You are working the medical-surgical unit and have been assigned a 42-year-old male patient who has...
You are working the medical-surgical unit and have been assigned a 42-year-old male patient who has had a colon resection with colostomy two days ago. His history includes diabetes, colon cancer, and hypertension. His abdominal incision was assessed with this morning’s dressing change. His vital signs are within normal range for him and he shows no signs of surgical incision infection at this time. He lives at home with his wife and has two teenage children still at home. He is unsure about how to change his appliance and care for his colostomy. He is worried about how he will be able to continue to work or do other daily activities with the ostomy. He has stated, “what if I am out to eat and my bag is full”, “what will my kids think about the colostomy”, “guess I will have to give up bowling league now” and “how can I have relations with my wife, she won’t find me attractive with this”.The plan is to have this patient discharge to home tomorrow or the next day.
NOTE: YOU MAY NOT USE RISK FOR INFECTION OR ACUTE PAIN FOR THIS CARE PLAN
Homework Answers
Answer :
Nursing diagnosis :
1.Fear and anxiety related to care of colostomy bag as evidenced by he is worrying about to how to maintain daily living activities.
2. Social isolation related to colostomy as evidenced by with the colostomy he can not mingle in all works in the home and outside.
3. Knowledge deficit related to cleaning of colostomy wound and dietary patterns as evidenced by he is having doubt regarding eatables.
Interventions :
* educate the clients regarding changing of colostomy bag if it falls.
* explain he can perform daily living activities by having colostomy bag also, if he is comfortable.
* he can take easily digestible foods, avoid fried and spicy foods.
* explain client regarding infectious signs like redness and itching, pus formation at site, he has to consult doctor immediately.
* explain how to use all medications and regarding precautions to prevent further infections.
* educate or explain the family members regarding good communication among them, and it's not isolated problem.
* provide psychological support and emotional support to the clients and his family members.
* explain regarding follow up care.
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