His daughter might also face difficulty

Running head: CASE STUDY
CASE STUDY
Name of the Student:
Name of the University:
Author Note:

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CASE STUDY
Answer 1.
Ted is an older adult individual who has gone through a temporary colostomy surgery
four days ago. On the fourth day after taking his regular metformin dose along with a light
breakfast, he started vomiting. He vomited for two times and reported to feel nauseous. He
also complained about pain in the abdomen, which was getting worse with palpation. Upon
examination, his stoma appeared normal, but his abdomen was distended. He was slightly
feverish, his blood pressure and respiratory rate were slightly high, and his blood oxygen
level was also low.
The patient is a widower who lives alone in a retirement village. The village is about
two and a half hours away from the city, where the daughter of the patient lives with her
family. Patient’s son lives overseas, and the patient has a helpful neighbour, who is also an
older adult individual named Gwen.
Ted has a post-operative complication and considering his age, he will require
assistance in the management of his health conditions, after his discharge from the hospital.
Due to the geographical distance, it will not be possible for the patient’s son to visit him
every day. His daughter might also face difficulty with visiting him regularly since she has
three children to care for. Gwen, his neighbour, can help him to some extent. However, she is
also an older adult individual, and there might also be some limitations for her helping
resulting from some cultural and social issues.
Answer 2.
The patient had a medical history of type II diabetes mellitus, obesity, gout and heart
failure condition. He also had a colostomy previously along with a biopsy. The biopsy result
suggested that he had a malignant mass. He was prescribed with metformin for his diabetic
condition, captopril for his heart failure condition, allopurinol for his gout condition,

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CASE STUDY
paracetamol for pain management and frusemide for ensuring proper urine output after the
surgery. He had no solid food or liquid intake through the mouth for 48 hours after his
surgery. He was given a liquid diet on the third day morning and from the evening, he was on
a light diet. He started to feel nauseous and vomited two times after he had a light breakfast
and his regular metformin dose. He was also experiencing slight respiratory problem along
with a pain in his abdomen, even though he was being administered with morphine for
effective pain management. Upon examination, his colostomy bag was found to be intact.
However, there was a sluggish bowel sound along with no passage of flatus. His dressing at
the site of surgery was intact, and there was only a minimal level of ooze present. Ted also
had a urinary catheter and a medivac drain attached to his body. The medical examination
also found that the patient has moist productive cough along with right-sided inspiratory
cackle.
Even though it is a common practice for keeping the patients nil by mouth for at least
48 hours post gastrointestinal surgery, it also presents with a significant risk of postoperative
ileus in the patients (Volpi et al., 2016). The patient was receiving morphine therapy, and
thus it is not usual for him to feel the pain from the operation cut (Gan, 2017). His bandage
appeared to be clean and tight with minimal oozing. Thus the site cannot be infected. There
was no inflammation in his stoma either as it appeared normal, which can be described as
pink, warm, moist and slightly elevated from the skin (Steinhagen, Colwell & Cannon, 2017).
The metformin was given to him more than 72 hours post-surgery according to the normal
procedure to avoid the risk of hypoglycaemia in the patient (Duggan, Carlson & Umpierrez,
2017). However, upon examination, it was found that he had not passed flatus, and his
abdomen was slightly distended, which were the significant signs of postoperative ileus,
resulting from the gas accumulation within the bowel. Frequent vomiting, the feeling of