Question

Discuss priorities when caring for a patient having the various types of surgery ( proctocolectomy , total colectomy ) for ulcerative colitis. Discuss the management of a patient postoperatively who had a bowel resection and descending colostomy.

Answer 1

The priority care of a patient after surgery always include a patent airway circulation and breathing. The surgical stoma should inspected regularly for any skin changes and discharge.

Fluid management is very important as the patient is on nil per oral and blood loss during surgery till patient starts to take orally.

Pain assessment using a facial expression scale should be carried out.

Regular monitoring of vitals signs plays a important role.

Management of a patient with bowel resection and descending colostomy:

Above mentioned care is common with the addition of

As the patient is on nil per oral order.. Fluid intake can be started once bowel sounds resumes. If fluid intake is tolerated then semisolid food can be given to the patient.

Stoma care to be carried out every alternative day.. Apply appropriate skim barriers example hydrocolloid wafers. Empty irrigate and clean parody pouch on routine basis.

Mobility can be resumed a day after the surgery as it stimulates bowel function.

Educate the patient to avoid strenuous exertion and heavy lifting for 4 to 6 weeks and to avoid gas producing vegetables.