Principles of Nursing: Surgical Question Answer 2022

Running head: PRINCIPLES OF NURSING: SURGICAL
PRINCIPLES OF NURSING: SURGICAL
Name of the Student:
Name of the University:
Author’s Note:

PRINCIPLES OF NURSING: SURGICAL1
Answer 1
From the review of the case study, it was known that Edward William or Ted is an 82
year old man who had bowel resection and formation of temporary colostomy; thus, was
operated. Previously, colposcopy and biopsy were conducted upon him that clearly confirmed
that there was a presence of a malignant mass in his colon. From the past medical history, it
was known that he had suffered from heart failure, type II diabetes mellitus, gout and obesity
where his BMI was 37.6m2. From his familial background, Ted is a widower and lived alone
after his wife died due to a bout of pneumonia three years ago. About a year ago, he had
moved to a retirement village that is approximately two and a half hours away from the city
and was near to where he used to live with his wife and children. His children, a son, named
Christopher lives overseas with his family comprising of his wife and son and his daughter
Janice who lived in the city with her husband and three children. Ted has a partner, Gwen,
who was 78 years old and lived in the same retired village. From bio psychological
assessment, it can be stated that Ted was responding in a positive manner to the operation;
the evaluation was done after four days. Instead of an issue of abdominal pain, it was no such
serious complication found. As it was found that he does not have an immediate family and
the only one who was with was an older woman thus, it can be stated both Ted and Gwen had
an accepting attitude toward the surgery. The emotional and cultural impact of the surgery on
Ted and his family was no significant in nature (Williams, 2017). It can be seen that the age
is one of the most significant factors that affected his life and daily processes over the time
and since the mass found to be malignant, thus, Ted had agreed to the surgery in no time.
This is because delaying it may increase the possibility of its growing its size and pose a
threat to life (Wilson et al., 2018). From the spiritual aspects, it can be stated that Ted had
prioritised medical services more than spiritual or religious belief or value; as a result, he was
willing to conduct the colposcopy as soon as the malignant mass identified in his colon.

PRINCIPLES OF NURSING: SURGICAL2
Answer 2
From stages two and three of Clinical Reasoning Cycle, collection of cues and
information, the case study had been able to present all the details. After four days of
operation, he had not eaten anything in the first 48 hours of the surgery and on day 3, he was
given a fluid diet and light diet in the evening. On assessing his vital signs, he had a slightly
high temperature (38.1), normal heart rate, and elevated somewhat bp (135/85). He had a
right-sided inspiratory coarse crackle and moist product cough. As per the opinion of García
et al. (2019), coarse crackle is found to be louder, long-lasting and low pitched thus, it
indicates that there is excessive fluid in the lungs and may be caused due to aspiration,
pulmonary edma, pneumonia that require thorough investigation. On the other hand, the
productive and moist cough stated that it produces mucous or sputum and thus there is
congestion in the chest. This may indicate to the fact that he might be suffering from
pneumonia-like symptoms (Li et al., 2020). According to the study by Zhu et al. (2020),
pneumonia is an infection that causes inflammation of the air sacs in one or both the lungs.
The air sacs are filled with fluid and cause coughing, fever, abdominal pain and difficulty in
breathing. In addition to this, he had compliant of abdominal pain which was in the scale of 4
to 5 out of 10 however, on palpitation worsen and increase to 7 out of 10 and it was observed
that his abdomen was distended. This indicates that there is swelling in the abdominal area
due to accumulation of fluid in the activity, which gives the swelling appearance (Mesquita &
Rosas, 2017). The colostomy bag was intact and the stoma can be seen through the bag. The
physical feature of stoma includes warm, moist, pink and raised above the skin. This is one of
the indications that occur after surgery and is a common aspect that reduces in size with time.
The concerning factor was no output after the surgery, sluggish bowel sound and did not pass
flatus. This indicates that he a temporary delay in the gastrointestinal mobility after surgery
or postoperative ileus. According to Katayama et al. (2016), the probable reason of this is the