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Scenario Based on Nursing Care Plan

   

Added on  2020-04-01

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Running Head: SCENARIO BASED NURSING CARE PLAN 1SCENARIO BASED NURSING CARE PLAN (Institutional Affiliation)(Name of student)Scenario Based Nursing Care Plan

SCENARIO BASED NURSING CARE PLAN 2Problem Statement 1: Anastomotic Leakage Anastomotic leakage is not only one of the commonest postoperative problems after colostomy but also among the most serious problems. In most cases, this problem occurs 3 to 5 days postoperatively (Floodeen, 2016). Anastomotic leakage has a high prevalence and contribution to mortality. For example, anastomotic leakage accounts for about 2.9% to an alarming 15.3% of severe problems that are particular to intestinal surgery(Floodeen, 201). As far as mortality is concerned, anastomotic leakage accounts for at least one third of all mortalities associated with colorectal surgery. Mr. Peter Jones is in the third day of postoperative care. I have chosen anastomotic leakage as a postoperative problem likely to affect Mr. Peter Jones as high priority for a number of reasons. Firstly, it is because Jones is of male gender. Based on univariate analysis, the male gender is one of the major risk factors for anastomotic leakage (OR=3.5). As such, Mr. Peter Jones stands a higher chance of having this postoperative problem. Secondly, Mr. Jones has previous history of colostomy which is a risk factor for anastomotic leakage. Finally, Mr. Peter Jones has been previously diagnosed with cancer. Cancer is a significant risk factor for anastomotic leakage. Problem 2: Stress Induced by Current Surgery More often than not, stress that comes immediately after a surgical operation has been known toaffect a couple of patient (Abd-Elfattah, 2014). Basically, this kind of stress is linked to a range of physical factors that include, but are not limited to discomfort, the body’s reaction to specific painkillers and antibiotics (Jestin, Påhlman, & Gunnarsson, 2008). Also, stress after surgery can occur as a result of psychological factors including facing death possibility (I. Syed, 2016). From the emotional point of view, post-operative stress can occur as a result of the patient’s disappointment in the likely results of the surgery and also due to his/her resulting feeling of fear and vulnerability. The signs and symptoms of post-operative are mainly manifested in reduced appetite, fatigue, mood swings,despair and hopelessness.

SCENARIO BASED NURSING CARE PLAN 3I have chosen stress as the problem to likely affect Mr. Peter Jones on high priority for various reasons. Firstly, stress after operation affects scores of people, yet it goes unrecognized in most incidences. Stern opines that, of all the primary care physicians fail to recognize at least 50% of depression/stress cases in patient("Feeling Co-Operative," n.d). This is worrying since stress after operations affect lots of people. For example, as of 2007, 3 out of 100 Americans were diagnosed with stress after operation as compared to 1997 where only 2 people out of 100 people were affected. Secondly, Mr. Jones stands high chances of being affected by stress owing to his medical history. Mr. Peter Jones has a history of cancer; a disorder that is associated with stress resulting from the possibility of death. Problem 3: Rapid And Shallow BreathingJust 48 hours after surgery, a patient may experience shallow, rapid breathing (Engoren & Blum, 2013). In most cases, this occurs in incidences in which the lung experiences either systemic or direct insult. Though it is a rare condition, the complication requires care that is intensive in nature coupled with mechanical ventilation that has positive end pressure (Engoren & Blum, 2013).I have chosen this problem as high problem for Mr. Peter Jones since he has predisposing risk factors to the complication. Firstly, he has undergone laparoscopy and colostomy. These surgical procedures are likely to have caused obstruction of the airways. Incisions in the right upper quadrant of the abdomen, a procedure associated with colostomy, is also linked to infective breathing patterns. Nursing Diagnosis(From NADA-1)Nursing GoalNursing InterventionRationale Evaluation/ExpectedOutcome 1.Colorectal anastomoticPrevent Hypotension and cardiac dysrhythmiasAdminister medicationVarious medications should be administered to

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