Question

A patient with colorectal cancer stage I has had a bowel resection with anastomosis procedure. the med/surg unit nurse who is receiving this patient from the post anesthesia care unit is anticipating that the patient will need

a) education about how to care for a temporary colostomy

b) psychosocial support while learning to care for a permanent ileostomy

c) additional chemotherapy or radiation to treat the sites of metastasis

d) education about how to care for an abdominal surgical wound

Answer 1

a. Education about how to care for a temporary colostomy:

Temporary colostomy is done in certain lower bowel problems to give rest to a part of bowel. Its kept rmpty by krrping stool away from reaching that part of the bowel. Thus, stool bypasses the damaged area of bowel.

In such patients, usually 1 week of hospital stay is recommended. It may take about 2 months for healing of bowel.

The patient must be advised not to hit ot rub the stoma site that may lead to bleeding. The maintenance of pouch and cleaning is essential. Pouch should be changed before going to bed, or if it is full or leaking. Foofs like applesuace, bananas can be taken to thicken stools.Clean the site with water or soft water wioes. Don't apply oil, ointments, powder unless directed to do so. Seek medical help if it is bleeding, ot in case of skin breakdown or pain at the site or any colour change or rashes.

b. Permanent ileostomy is done to bypass your ileum, rectum or bowel from stools by a permanent bag or pouch. It can affect the person mentally to a greater extent. So psychosocial support from nurse is much required. The procedure must be explained well and assurance must be provided that they can still be equally effective and productive in every aspects.

c. In case of metastasis, there will be a requirement for additional chemotherapy or radiation. Thus, patient must be informed about his or her condition and the outcome of additional treatment procedures muat be informed. Especially the benefits of such treatment must be given. The success rate of adjunct therapy must be provided to the patient so that they will be ready for the treatment.

d. After an abdominal surgery, the patient must be educated enough to take care of the wound site. Cleaning the site is essential. Advise them not to irritate the site by rubbing thus, allowing it to heal. Also tell them not to apply any products other than those prescribed by the surgeon.Special care in fietary intake is recommended. Advise them not to take spicy or oily foods.