Case Study: Discussion of Medical Treatment and Development of Nursing Care Plan

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Case study: discussion of medical treatment and development of nursing care plan Pre-operative care After a provisional diagnosis of acute appendicitis has been made to Jane, diagnostic tests including chest x-ray, abdominal x-ray and a blood test are ordered for her. Chest x-ray (CXR) also known as chest radiograph, it is a projection radiograph imaging the chest, lungs, heart, large arteries, ribs and diaphragm. CXR is used to diagnose health problems affecting the chest, its structure and content (Roy, 1992). A CXR is ordered for Jane because pneumonia in the lower right lung can cause similar pain to acute appendicitis. June’s CXR is expected to be normal, in which the lungs should be appear in dark color with no white dots as whiteness in the lungs area indicates the absence of air (Maskell 2012, pp.90-101). Therefore, the doctor needs to check if there is whiteness presented in June’s lower right lung for the concern of pneumonia. An abdominal x-ray (AXR) is an imaging test to check the organs and structures in the abdominal area. This includes the liver, stomach, spleen, large and small intestines. When the test is focus on looking at the bladder and the kidney structures, it is called a KUB (Judith 2002, p.707). Many believe that an AXR does not help in diagnosing appendicitis but it can be used to identify other sources of abdominal pain such as appendix stone. However, Dr Lee (1976, pp.763-766) has an opposite point of view. He states that the value of AXR in acute appendicitis should be fully appreciated as there are several radiological signs in acute appendicitis, increased soft-tissue density in the RLQ, alteration of the right flank stripe and alteration of the psoas outline for example. These signs should appear in June’s AXR if she has appendicitis. Laboratory tests such as FBC and UEC’s are also ordered for June. In a full blood count

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