Docstoc

Chapter 31

Document Sample
Chapter 31 Powered By Docstoc
					Understanding Medical Surgical Nursing, 3rd Edition
                                    Linda S. Williams / Paula D. Hopper




               Chapter 34

     Nursing Care of Patients with
        Lower Gastrointestinal
              Disorders
    Understanding Medical Surgical Nursing, 3rd Edition
                                        Linda S. Williams / Paula D. Hopper




    Lower Gastrointestinal System
   Small Intestines
   Large Intestines
   Rectum
   Anus
    Understanding Medical Surgical Nursing, 3rd Edition
                                        Linda S. Williams / Paula D. Hopper




                  Constipation
 Fecal Mass Held in Rectum
 Feces Become Dry, Hard
 Many Causes
 Prevention: High Fiber Diet, Fluids,
  Exercise
 Obstipation
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




        Constipation (cont’d)
 Signs and
  Symptoms
  ◆   Abdominal Pain        Headache
  ◆   Distention            Fatigue
  ◆   Indigestion           Decreased Appetite
  ◆   Rectal Pressure
  ◆   Incomplete
      Emptying
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




       Constipation (cont’d)
 Complications
  ◆ Impaction
  ◆ Ulcers
  ◆ Straining
  ◆ Megacolon
  ◆ Chronic Laxative Abuse—Fibrosis
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




       Constipation (cont’d)
 Therapeutic Interventions
  ◆ High Fiber Diet
  ◆ 2-3 L Fluid Daily
  ◆ Strengthen Abdominal Muscles
  ◆ Exercise
  ◆ Bulk-Forming Agents
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




       Constipation (cont’d)
 Therapeutic Interventions
  ◆ Stool Softeners
  ◆ Education
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




       Constipation (cont’d)
 Data Collection
  ◆ Establish Rapport
  ◆ History
  ◆ Auscultate Bowel Sounds
  ◆ Inspect/Palpate Abdomen
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




       Constipation (cont’d)
 Nursing Diagnoses
  ◆ Constipation
  ◆ Anxiety
  ◆ Perceived Constipation
  ◆ Deficient Knowledge
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




                   Diarrhea
 Fecal Matter Passes Rapidly
 Decreased Absorption
 Causes
  ◆ Bacterial/Viral Infection
  ◆ Food Allergies
 Prevention
    Understanding Medical Surgical Nursing, 3rd Edition
                                        Linda S. Williams / Paula D. Hopper




Diarrhea Signs and Symptoms
   Fever
   Foul Smell
   Abdominal Cramping
   Distention
   Anorexia
   Intestinal Rumbling
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




           Diarrhea (cont’d)
 Therapeutic Interventions
  ◆ Identify Cause
  ◆ Replace Fluids/Electrolytes
  ◆ Increase Fiber/Bulk
  ◆ Diphenoxylate (Lomotil), Loperamide
    (Imodium)
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




           Diarrhea (cont’d)
 Therapeutic Interventions
  ◆ Lactinex Restores Normal Flora
  ◆ Antimicrobial Agents
 Understanding Medical Surgical Nursing, 3rd Edition
                                       Linda S. Williams / Paula D. Hopper




           Diarrhea (cont’d)
 Nursing Diagnoses
  ◆ Acute Pain
  ◆ Diarrhea
  ◆ Risk for Deficient Fluid Volume
  ◆ Risk for Infection
  ◆ Risk for Impaired Skin Integrity
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




               Appendicitis
 Inflammation Of The Appendix
 Fever, Nausea/Vomiting, Anorexia, Pain
  Right Lower Quadrant
 Increased White Blood Cells
 NPO, Surgery
 Postop Care
Understanding Medical Surgical Nursing, 3rd Edition
                                    Linda S. Williams / Paula D. Hopper




          McBurney’s Point
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




                 Peritonitis
 Inflammation/Infection of Peritoneal Cavity
 Signs and Symptoms
  ◆   Abdominal Pain
  ◆   Abdominal Rigidity
  ◆   Nausea/Vomiting
  ◆   Fever
    Understanding Medical Surgical Nursing, 3rd Edition
                                        Linda S. Williams / Paula D. Hopper




             Peritonitis
      Therapeutic Interventions
   NPO
   Fluid/Electrolyte Replacement
   Nasogastric Tube
   Antibiotics
   Surgery
   Pain Control
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




