Colorectal Cancer Survivor Follow-Up Care

This assignment delves into the crucial aspects of follow-up care for individuals who have survived colorectal cancer. It examines various resources such as clinical practice guidelines from organizations like the American Society of Clinical Oncology (ASCO) and the European Society for Medical Oncology (ESMO), as well as research articles that highlight best practices in survivorship care planning. The focus is on understanding the physician's role in this process, including surveillance protocols, secondary prevention measures, and the utilization of tools like Carcino-Embryonic Antigen (CEA) measurements.

Running head: NURSING CARE PLAN POST LAPAROSCOPIC SURGERY
Nursing care plan post laparoscopic surgery
Name of the student:
Name of the university:
Author note:

1NURSING CARE PLAN POST LAPAROSCOPIC SURGERY
Table of Contents
Problem 1: 2
Problem 2: 2
Problem 3: 2
Nursing care plan: 3
References: 11

2NURSING CARE PLAN POST LAPAROSCOPIC SURGERY
Problem 1:
As the patient has undergone a laparoscopic surgery, the most vital postoperative problem or
risk factors for the patient are infection. According to the case study the patient has a large
dressing covering his surgery wound, which increases the potential risk for the patient obtaining
infection. Hence the first problem chosen for the patent is the risk for infection (Klabunde et al.,
2016).
Problem 2:
Another potential risk for the patient post the laparoscopic surgery is relapse of bowel
obstruction. It has to be understood in this context that the patient had already been suffering
from extreme constipation and bowel obstruction prior to the surgery due to a tumour obstruction
in the recto sigmoid region of the colon and multiple lesions in the liver. Now as the patient has a
stoma, a common complication that occurs in such cases is the retraction of the bowel back into
the abdomen either causing severe bowel incontinence, or diarrhoea (Meyerhardt et al., 2013).
Problem 3:
The third patient problem identified from the case study is the anxiety, a very common
occurrence in patients undergoing postoperative care. Given the fact that the patient has been
suffering from acute hypertension for the past eight years only escalate the possibility of the
patient suffering from greater anxiety due to his surgery and the possibility of further
complications in the future. Cancer diagnosis is also extremely difficult for the patient to
undergo and anxiety is a vital patient problem keeping the cancer diagnosis in account (Verberne
et al., 2015).

3NURSING CARE PLAN POST LAPAROSCOPIC SURGERY
Nursing care plan:
Nursing
diagnosis
(from
NANDA-
I)
Goal Nursing interventions Rationale Evaluation/
expected
outcome
1)
Risk for
infection
at the
surgical
wound
site
 Mr. Jones does not
acquire infection
in his wound site,
and any evident
sign and symptom
of infection is not
shown by him
(Verberne et al.,
2015).
 The patient will be
comfortable and
will receive
meticulous
infection control
policy
 The surgical
wound site of the
 Frequent and
periodical
assessment and
monitoring of the
surgical wound site
to check for any
sign of infection
such as redness,
swelling, and
tenderness in the
wound site, pain in
the wound site, or
presence of
exudates
discharging from
the wound site.
 Diligently adhering
 Infection in
the surgical
wound site
is a very
common
post
operative
complicatio
n; periodic
critical
assessment
of the
wound site
will help in
earliest
diagnosis of
any
 The patient
remains free
of infection,
and does not
show any
signs or
symptoms of
infection
(Verberne et
al., 2015).
 The surgical
wound of the
patient
remains free
of any
infectious
agents and

4NURSING CARE PLAN POST LAPAROSCOPIC SURGERY
patient will be
cleaned as per
guidelines as
frequently as
possible.
 The nursing
professional will
diligently abide by
five moments of
hand hygiene
while handling the
patient every time.
 The patient will
engage in hand-
washing and
personal hygiene
as well.
to aseptic
techniques for
wound cleaning and
wound dressing
 Complying to the
five minutes of
hand hygiene
policy and teaching
the patient adequate
hand- washing
requirements as
well (Verberne et
al., 2015).
 Incorporating
protein rich and
calorie rich food in
the diet plan for the
patient and
encouraging him to
drink 2 to 3 litres of
water a day.
infection if
the patient
acquires it.
 Maintaining
aseptic
technique
while
wound
dressing and
wound
managemen
t will
exponentiall
y decrease
the risk of
contaminati
on, and
avoid any
potential
transmission
s.
 The
components
the wounds
at an
expected
pace.
 The patient
understands
the benefits
of hand
hygiene and
performs
hand hygiene
successfully
along with
the care
professionals
.
 The patient
remains free
of infection
throughout
his stay.

5NURSING CARE PLAN POST LAPAROSCOPIC SURGERY
of five
moments of
hand
hygiene will
effectively
eradicate the
most of the
pathogens;
hence
regular hand
washing is
known to
minimize
the risk of
infection.
 Protein and
calorie rich
food will
enhance the
innate
immunity of
the patient
and the

6NURSING CARE PLAN POST LAPAROSCOPIC SURGERY
water intake
will
detoxify his
body and
negate the
risk for
urinary tract
infection
(Wagner et
al., 2013).
2) Bowel
obstructi
on and/or
diarrhoea
.
 The patient will
achieve improved
bowel
improvements.
 The patient will
not feel bloated
nor will experience
any pain sue to
bowel obstruction
(Van Cutsem et
al., 2014).
 The colostomy of
the patient will be
 Assessment and
analysis of the
onset or pattern for
diarrhoea in the
patient.
 Observation of the
stool frequency and
characteristics.
 Observation for
associated factors
of bowel
incontinence, like
fever, abdominal
 Irritable
bowel
incontinenc
e of
obstruction
in most
cases can
lead to
chronic
diarrhoea,
assessment
of possible
onset will
 The patient
will avoid
relapse to
bowel
obstruction
and will
avoid the risk
of diarrhoea
as well
()Meyerhardt
et al., 2013.
 The
colostomy of

7NURSING CARE PLAN POST LAPAROSCOPIC SURGERY
functional
throughout his stay
in the facility.
pain, cramping, or
bloodied stool.
 Management and
prompt changing of
the stoma and
periodic clearing
(Meyerhardt et al.,
2013).
 Encouraging the
patient to remain on
bed rest and
restricting food
intake that can
precipitate
diarrhoea.
serve in
early
detection
and
preventative
managemen
t.
 Stool
characteristi
c
assessment
will help in
understandi
ng the
severity of
the
complicatio
n and arrive
at more
reasonable
clinical
judgment.
 The
the patent
will be free
of infection
and the
patient will
remain
comfortable.

8NURSING CARE PLAN POST LAPAROSCOPIC SURGERY
assessment
of
associated
factors will
reveal
important
information
regarding
etiology of
the
complicatio
n.
 Prompt
stoma
managemen
t will reduce
the risk of
infection
and
blockage
(Mayer et
al., 2014).
 Bed rest

9NURSING CARE PLAN POST LAPAROSCOPIC SURGERY
will
decrease
intestinal
motility and
increase the
metabolic
rate and
restricting
diet will
help in
controlling
the onset of
diarrhoea.
3) post
operative
and post
diagnosti
c anxiety
 The patient
understands and
accepts the cancer
diagnosis and
participates
optimistically in
the care planning.
 The patient
expresses the
contributing
 Explaining the
patient the details
of his medical
condition and
helping him cope
with cancer
diagnosis with
positivity.
 Establishing
mutually respectful
 Patient
education
will help
him
understand
the
prognosis
more clearly
and
overcome
 The patient
will be able
to
communicate
his fears.
 The patient
will
understand
his recovery
scope and be