Scenario: A bowel resection was done 3 days ago to treat an
Scenario: A bowel resection was done 3 days ago to treat an abscess… Scenario: A bowel resection was done 3 days ago to treat an abscess caused by diverticulitis. The patient now has a temporary colostomy to divert stool from the inflamed bowel and allow it to rest and heal. The patient is drowsy but awakens easily with verbal stimuli. Vital signs are all stable. He states he is maintaining his pain at 3/10 without activity (on a 0-10 pain intensity scale), which he says is a manageable level, by using his patient-controlled analgesia (PCA) pump sparingly. He reports that as long as he does not move his pain is manageable. He is hesitant to do anything that causes increased pain and does not like to use his PCA due to his fear of addiction. His stoma is located on his left lower quadrant and is rosy red. There is a scant amount of drainage in his colostomy pouch. His abdominal dressing is clean and dry. He is voiding adequate amounts of urine and is NPO. He has a nasogastric tube to low intermittent suction. He is receiving Lactated Ringer’s solution via a peripheral IV. 1. NGN Item Type: Extended Multiple ResponseWhen planning care for this patient, for which priority potential complications will the nurse monitor? Select all that apply.Deep vein thrombosisPanic attackAtelectasisElectrolyte imbalanceChronic painBowel obstructionSepsisUrinary tract infectionRationale: 2. NGN Item Type: MatrixUse an X for the nursing actions listed below that are Indicated (appropriate or necessary), Contraindicated (could be harmful), or Nonessential (makes no difference or not necessary) for the client’s care at this time. Nursing ActionIndicatedContraindicatedNonessentialEncourage patient to stay in bed and lie still. Instruct patient to use PCA before activity. Assess the skin surrounding the stoma for breakdown. Implement nonpharmacologic pain control methods. Check back with the patient the next day when he may be more comfortable with increasing his activity. Consider collaborating with the surgeon to provide multimodal analgesia. Rationale:Health Science Science Nursing NUR 234
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