Comprehensive Nursing Case Study: Managing a Patient with Colostomy

This case study details the journey of a patient adapting to life with a colostomy, addressing the physical and psychological challenges encountered. The patient has a history of hernia and pancreatitis and now requires a permanent stoma. It emphasizes the significant psychological effects, including anxiety, fear of social stigma, and altered body image. Utilizing Gordon’s functional health patterns model, the primary nursing concern identified is the risk of post-operative depression and anxiety, potentially exacerbated by socio-economic factors. The proposed care plan focuses on comprehensive patient education, collaborative management with a multidisciplinary team including psychologists, and diligent follow-up to ensure coordinated care. The study underscores the importance of patient-centered care, recognizing the individual needs and providing adequate support to facilitate adaptation to the changes, with a focus on improving the patient's confidence and self-management abilities. Desklib provides resources like this case study to aid students in their studies.

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Colostomy
This is a patient journey of a patient who got stoma bag in place for the rest of his life. The
patient has a previous medical history of hernia and pancreatitis. The patient now uses a
colostomy bag for the rest of his life. Stoma is an artificial opening which is created surgically.
This write therefore explain how having a colostomy bag can impact life.
Living with a stoma is a life-changing experience for any individual (Swan 2011, pp.22-28). It
has various psychological effects (Liao, and Qin 2014, pp196-201). Nurses should therefore
focus on preparing the client together with his family for surgery through support and adequately
educating them before, during and after the stoma surgery (Rothrock 2018). It is also difficult to
initiate the dietary changes after the surgery and therefore adequate physical care should be
provided to the individual. The patient also starts to worry a lot about these changes. They have
fear of the unknown. For example, they keep thinking about what will happen in case the stoma
leaks and feces gets all over them in the public.
The quality of life decreases as a result of one having a stoma (Dabirian et.al 2011, p.1). The
individual has to cope with many issues which are so sensitive, this include, the fact they have
lost control over their elimination of faeces. Their sexual function is also affected and body
image disturbed (Reese et.al 2014, pp.461-468). The individuals also start facing stigmatization
and social isolation. Moreover, the mood decreases. The patient is best assessed using the
Gordon’s functional health patterns model (Gordon 2014). This is because it provides a
comprehensive nursing assessment of the patient.
The main issue after assessing the patient with stoma bag is risk of post-operative depression and
anxiety (Pritchard 2011). This may be associated with factors such as poor socio-economic

status. The best plan to help address this problem is to provide the patient with enough
information and education concerning his condition (Melnyk and Fineout-Overholt 2011). This
will help them beware of their condition and know what to expect and also let them collaborated
throughout their management. The confidence if the patient will also improve and they will be
able to manage their stoma all by themselves. Their anxiety levels will also decrease.
Nurses also ought to include psychologist in the treatment plan as part of the multidisciplinary
team to help manage the patient get over the psychological distress they are likely going to
experience (Taylor and Burch 2011, pp.286-290). The nurse should ensure that a proper follow
up is made to ensure that the team involved in the care of the patient actually do their part. This
may be done through ensuring that all the procedures are documented appropriately.
The care of the patient is therefore good and he is actively being managed according. The most
important knowledge gained is that it is very important to recognize that having a stoma can
make the patient suffer psychologically and therefore the patient should be provided with
adequate support to help me adapt to the changes that is happening in his body (Epner, and Baile
2012, pp.33-42). The patient care has to be also patient-centered, in that, the needs of the patient
are addressed individually.

References
Dabirian, A., Yaghmaei, F., Rassouli, M. and Tafreshi, M.Z., 2011. Quality of life in ostomy
patients: a qualitative study. Patient preference and adherence, 5, p.1.
Epner, D.E. and Baile, W.F., 2012. Patient-centered care: the key to cultural competence. Annals
of oncology, 23(suppl_3), pp.33-42.
Gordon, M., 2014. Manual of nursing diagnosis. Jones & Bartlett Publishers.
Liao, C. and Qin, Y., 2014. Factors associated with stoma quality of life among stoma
patients. International journal of nursing sciences, 1(2), pp.196-201.
Melnyk, B.M. and Fineout-Overholt, E. eds., 2011. Evidence-based practice in nursing &
healthcare: A guide to best practice. Lippincott Williams & Wilkins.
Pritchard, M.J., 2011. Using the Hospital Anxiety and Depression Scale in surgical
patients. Nursing Standard, 25(34).
Rothrock, J.C., 2018. Alexander's Care of the Patient in Surgery. Elsevier Health Sciences.
Reese, J.B., Finan, P.H., Haythornthwaite, J.A., Kadan, M., Regan, K.R., Herman, J.M., Efron,
J., Diaz, L.A. and Azad, N.S., 2014. Gastrointestinal ostomies and sexual outcomes: a
comparison of colorectal cancer patients by ostomy status. Supportive Care in Cancer, 22(2),
pp.461-468.
Swan, E., 2011. Colostomy, management and quality of life for the patient. British Journal of
Nursing, 20(1), pp.22-28.
Taylor, C. and Burch, J., 2011. Feedback on an enhanced recovery programme for colorectal
surgery. British Journal of Nursing, 20(5), pp.286-290.