Question

I have to do a concept math to this story

Jesus Garcia is a 28yo who was directly admitted to the medical unit on Tuesday evening with a diagnosis of

dehydration. Fifteen days ago, Jesus underwent a partial colectomy with creation of a transverse colostomy.

Jesus’ girlfriend Virginia has been taking care of him since discharge and reports that Jesus has resisted

participation in colostomy care.Virginia needs to return to her full-time job and is concerned with how Jesus will manage without her at his side.

Please give 3 assessments, 3 risk factors for this patient, 3 psychosocial concerns, and 3 labs and diagnostics for this patient.

Answer 1

Assessment

• colour.

Red - Healthy
Dark Pink – Healthy
Pale Pink – anaemia, low haemoglobin
Dark red/purplish tint - bruising
Purple or Blue - lack of blood supply to the stoma
Brown - lack of blood supply to the stoma
Black – Necrosis; lack of blood supply to the stoma

• Consistency of output – Thick, Viscous, Liquid, Pasty, Oily, Formed, Soft, Thin, Tarry, Bloody
• Odour- i. Presence or Absence

ii. Strong, foul, pungent, faecal, musty, sweet

Risk factor

since he is resisting colostomy care

• infection
• oozing out of waste from the pouch (damage to the skin integrity around the colostomy)
• prolapse of the colostomy

Psychological concerns

• disturbed body image- due to the presence of bag, carrying faecal matter, flatulence etc
• social isolation
• depression (suicidal ideation)

Diagnostic studies (preoperatively)

• contrast enemas (colonoscopy, sigmoidoscopy, barium enema)
• abdominal x-ray
• ultrasound