Indian Journal of Surgical Nursing

This is a case presentation on Klatskin’s tumour. He is aged 47 admitted to Gastroenterology ward with the complaints of progressive abdominal distention over a period of one month, with pain in right upper quadrant. His abdominal girth confirmed distention due to ascites and thrill on ballottement. He had hypoalbuminemia in diuretic stage but his Serum Protein levels were within normal limits. He had stent fixation markings and scar due to radiation therapy on his abdomen. His Alkaline Phosphatase indicated an obstruction of biliary system. Paracentesis confirmed infection. He was diagnosed as Hilar Cholangio Carcinoma i.e., Klatskin’s Tumor with Stenting and Post Radiation Therapy with Reactive Mesothelial Proliferation. He was found to have Liver Secondaries (Unresectable Tumor) since the growth extended to the under surface of the liver. ERCP was attempted twice and precut was extended. Liver enzymes were given along with symptomatic treatment. His activities were gradually increased as he could tolerate. The case presentation is extended with the application of nursing process as well. 

Key words: Klatskin’s tumor, Paracentesis; Stent; As cites. 

To assess the post operative activities (Ambulation, Deep breathing exercises, circulatory exercises, abdominal exercises and daily activities) among experimental and control group after pre operative teaching on early ambulation. To evaluate the effectiveness of computer–assisted pre operative teaching in reduction of post operative complications by early ambulation in experimental and control group.  Sixty samples (30 in experimental and control group) were selected by convenient sampling technique from the male and female surgical ward, post operative annex ward .The researcher used post test only design Interview schedule is used to collect the demographic information, Observational checklist deals with post operative activities and, Assessment of physiological parameters, used as an instrument to assess the effectiveness of computer assisted pre operative teaching in reduction of post operative complication among patient undergoing abdominal surgery. The finding of the study shows that ,the mean score for the 3rd day was 37.74(75.54%) with SD of 7.79 in experimental group, 18.07(36.14%) with SD of 1.82 in control group and their percentage of gain score difference is 39.40%. Since the percentage gain score difference is increasing it shows that computer assisted teaching has effectiveness in experimental than control group. There is no statistically significant difference in reduction of post operative complications in both groups. The major conclusion drawn from this present study is that there is increasing level of activity occurs in the experimental group by means of computer assisted pre operative teaching. There is significant difference between the effectiveness of computer assisted pre operative teaching on early ambulation between experimental and control group.  

Keywords: Early ambulation; Post operative complications; Abdominal surgery. 

An experimental study was conducted to assess the effectiveness of progressive muscle relaxation technique on pain perception among patients who are subjected to abdominal surgery. Experimental repeated measures design was chosen for this study. With a total of 40 male and female patients, 20 patients were considered as experimental group and 20 as control group. The technique that was adopted for this study was random sampling method. Progressive muscle relaxation was given as intervention for experimental group and only observation was made in the control group. Collected data were analyzed by descriptive and inferential statistics. Study results showed that mean pain score for the first day morning in pretest was 6.70 with standard deviation 0.92 and the post test mean was 6.30 with standard deviation 1.03. Thus the mean pain score (6.3) on third post operative day was less compared to mean pain score (6.7) on the first post operative day. From the above mentioned statistical values it is observed that there is a high statistical significance in pain perception at P<0.001 and there were no changes were in level of pain in control group. This clearly indicates that progressive muscle relaxation technique has influence on pain perception in the experimental group.

Key Words: PMR (Progressive Muscle Relaxation); IASP (International Association for the study of Pain); SBP (Systolic Blood Pressure); DBP (Diastolic Blood Pressure).

Evidence-based practice (EBP) involves complex and conscientious decision-making which is based not only on the available evidence but also on patient characteristics, situations, and preferences. It recognizes that care is individualized and ever changing and involves uncertainties and probabilities. Evidence-Based Nursing (EBN) is a type of evidence-based healthcare, drawing on some of the traditions of evidence-based medicine. It involves identifying solid research findings and implementing them in nursing practices, in order to increase the quality of patient care. The goal of EBN is to provide the highest quality and most cost- efficient nursing care possible. EBN is a process founded on the collection, interpretation, and integration of valid, important, and applicable research. In order to practice evidence based nursing, practitioners must understand the concept of research and know how to accurately evaluate this research. These skills are taught in modern nursing education and also as part of professional training.

Key Words: Evidenced based practice; Evidenced based nursing; Evidenced based nursing practice; Intensive care unit.