                 Peritonitis
 Complications
  ◆ Intestinal Obstruction
  ◆ Hypovolemia
  ◆ Septicemia
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




         Peritonitis (cont’d)
 Nursing Diagnoses
  ◆ Acute Pain
  ◆ Deficient Fluid Volume
  ◆ Imbalanced Nutrition: Less Than Body
    Requirements
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




   Diverticulosis/Diverticulitis
 Diverticulum
  ◆ Outpouching of Bowel Mucous Membrane
 Diverticulosis
  ◆ Multiple Diverticula
 Diverticulitis
  ◆ Inflammation/Infection of Diverticulum
Understanding Medical Surgical Nursing, 3rd Edition
                                    Linda S. Williams / Paula D. Hopper




               Diverticulum
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




  Diverticulosis/Diverticulitis
 Causes
  ◆ Chronic Constipation
  ◆ Decreased Intake of Dietary Fiber
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




  Diverticulosis/Diverticulitis
            (cont’d)
 Therapeutic Interventions
  ◆ Prevent Constipation
  ◆ Intravenous Antibiotics
  ◆ Pain Control
  ◆ Surgery
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




   Inflammatory or Infectious
           Disorder
           Nursing Diagnoses
 Acute Pain
 Risk for Deficient Fluid Volume
    Understanding Medical Surgical Nursing, 3rd Edition
                                        Linda S. Williams / Paula D. Hopper




              Crohn’s Disease
   Inflammatory Bowel Disease
   Any Part of the Intestine
   Remissions and Exacerbations
   Cause Unknown
   Hereditary
 Understanding Medical Surgical Nursing, 3rd Edition
                                      Linda S. Williams / Paula D. Hopper




    Crohn’s Disease (cont’d)
 Signs and Symptoms
  ◆ Abdominal Pain or Cramping
  ◆ Weight Loss
  ◆ Diarrhea
  ◆ Fluid and Electrolyte Imbalance
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




    Crohn’s Disease (cont’d)
 Complications
  ◆ Malnutrition
  ◆ Fissures
  ◆ Abscesses
  ◆ Fistulas
Understanding Medical Surgical Nursing, 3rd Edition
                                    Linda S. Williams / Paula D. Hopper




                   Fistulas
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




    Crohn’s Disease (cont’d)
 Diganosis
  ◆ Endoscopy with Biopsy
  ◆ Barium Enema
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




       Crohn’s Disease
   Therapeutic Interventions
 Avoid Offending Foods
 Medications
  ◆ Antiinflammatories
  ◆ Antidiarrheal
  ◆ Antibiotics
  ◆ Immunosuppressants
  ◆ Corticosteriods
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




    Crohn’s Disease (cont’d)
 Therapeutic Interventions
  ◆ Surgery if Necessary
  ◆ Elemental Formula or TPN if Required
  ◆ Support and Education
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




           Ulcerative Colitis
 Inflammatory Bowel Disease
 Large Colon and Rectum
 Remissions and Exacerbations
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




   Ulcerative Colitis (cont’d)
 Signs and Symptoms
  ◆ Abdominal Pain            ◆ Weight Loss
  ◆ 5-20 Stools Daily         ◆ Cramping
  ◆ Rectal Bleeding           ◆ Vomiting
  ◆ Fecal Urgency             ◆ Fever
  ◆ Anorexia                  ◆ Dehydration
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




    Ulcerative Colitis (cont’d)
 Therapeutic Interventions
  ◆ Avoid Offending Foods
  ◆ Medications
     •   Antiinflammatories
     •   Antidiarrheal
     •   Immunosuppressants
     •   Corticosteriods
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




    Ulcerative Colitis (cont’d)
 Therapeutic Interventions
  ◆ Surgery if Necessary
  ◆ Elemental Formula or TPN if Required
    Understanding Medical Surgical Nursing, 3rd Edition
                                        Linda S. Williams / Paula D. Hopper




    Inflammatory Bowel Disease
         Nursing Diagnoses
   Acute Pain
   Diarrhea
   Deficient Fluid Volume
   Anxiety
   Impaired Skin Integrity
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




 Inflammatory Bowel Disease
  Nursing Diagnoses (cont’d)
 Ineffective Nutrition: Less Than Body
  Requirements
 Ineffective Coping
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




