr S. is a 45-year-old man who has just been admitted to the ICU postoperative cardiac surgery. He has had an uneventful coronary artery bypass graft with no complications in the operating room. He is intubated and placed on complete mechanical ventilation. His vital signs are: blood pressure (BP) 150/90 mm Hg, heart rate 86 beats per minute, respiratory rate 12 breaths per minute, and temperature 35.3°C
The target systolic BP for Mr S. is less than 130 mm Hg and the surgeon’s postoperative orders include BP medications and intravenous morphine sulfate for pain. In addition, the surgeon prescribes an nonsteroidal anti-inflammatory drug, ketorolac, to be administered to the patient once it has been determined that they are not bleeding excessively and have acceptable renal function.
The ICU where Mr S. is admitted has a respiratory therapist (RT) on staff. This RT is aware that mechanical ventilation is very uncomfortable for patients. There is a standing order in the ICU that heart surgery patients may be weaned from the ventilator as tolerated and extubated when stable.
When Mr S. is beginning to arouse from the anesthesia, he is grimacing and his BP is rising above the target level. The nurse administers morphine sulfate as ordered. In addition, Mr S. is given a warming blanket to increase his body temperature.
The next morning, Mr S. is seen by the ICU physiotherapist. When assessing Mr S.’s comfort needs, the physiotherapist recognizes that he is anxious about moving and exercising so soon after surgery. With this in mind, the physiotherapist carefully explains her plan of care to Mr S. in a calm and unhurried manner. This allows Mr S. to relax. He becomes willing and able to work with the physiotherapist in his postoperative exercise routine.
The healthcare team worked collaboratively to enhance the patient’s comfort during the immediate postoperative period. This, in turn, led to Mr S. having a successful recovery period with no significant complication
How did the nurse applied the theory of Abdellah in this case?