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Nursing Colostomy Checkups And Maintenance (Essay Sample)


question and answer with correct in text referencing and referencing apa must have in text referencing subject care plans


1a)Identify the factors that you would need to consider prior to and during an assessment
Prior to assessment of the above-named patient, identification of the intermediate needs should be done first, some of the factors to be considered here are: any possibility of infection risks, manual handling risks to the patient due to his permanent colostomy and the contact details of his son. During the assessment process, the health status, cognitive ability, the tools that are to be used for assessment should be assessed first like pain assessment tool to provide accurate results after assessment. (Ainsworth 2013 pg. 327)
1b)Using the information from the case study, identify and define three (3) physical or psychologically factors that will need to be implemented into Mr. Bott's care plan
Considering Mr. bott's conditions during admission and assessment the following factors should be put into consideration when implementing his care plan:
Colostomy checkups and maintenance
* the pouching system should be checked regularly and changed at the appropriate time
* provision of a well-balanced diet to maintain the colostomy state should be provided
for physical care the following factors should be considered:
provision of full range motion to maintain joint mobility to prevent venous stasis
positioning- the patient should be positioned in a good manner to prevent contractures and prevent compressive neuropathies
management of sensory difficulties
frequent assessment of the skin with emphasis on the bony areas and other depended body parts to check for signs of breakdown
establishment of an exercise program to help him recover to his normal condition
preparations for ambulation- as soon as the patient starts to get well, an active rehabilitation to help him maintain balance while suiting and standing should be done. (Sardina 2013 pg. 105)
The pulse rate for this patient is beyond the range of a normal person, the correct pulse range lies between 60 to 100
Respiration-the normal range should be 12 to 16
Blood pressure, the normal range should be between 120 over 80 (120/80) to 140 over 90 (140/90).
(Sellier, 2013 pg. 153)
2. I will use the following data to perform neurological observations
* eye opening
* appropriateness of vocalization
* motor activity
* Level of consciousness.
The level of consciousness that may deteriorate if there is a problem in relation to the brain in case of injuries to the brain, space occupying lesion such as brain tumor, increased intracranial pressure which can be determined by checking at the amount of brain tissue, blood and cerebrospinal fluid within the skull cavity.
* Pupillary reaction.
Note if the pupil sizes are equal. A pen torch with a bright narrow beam is recommended. Similarly observe the pupil's reaction to the beam light. A change in pupil size and subsequent reaction to light indicates increase of the intracranial pressure.
* Vital signs.
-Respirations - Note down the rate, depth and pattern of breathing as the brain controls breathing. Any problem with the brain can affect respiration activity
-Temperature. The temperature should be taken into account since the hypothalamus regulates the body temperature. Therefore, any minor problem with the hypothalamus will result to abnormal temperatures.
-Blood pressure and pulse. A raise in the intracranial pressure will result to increased blood pressure, and a fall in the respiratory rate and the bradycardia
* Motor function.
Assessment of the lower limps can depict the functioning of the spinal. Involuntary movement of the patient's limp may be a result of cerebral dysfunction.
(Sellier, 2013 pg. 79)
3. considering Mr. bott's age, his care plan should be planned in such way that he should be treated with respect, and addressed properly
Mr. Bott's beliefs are important and should be taken into consideration in his plan care. The nurses should be aware on how his spiritual beliefs play a part in health-related decision-making. For example, do they have deep religious convictions, or do they view their religion primarily and try to incorporate them into the care plan
Mr. Bott's cultural practices should be considered when planning for his care plan in that, the nurses should consider on how the cultural beliefs can affect his healing process and adjust it to suit his cultural beliefs
The care plan should also cover on Mr. Bott practices and how they might affect medical treatment, rehabilitation and their overall health and wellbeing.
How diagnosis may affect their spiritual worldview.
What their needs and wishes are while in hospital, including if they would actively like to see a chaplain.
An environment that is respectful to his beliefs and culture should be created
4. steps involved in changing colostomy bag
* Washing of hands and cleaning of procedure gloves
* Folding of the linens to expose the ostomy site, a clean towel is placed across the abdomen of the patient under the pouch that exists
* The patient is positioned in such a way that skin folds doesn't occur along the line of the stoma
* The pouch is opened-if openable by removing the clamp and unrolling it at the bottom.
* If the pouch is drainable, the existing ostomy pouch is drained into a bedpan
* Using one hand, the old fastener is removed from the skin gently starting from the top to downward direction. The other hand is used to hold tension on the skin in the opposite direction of the pull. In case of any resistance when removing the fastener, adhesive remover is used
* The stoma and peristomal skin is inspected. The stoma and skin are cleaned using mild soap and the area is allowed to dry.
* The size of the stoma is measured using appropriate method and a clean gauze pad is placed over the stoma
* After removing the glove and washing hands, the size of the opening is traced on a paper that is at the back of the new fastener
* The traced paper is peeled off from the fastener. For those ostomy fasteners that come with an outer ring of tape attached, the backing should not be removed until the fastener is positioned securely. Ostomy skin care products are applied at this stage
* The gauze is removed followed by centering of the fastener opening around the stoma. For a open-ended pouch, the end is folded over the clamp until it “cli...

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