Case Study with Short Answer Questions

This case study discusses the nursing care considerations for the safe administration of morphine, non-pharmacological nursing comfort measures for postoperative pain management, and nursing considerations for caring for a patient with a sigmoid colostomy during the postoperative period.

CASE STUDY WITH
SHORT QUESTION

Table of Contents
QUESTION 1...................................................................................................................................3
Question 1: Postoperatively, Mr. Hemsley has been ordered PRN I.V. 2.5mg to 5mg
Morphine for his pain relief. Discuss one (1) nursing care consideration for the safe
administration of this medication...........................................................................................3
QUESTION 2...................................................................................................................................4
Question 2: Discuss one (1) non-pharmacological nursing comfort measure you can undertake
to help manage Mr. Hemsley’s postoperative pain................................................................4
QUESTION 3...................................................................................................................................5
Question 3: A sigmoid colostomy was performed on Mr. Hemsley during surgery. Discuss
one (1) nursing consideration when caring for the patient with a colostomy during the
postoperative period...............................................................................................................5
REFERENCES................................................................................................................................6

QUESTION 1
Question 1: Postoperatively, Mr. Hemsley has been ordered PRN I.V. 2.5mg to 5mg Morphine
for his pain relief. Discuss one (1) nursing care consideration for the safe administration of
this medication.
Mr. Hemsley has been facing the issue of rectal adenocarcinoma which may require proper
support and care. Due to this, the postoperatively that provide the context which show the PRN
I.V 2.5 mg to 5mg Morphine which is used for the pain management (Yan and et. al., 2022).
Therefore, the drug and medication are used to show the aspect which is related with the safe
administration for the medication. The proper safe procedure is used to follow the context that
show the aspect which is well related with the issue that may show the aspect that provide the
procedure of safe medication process which include route of administration. In the context to the
morphine, the drug is eventually applied as the analgesic which may play role in the management
of pain with the Mr. Hemsley (Abd-Elhay, Osman, Gadallah, and Sayed, 2019). Therefore, the
morphine injection is usually coming as the form of solution that is well related with the dosage
form which is solution that is liquid to inject the intramuscularly into the term of muscle or the
intravenously that is administer to the vein. It is usually injected once every 4 hours as per the
requirement. In the case of Mr. Hemsley, they are facing the issue which is providing the aspect
that he requires support for their pain management where the analgesic is the best suitable option
which is used in order to manage and reduce the pain which is face by patient due to the rectal
issue (Wang, Tian, and Zhang, 2020). Prn i.v. 2.5mg is also recommended in such a way which
may showing the aspect to reduce the pain. In addition, the proper indication is used to follow
which may show the aspect which is well focus on the safe administration where proper I.V
guidelines are used to follow the context that provide the aspect that show the context of less
complication due to the improper administration. Some of the adverse effect which may analyse
due to the fraction of administration when the medication is provided to the patient such as
nausea and vomiting. Therefore, the proper monitoring and administration is taking care by the
nurses with the procedure of safe administration which is helpful to reduce the issue of adverse
reaction that may seen after the administration of drug (Halemani, Shashidhara, and D’Souza,
2021).

QUESTION 2
Question 2: Discuss one (1) non-pharmacological nursing comfort measure you can undertake to
help manage Mr. Hemsley’s postoperative pain.
There are various of non-pharmaceutical nursing intervention are used to taken in order to create
the comfort which is related with the Mr. Hemsley situation. Therefore, the massage and
physical therapy may play vital role in the management of pain which is may show the impact
that is helpful for the patient that provide relaxation and comfort from the massage and therapy.
They are usually help to relax the muscle and provide the comfort to the patient which may
create the issue of pain due to the situation of rectal adenocarcinoma. Massage is defined as the
clinical tactic which is used by using the muscles fraction that used to induce the aspect which
may contribute to the pain management. The lot people are used to show the aspect which is
taking the relief from the gentle massage and some of the hospice agencies hire on the volunteer
who are usually trained in the context of massage therapy (Halemani, Shashidhara, and D’Souza,
2021). There are several of studies which is well focus on the context that found that the massage
is more effective when taking the comparison with the other form which may related with the
medication and so on (Theodoropoulos, 2018). Therefore, this non-pharmaceutical intervention
well supports the patient in such a way which show effectiveness in the relieving of pain and
other symptoms for the people with the illness which is serious and critical. The physical therapy
is showing the aspect where person has been active before and now, they are confined to the bed
just moving the hand and fits which can help the Mr. Hemsley to gain some of the activeness in
their strength and focus on the aspect which promote to the pain management. There is other
technique which is also used with the study of case study that include the relaxation technique
where the guided imagery, hypnosis, biofeedback, breathing technique and gentle movement are
used which is also kwon as the Tai chi. This relaxation technique is usually focus on the
effectiveness that is particularly related with the patient. It helps to reduce the complication
which is related with the anxiety (Mirza and et.al., 2021).

