Cognitive Skill: Generate Solutions Scenario: A 60-year-old male had a bowel resection 4 days ago to treat an abscess ca

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Cognitive Skill: Generate Solutions
Scenario: A 60-year-old male had a bowelresection 4 days ago to treat an abscess caused by diverticulitis.He has a temporary colostomy to divert stool from the inflamedbowel and allow it to rest and heal. Since his surgery, thepatient’s postoperative recovery has been uneventful. Hisnasogastric tube was discontinued today, and he will be started ona clear liquid diet this afternoon and advanced to solids astolerated. His pain is managed by administration of a nonsteroidalanti-inflammatory drug every 6 hours and using hispatient-controlled analgesia (PCA) pump before activity. His stomais located on his left lower quadrant and is rosy red. There is asmall amount of liquid brown stool in his colostomy pouch. Hisabdominal dressing remains clean and dry. He is voiding adequateamounts of urine and is receiving Lactated Ringer’s solution via aperipheral IV.
NGN Item Type: Extended Drag and Drop
Use an X (or drag and drop) to indicate which actionslisted in the left column would be included in the plan of care forthis patient.
Nursing Actions
Implementation
Monitor for signs and symptoms of nausea.
Encourage use of incentive spirometry.
Assist patient to ambulate.
Change the colostomy pouch every 8 hours.
Monitor complete blood count.
Educate patient on a low-fat diet.
Notify the surgeon about the patient’s stoma color.
Rationale for your choices above:
Cognitive Skill: Take Action
Scenario: A 60-year-old male had a colonresection and colostomy 2 weeks ago. He was discharged home 7 daysafter surgery and received discharge instructions and teachingbefore leaving the hospital. He is now at the clinic for afollow-up visit. The nurse evaluates the effectiveness ofactions.
NGN Item Type: Extended Multiple Response
Which of the following findings indicate effectiveness?Select all that apply.
____1. The patient has not taken prescribed pain medication dueto fear of “addiction.”
____2. The stoma is rosy red.
____3. The patient changes the colostomy drainable pouch every 5days unless it is leaking, and then changes it at that time.
____4. The patient empties the colostomy drainable pouch when itbecomes 75% full.
____5. The patient reports 7/10 pain (using a 0-10 painintensity scale) during activity.
____6. The patient eats three regular meals a day with norestrictions.
____7. The patient sits in his recliner most of the day andambulates to the bathroom three to four times a day.
____8. The skin surrounding the stoma is slightly reddened.
Rationale for your choices above:
Cognitive Skill: Evaluate Outcomes