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Bill Jones 50-year-old man, anagesia is ineffective - Coggle Diagram
Bill Jones 50-year-old man
FAMILY HISTORY COLON CANCER ,
OBJECTIVE DATA
overweight and has a BMI of 35.2
colonoscopy is prescribed
health teaching about dietary restrictions and bowel preparation
about colonoscopy
Giving instructions for taking GOLYTELY for optimum colon clearance
findings from the colonoscopy
During the colonoscopy 3 polyps are removed and a suspicious lesion
pathology testing
discharged
walk to home is appreciated as it will help passing gas following colonscopy
SUBJECTIVE DATA
quit smoking in the past year
unhealthy lifestyle
TWO DAYS LATER AFTER COLONOSCOPY
abdominal pain and fever 38.9 C
Diagnostic studies confirm bowel perforation
Admit to hospital
Mr. Jones is scheduled for a bowel resection with a temporary colostomy.
nurse teaches how to care for the colostomy and evaluates the effectiveness of the teaching.
providing information regarding diet, hydration, resources for emotional support, importance of follow up care and reportable sign symptoms i.e. fever, diarrhea, dehydration, tenderness, erythema. pain etc.
bowel resection with temporary colostomy surgery done
POST-OP
vomiting and pain discomfort
Prescribe medication
ANALGESIC: Codeine, Fentanyl, Hydrocodone, Meperidine, Methadone, Naloxone or naltrexone, Oxycodone.
nurse reports hypokalemic lab value and bilateral crackles on lung auscultation
reinforcing the use of incentive spirometer
check the colostomy site for leakage and skin irritation
feeling itchy
nurse monitors lab values to evaluate the effectiveness of antibiotic therapy.
NPO status is continued
abdomen becomes firm and tender
checking for bowel sounds in all four abdominal quardents
FOLLOW UP CARE
pathology results from his colonoscopy confirm cancerous cells present.
cancer was limited to the tumour and the mucosal layer of his sigmoid colon
no evidence of lymph node involvement or metastasis
TREATMENT PLAN
no chemotherapy
vigilant surveillance to detect new growths will be important and colonoscopy is planned in one year.
anagesia is ineffective
reassessment of pain , check for PRN analgesic