Acute Care Nursing : Assignment
Added on 2019-10-31
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Acute careName of the student:Name of the university:Author note:
PART ALaparotomy is a type of incision in the abdominal cavity. This type of operation is generally forthe examination of the abdominal organs and for the diagnosis of any type of problem whichincludes abdominal pain. After the laparotomy had been done it can cause to various problems.Here in this care plan there has been described the top three priority problems are risk ofconstipation, acute pain and skin/tissue integrity, impaired[ CITATION Ack16 \l 1033 ].Learning triggers.Rationale/clinical reasoning relating to the IBLscenarioWhat is intestinal obstruction? What are thetypes of intestinal obstruction? What is thedifference in the clinical manifestations ofsmall or large intestinal obstruction?It is a type of blockage in the intestine may bepartial or complete which prevents the passingof the contents of the intestine. Types ofobstruction are small bowel obstruction andlarge bowel obstruction (Cobb et al, 2105).Clinical manifestations of small bowelobstructionadhesions (previous operation)external herniasmall bowel volvulus (primary)neoplasmsClinical manifestations of large bowelobstructioncarcinoma of colonvolvulus (sigmoid)diverticular disease) What are some of the presenting complaintsof Mr Jones that is indicative of bowelobstruction?Mr. Jones is noticing some blood with hisstool; he was also suffering from abdominalpain and constipation. What are the surgical goals and the pre-operative preparation for a patient going forcolorectal surgery?The patient starts preparing for the surgery fewdays before the surgery[ CITATION Doe14 \l1033 ]. The doctor may prescribe the oralantibiotics to start days before the surgery. Thepatient is asked to keep the colon as empty aspossible to keep the risk of infection at bay. 2) The operation has a stoma and a largedressing covering his laparotomy wound.The basic principle of the surgery is to removeWhat type of surgery does Mr Jones need for
the vascular pedicle along with the lymphaticswhich feeds the tumor. This procedure is doneto obtain a tumor free margin.his recto sigmoid tumour? Why is a colostomyperformed in Mr Jones’ case?An emergency laparotomy was done on Mr.Jones for the resection of the recto-sigmoidtumor. After the surgery he has a stoma and alarge dressing covering his laparotomy wound(Lambrecht et al., 2015).4) What are the types of ostomies? What arethe specific nursing management after ostomysurgery? Two types of ostomies are ilieostomyand colostomy. Nursing care management planafter surgery are:Assessment on the stoma location and thecolostomy. Position a collection bag or drainable pouchover the stoma.Empty a drainable pouch or replace thecolostomy bag according to the need or when itis one-third full.Provide stomal and skin care for the client witha colostomy[ CITATION Zha17 \l 1033 ].How long will it take for Mr Jones’s colostomyto be active? What are some of the possibleareas of concerns of Mr Jones going home witha colostomy?Post operative care for Mr. Jones are:Mr. Jones has to strictly follow a balanced dietwhich comprises a lot of fresh fruits ansvegetables.Eating yogurt or drinking buttermilk may helpreduce gas.Mr Jones must change his pouch. Empty thepouch when it is one-third full.Mr Jones must stop eating such foods likecabbage, broccoli, onions, garlic and fish in toreduce the odour of the bowel.Every time while emptying the pouch, verycarefully clean the pouch opening. Neverforget to clean both inside and outside of thepouch with a wet toilet paper.He must rinse his pouch 1 or 2 times daily afteryou empty it (Di Gesaro, 2012)5) Identify some of the general post-operativenursing care concerns after a laparotomy? A small tube may have been passed throughyour nose and into your stomach to help drainstomach secretions for a day ortwo[ CITATION Doe14 \l 1033 ].A urinary catheter may be inserted to drain offurine.Pain relief should be given regularly, asordered by the doctor.5) Prepare a patient & family teaching guidefor Mr Jones & Mrs Jones on ostomy self care.What are the effects on food on stoma output? Eat meals regularly. This means eating smallmeals every 2 to 3 hours or 6 to 8 times a day.At each meal and snack try to eat a starchyfood and protein food. Starchy foods includebread, cereal, rice, pasta andpotatoes[ CITATION Doe14 \l 1033 ]. Proteinfoods include meat, fish, cheese, peanut butterand eggs.Part BNursingdiagnosis(fromNANDA-I)GoalNursinginterventionsRationaleEvaluation/expectedoutcome
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