   Irritable Bowel Syndrome
 Altered Intestinal Motility/Increased
  Sensitivity to Visceral Sensations
 Bowel Mucosa Not Changed
 Psychological Stress/Food Intolerances
 More Common in Women
    Understanding Medical Surgical Nursing, 3rd Edition
                                        Linda S. Williams / Paula D. Hopper




      Irritable Bowel Syndrome
         Signs and Symptoms
    Gas
    Bloating
    Constipation
    Diarrhea
    Abdominal Pain
    Depression, Anxiety
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




   Irritable Bowel Syndrome
             (cont’d)
 Diagnosis
  ◆ History
  ◆ Physical Examination
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




    Irritable Bowel Syndrome
              (cont’d)
 Therapeutic Interventions
  ◆ High Fiber and Bran Diet
  ◆ Avoid Trigger Foods
  ◆ Smaller, Frequent Meals
  ◆ Stress Management
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




    Irritable Bowel Syndrome
               (cont’d)
 Therapeutic Interventions (cont’d)
  ◆ Behavioral Therapy
  ◆ Exercise
  ◆ Medications
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




   Irritable Bowel Syndrome
             (cont’d)
 Nursing Diagnoses
  ◆ Constipation
  ◆ Diarrhea
  ◆ Readiness for Enhanced Therapeutic Regimen
    Management
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




         Bowel Obstruction
 Flow of Intestinal Contents Is Blocked
 Mechanical: Blockage Occurs Within the
  Intestine
 Paralytic: Peristalsis Is Impaired
 Partial or Complete
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




         Abdominal Hernias
 Pathophysiology
  ◆ Protrusion of Organ or Structure Through
    Weakness or Tear in Wall of Abdomen
 Etiology
  ◆ Weakness in Abdominal Wall with Increased
    Intraabdominal Pressure
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




      ABDOMINAL HERNIAS
           (cont’d)
 Types
  ◆ Inguinal
  ◆ Umbilical
  ◆ Ventral (Incisional)
Understanding Medical Surgical Nursing, 3rd Edition
                                    Linda S. Williams / Paula D. Hopper




          Types of Hernias
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




  Abdominal Hernias (cont’d)
 Signs and Symptoms
  ◆ None
  ◆ Bulging
 Complications
  ◆ Strangulated Incarcerated Hernia
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




  Abdominal Hernias (cont’d)
 Therapeutic Interventions
  ◆ None
  ◆ Observation
  ◆ Support Devices
  ◆ Surgery
     • Herniorrhaphy
     • Hernioplasty
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




  Abdominal Hernias (cont’d)
 Nursing Care
  ◆ Education
  ◆ Postop
     • No Coughing
     • Activity
     • Education
    Understanding Medical Surgical Nursing, 3rd Edition
                                        Linda S. Williams / Paula D. Hopper




            Bowel Obstruction
   Flow of Intestinal Contents Blocked
   Mechanical
   Paralytic
   Partial
   Complete
Understanding Medical Surgical Nursing, 3rd Edition
                                    Linda S. Williams / Paula D. Hopper




Mechanical Bowel Obstructions
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




  Bowel Obstruction (cont’d)
 Signs and Symptoms
  ◆ Abdominal Pain
  ◆ Blood and Mucus per Rectum
  ◆ Feces and Flatus Cease
  ◆ Fecal Vomiting May Occur
  ◆ Bowel Sounds High-Pitched/Tinkling or Absent
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




  Bowel Obstruction (cont’d)
 Signs and Symptoms
  ◆ Abdominal Distention
  ◆ Fluid/Electrolyte Imbalance
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




  Bowel Obstruction (cont’d)
 Diagnosis
  ◆ Abdominal X-Ray
  ◆ CT Scan
  ◆ CBC and Electrolytes
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




  Bowel Obstruction (cont’d)
 Therapeutic Interventions
  ◆ NPO
  ◆ Frequent Mouth Care
  ◆ Nasogastric Tube
  ◆ Fluid and Electrolyte Replacement
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




  Bowel Obstruction (cont’d)
 Therapeutic Interventions
  ◆ Medications
     • Antibiotics
     • Antiemetics
     • Analgesics
  ◆ Surgery
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




