Question

In: Nursing

James a 44 year old male client with a history of ulcerative colitis had a total...

James a 44 year old male client with a history of ulcerative colitis had a total colectamy and a continent ileostomy (lock pouch). the client is postoperative day 1 and the atoms is bright red amd shiny in appearance. the retention catheter insterted into the nipple valve is in place to continuous drainage to the collection bag and the nurse monitors the intake and output closely and the lab values for any electrolyte imbalances. the client ask the lvn if the ileostomy drainage will always be around a liter a day or will it decrease eventually.

A. What postoperative nursing management pertaining to the kick pouch does the client need?

B. What client education does the nurse need to provide regarding management of the kick continent ileostomy?

Expert Solution

Answer

A - Post operative nursing management

Early mobilization - for better recovery

Post operative anlagesia - provide pain relief after postoperarive analgesia .

Drains / tubes : remove all the tubes inserted after induction of anasthesia and other things before patinet wake ups .

- IV fluid and nutrition - as the patient are on recovery eating food may not good so iv fluid amd nutrition is important to induce in liquid form , approriate diet guide .

Avoid post operarive ileus : it is delayed passage of flatus and bowel movement lead to abdominal distention .

Instruction to patient to recovery aids and better management .

* B - client education for management of kick continent iliostomy .

- wash the skin warm water and dry it well before tou attach the pouch .

- avoid skin care product containing alcohol.

- do not use product with oil around stoma

- call doctor when stoma is swollen

- dehydration is major risk so keep hydrating .

- enhance electrolyte drinks

Nightingale answered 2 years ago

TM is a 38 year old male with ulcerative colitis admitted to the medical unit at...

TM is a 38 year old male with ulcerative colitis admitted to the medical unit at the hospital for acute exacerbation of the disease. This is his second admission in the last six months. TM says he is frustrated with this disease. In the last week TM has had 15-20 diarrhea episodes a day. He needs to hurry to the bathroom often throughout the day and night. He reports sleeping only an hour at a time at night and trouble...

A 42-year-old patient with history of ulcerative colitis (UC) and anemia, went to the ED. While...

A 42-year-old patient with history of ulcerative colitis (UC) and anemia, went to the ED. While at the emergency room, he complaints of abdominal pain/swelling alongside blood in her stool which is watery which has been going on for some days now. Vital signs are (BP) of 90/56, heart rate (HR) 115 bpm, respiratory rate (RR) of 32, temperature of 101.9°F, oxygen saturation (O2 sat.) of 98% on room air, and a pain of 8/10 (using the verbal numeric pain...

A 67-year-old retired businessman has a history of gastric ulcers and ulcerative colitis. He reports eating...

A 67-year-old retired businessman has a history of gastric ulcers and ulcerative colitis. He reports eating a well-balanced “mostly vegetarian” diet. He states he dislikes taking prescription drugs and prefers natural herbal remedies because they are “not toxic like drugs.” He takes a variety of herbal preparations to relieve his gastrointestinal problems although he admits he has not experienced any significant relief in symptoms. His doctor prescribed a proton pump inhibitor and sulfasalazine, which he states he takes “reluctantly.” He...

Discussion Board 3 11 unread reply.11 reply. 1. A client with ulcerative colitis has a total...

Discussion Board 3 11 unread reply.11 reply. 1. A client with ulcerative colitis has a total colectomy with formation of a terminal ileum stoma. What is an important nursing intervention for this patient postoperatively and why? 2. Upon assessment of the client to inspect the abdominal dressing, you find the original surgical dressing saturated with fresh bloody drainage. What do you do? 3. The client is receiving TPN at 85 mL/hr via a right subclavian central venous catheter. The nurse...

Mrs. Jones is a 46 yesrs old was admitted with a diagnosis of ulcerative colitis. she...

Mrs. Jones is a 46 yesrs old was admitted with a diagnosis of ulcerative colitis. she is to receive vancomycin 500 mg IV piggyback every 6 hours. Describe the nursing implications when patients receive vancomycin. Explain peak and through.

James is a 51-year-old male Hispanic truck driver with a long history of diabetes and hypertension....

James is a 51-year-old male Hispanic truck driver with a long history of diabetes and hypertension. His current medication regimen is Lisinopril 20mg QD, metformin 1000mg QD, Lipitor 40mg QHS, and ASA 81mg QD. His A1C is 7, BP is 144/80, total cholesterol is 266, HDL 44, LDL 177, and Trig 199. What other information should you know about this patient to feel confident that his care is fairly well optimized? What parameters would you like to see improved? What...

Client Profile Mr. Escobar is a 47-year old male with a history of cirrhosis. He lives...

Client Profile Mr. Escobar is a 47-year old male with a history of cirrhosis. He lives with his wife and teenage sons. His wife brought him to the emergency department today because she noticed that Mr. Escobar had increasing confusion and lethargy and was having difficulty walking. His wife states, ?He is probably acting a little funny because he is sleep deprived. He hasn?t slept very much in the past few days. Case Study Mr. Escobar is afebrile. His blood...

Mark Ilescu is a 44-year-old client who has been diagnosed with primary hypertension. His medical history...

Mark Ilescu is a 44-year-old client who has been diagnosed with primary hypertension. His medical history includes type 1 diabetes mellitus, with early signs of nephropathy. He had a myocardial infarction 2 years ago and has been treated with a beta-blocker, metoprolol, since that time. He has been taking hydrochlorothiazide in addition to the beta-blocker to treat his hypertension. His blood pressure today is 138/92 mm Hg, which is consistent with the readings on his last three visits. His physician...

W.C. is a 56 year-old white male. His history was remarkable in that he had weighed...

W.C. is a 56 year-old white male. His history was remarkable in that he had weighed 230 pounds until 2.5-3 years before, when he voluntarily went on a rigid diet and lost 50 pounds over about 1 year. He has maintained his current weight of 180-190 pounds for the last 1.5 years. Six years ago he complained of numbness in his feet and poor healing of cuts and bruises. He was seen by a physician who noted high blood glucose...

Jack Lane, a 54-year-old male client who teaches history at the local high school, is seen...

Jack Lane, a 54-year-old male client who teaches history at the local high school, is seen at the outpatient surgical center for a left inguinal herniorrhaphy via a laparoscopic approach. The client was moving to a different house and developed the hernia while lifting heavy objects 1 week ago. When the client is standing, the nurse sees bulging in the left inguinal area, which decreases when he is lying flat. The vital signs include T, 99° F; BP, 120/78 mm...