QUESTION 3
Question 3: A sigmoid colostomy was performed on Mr. Hemsley during surgery. Discuss one
(1) nursing consideration when caring for the patient with a colostomy during the
postoperative period.
The sigmoid colostomy is usually performed on Mr. Hemsley complication where the nurses
play vital role in the support and care after the surgery. The nursing consideration which is
follow after the surgery of colostomy is that they must focus on the routine and pattern of
medication and make proper report complexities and coordinated with the healthcare
professional to reduce such type of issue (Odensten and et. al., 2019). Therefore, they usually
provide proper support and care, they will also show their involvement in the proper
communication and coordination regards with the treatment which may include liaising with the
surgical team and other member of the multidisciplinary team that may show contribution in the
care. Whereas, the other role which may also performed by the nurses is usually focus on the
empty, irrigate and cleanse ostomy pouch on the proper routine basis by using the advance
instrument. The frequent pouch change which is showing the irritation to the perforation of skin
and they are usually avoided. The emptying and rinsing the pouch with the proper solution which
is not measured to removed the bacteria which is showing the aspect that odor causing tool and
flatus but also show the aspect which is well related with the deodorizes towards the aspect of
pouch. These all consideration are related with the specification of support and care which is
provided by the nurses to the Mr. Hemsley where he faces the issue which is usually generate
with the post operative patient (Popazu, Voicu, Ciubară, Stan, and Ciubară, 2022).

REFERENCES
Books and Journals
Abd-Elhay, H.A., Osman, M.A., Gadallah, M.A. and Sayed, E.H., 2019. Post-operative
Peristomal Skin Complications in Children with Colostomy. Assiut Scientific Nursing
Journal, 7(19), pp.147-153.
Halemani, K., Shashidhara, Y.N. and D’Souza, S.R., 2021. An Evaluative Study to Assess the
Effectiveness of a Video-Assisted Teaching Module on Knowledge and Practice Regarding
Home-Based Colostomy Care of Children Among Primary Caregivers in Selected Hospital
Lucknow, Uttar Pradesh. Indian Journal of Surgical Oncology, 12(1), pp.146-151.
Halemani, K., Shashidhara, Y.N. and D’Souza, S.R., 2021. An Evaluative Study to Assess the
Effectiveness of a Video-Assisted Teaching Module on Knowledge and Practice Regarding
Home-Based Colostomy Care of Children Among Primary Caregivers in Selected Hospital
Lucknow, Uttar Pradesh. Indian Journal of Surgical Oncology, 12(1), pp.146-151.
Mirza, K.L., Wickham, C.J., Noren, E.R., Hwang, G.S., Ault, G.T., Ortega, A.E., Jafari, M.D.
and Cologne, K.G., 2021. Outcomes of colostomy takedown following Hartmann's
procedure: successful restoration of continuity comes with a high risk of
morbidity. Colorectal Disease, 23(4), pp.967-974.
Odensten, C., Strigård, K., Rutegård, J., Dahlberg, M., Ståhle, U., Gunnarsson, U. and Näsvall,
P., 2019. Use of prophylactic mesh when creating a colostomy does not prevent parastomal
hernia: a randomized controlled trial—STOMAMESH. Annals of surgery, 269(3), p.427.
Popazu, C., Voicu, D., Ciubară, A.B., Stan, D. and Ciubară, A., 2022. The Influence of the
Mental State on the Emergency Colostomized Patients Postoperative Evolution. BRAIN.
Broad Research in Artificial Intelligence and Neuroscience, 13(1Sup1), pp.267-276.
Theodoropoulos, D., 2018. Current options for the emergency management of diverticular
disease and options to reduce the need for colostomy. Clinics in Colon and Rectal
Surgery, 31(04), pp.229-235.
Wang, Y.X., Tian, J.X. and Zhang, K.S., 2020. The Research Status of Self-care Agency
Assessment and Intervention of Enterostomy Patients. TMR Integrative Nursing, 4(6),
pp.183-189.
Yan, M.H., Lv, L., Zheng, M.C., Jin, Y. and Zhang, J.E., 2022. Quality of Life and Its
Influencing Factors Among Chinese Patients With Permanent Colostomy in the Early
Postoperative Stage: A Longitudinal Study. Cancer Nursing, 45(1), pp.E153-E161.