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M71 POD7 for pelvic exenteration, radical cystectomy, ileoconduit,…
M71 POD7 for pelvic exenteration, radical cystectomy, ileoconduit, creation colostomy
History
locally advanced rectal cancer with long course chemotherapy with no effect. No evidence of metastasis
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Pelvic exenteration: removal of bladder, portion of the bowel (rectum), and prostate
Ileoconduit: creation of urinary conduit from piece of intestine, urine drains into bag that goes around stoma
Concepts
Elimination: changed pathways of elimination, loss of portion of bowel may change absorption, nutrition
Infection: Risk - invasive surgery (8 hours), bowel contents external, reduced nutrition, impaired immunity due to cancer
Nutrition: changes to bowel, prolonged cancer may alter nutritional absorption, lead to fluid and electrolyte imbalance. Restoring adequate nutrition after invasive surgery, changes to diet and mental health associated with eating
Stress and grief: Prolonged illness, chemotherapy, grieving through the process of cancer. Loss of health and physiological function, loss of independence. Dignity
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Psychosocial: Exhaustion, grief, depression, risk for impaired coping
Treatments
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AAT
POD2+: Goal 6 hrs activity, up 3x daily
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