Case Study: Colon Cancer Patient Care Plan and Discharge

This case study focuses on a patient diagnosed with colon cancer, detailing the assessment of potential problems following surgery. It outlines a comprehensive care plan, addressing issues such as pain management as the anesthesia wears off, the risk of wound infection, potential bleeding, low blood pressure, fatigue, urine retention, and hypoxemia. The interventions include prescribing pain medication, administering antibiotics, monitoring for bleeding, fluid management, oxygen therapy, and maintaining an indwelling catheter. The rationales behind each intervention are provided, emphasizing patient comfort, preventing complications, and promoting healing. The assessment also includes functional assessments of blood pressure, fatigue, and oxygen levels. The study highlights the importance of thorough postoperative care, including a discharge plan to ensure the patient's successful recovery.

ASSESSMENT POTENTIAL
PROBLEMS
INTERVENTIONS RATIONALES
Pain assessment
.wound site. This
involves checking
out or asking the
patient if there is
pain at the site of the
incision. Patients
usually experience
pain especially when
the anesthesia wears
off.
.
Pain as the
anesthesia wears
off.
The nurse should
prescribe or
administer pain
medication as
prescribed.
Patients who
undergo open
procedure will
always experience
pain as the
anesthesia wears off
(Bibeau, 2016). The
rationale for the
nursing intervention
therefore is to
protect the patient
from the excess
pain.
Risk for wound
infection. This
involves checking if
the wound is
infected .Bacteria
tend to colonize
open wounds.
Bacterial infection
at the wound or the
site of incision
The nursing
intervention in this
case includes
providing antibiotics.
using person
protection properly
(PPE).following five
moments of hand
hygiene. owing
In case there are no
hygienic conditions,
the bacteria might
colonise the healing
wound (Brulé et al.,
2015). The aim of
the antibiotics
therefore is to kill
the bacteria that
might have
colonised the
wound.
Physical assessment
of potential bleeding
at the anastomoses.
Some patient
experience bleeding
especially if the
wound is sewn using
hands. The nurse
should therefore
look out for signs of
bleeding.
Anastomotic
bleeding has been
reported in around
5.4% of hand sewn
colorectal
anastomoses.
The nursing
intervention in this
case include
conservative
management (Coant,
García-Barros,
Zhang, Obeid, &
Hannun, 2018).
Endoscopic control
together with
injections is also
another important
nursing intervention
in this case. The
nurse might also opt
to use clips or a
reoperation with
refashioning of the
anastomosis.
However, the nurse
should avoid
angiographic
embolisation or
The rationale for all
this nursing
interventions is to
prevent bleeding (De
Sousa e Melo et al.,
2017). This is
because it is at this
time that the patient
is in need of more
blood and therefore
the little that the
patient has must be
protected at all costs.

injecting the patient
using vasopressin as
it may lead ischemia.
Functional
assessment of the
blood pressure. Loss
of blood is
associated with low
pressure and
therefore the nurse
should check out for
this.
Low blood pressure.
In this case study,
the blood pressure of
the patient was
90/54 mmHg. The
low pressure post-
surgery usually
result due to loss of
blood or as a side
effect of anesthesia.
The nursing
intervention in this
case involves the
nurse monitoring the
patient of the
variations in blood
pressure. Another
important nursing
intervention is
introduction of
fluids. The fluids are
usually introduced
through the
Intravenous routes
such as normal
saline.
The rationale for this
intervention is that
increasing the
amount of fluids in
the body increases
the quantity of blood
as well and this will
restore the blood
pressure to normal
levels and to prevent
the patient from
dehydration.
Functional
assessment to
determine the level
of fatigue the patient
is experiencing. This
is in attempts by the
body to get rid of the
anesthesia that was
injected pre-surgery.
Sedation score of 1
according to the
results indicate
fatigue. The fatigue
is due to the
attempts by the body
to get rid of the
anesthesia used
before the surgery.
The nurse should
therefore provide a
comfort resting
position to the
patient.
The rationale for this
nursing intervention
is to ensure the
patient is in a
comfortable mood so
that the body can get
rid of the anesthesia.
Physical assessment
of possible urine
retentention.
Colorectal surgeries
are associated with
perceived increased
risk of post-
operative urinary
retention.
The nursing
intervention in this
case involves
maintaining the
indwelling catheter
in situ.
The rationale for this
nursing intervention
is to prevent POUR.
This refers to the
perceived increased
risk of post-
operative urinary
retention.
Oxygen level. The
nurse should check
for signs of
insufficient oxygen
due to loss of blood
since blood is the
one that supplies
oxygen.
Hypoxemia is
common due to loss
of blood during
surgery.
The nursing
intervention in this
case includes oxygen
therapy. To make
sure oxygen level is
at 95-100
The rationale for
oxygen therapy is to
provide oxygen to
the patient so as to
facilitate the process
of wound healing.