  Bowel Obstruction (cont’d)
 Nursing Care
  ◆ Acute Pain
  ◆ Deficient Fluid Volume
  ◆ Deficient Knowledge
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




        Anorectal Problems
 Hemorrhoids
 Anal Fissures
 Anorectal Abscess
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




 Anorectal Problems (cont’d)
 Nursing Care
  ◆ Postop Care
     •   Pain Control
     •   Sitz Baths
     •   Dressing Changes
     •   Stool Softeners
    Understanding Medical Surgical Nursing, 3rd Edition
                                        Linda S. Williams / Paula D. Hopper




         Lower Gastrointestinal
           Bleeding Causes
   Diverticulitis
   Polyps
   Anal Fissures
   Hemorrhoids
   Inflammatory Bowel Disease
   Cancer
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




      Lower Gastrointestinal
            Bleeding
 Occult Blood, Melena, Bright Red Stools
 Treat Cause
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




      Lower Gastrointestinal
        Bleeding (cont’d)
 Nursing Care
  ◆ Monitor Stools, Bleeding
  ◆ Vital Signs
  ◆ Diagnostic Prep
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




              Colon Cancer
 Major Cause: Lack of Dietary Fiber
 Signs and Symptoms
  ◆ Change in Bowel Habits
  ◆ Blood or Mucus in Stools
  ◆ Abdominal or Rectal Pain
  ◆ Weight Loss
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




      Colon Cancer (cont’d)
 Major Cause: Lack of Dietary Fiber
 Signs and Symptoms
  ◆ Anemia
  ◆ Obstruction
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




      Colon Cancer (cont’d)
 Diagnosis
  ◆ Colon Care
  ◆ Colonoscopy with Biopsy
  ◆ Sigmoidoscopy with Biopsy
  ◆ Proctosigmoidoscopy
  ◆ CT Scan
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




      Colon Cancer (cont’d)
 Diagnosis
  ◆ Barium Enema
  ◆ Abdominal and Rectal Examination
  ◆ Fecal Occult Blood
  ◆ CEA
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




      Colon Cancer (cont’d)
 Therapeutic Interventions
  ◆ Surgery
     • Resection
     • Abdominoperineal Resection
     • Colostomy
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




      Colon Cancer (cont’d)
 Therapeutic Interventions (cont’d)
  ◆ Radiation
  ◆ Chemotherapy
  ◆ Analgesics
  ◆ TPN as Necessary
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




      Colon Cancer (cont’d)
 Nursing Diagnoses
  ◆ Acute Pain
  ◆ Anxiety
  ◆ Imbalanced Nutrition: Less Than Body
    Requirements
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




      Colon Cancer (cont’d)
 Nursing Care
  ◆ Support and Education
  ◆ Postop Care
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




       Ostomy Management
 Ostomy:
  ◆ Surgically Created Opening Diverts Stool or
    Urine to Outside of Body
 Stoma:
  ◆ Portion of Bowel Sutured onto Abdomen
 Abdominal Ostomies: Ileostomy,
  Colostomy, Urostomy
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




                 Ileostomy
 Terminal Ileum to Abdominal Wall After
  Total Colectomy
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




           Ileostomy Types
 Conventional Ileostomy
  ◆ Small Stoma Right Lower Quadrant
  ◆ Continuous Flow Liquid Effluent
 Continent Ileostomy
  ◆ Internal Reservoir with Nipple Valve
  ◆ Empty Reservoir 3-4 Times Daily
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




    Ileostomy Types (cont’d)
 Ileoanal Anastomosis
 Ileorectal Anastomosis
Understanding Medical Surgical Nursing, 3rd Edition
                                    Linda S. Williams / Paula D. Hopper




       Continent Ileostomy
Understanding Medical Surgical Nursing, 3rd Edition
                                    Linda S. Williams / Paula D. Hopper




     Ileal–Aanal Anastomosis
             J Pouch
Understanding Medical Surgical Nursing, 3rd Edition
                                    Linda S. Williams / Paula D. Hopper




           Types of Stomas
 Understanding Medical Surgical Nursing, 3rd Edition
                                      Linda S. Williams / Paula D. Hopper




                 Colostomy
 Effluent Becomes Less Liquid and More
  Solid as Location of Ostomy Becomes
  More Distal in Colon
 Types
  ◆ End Stoma
     • Proximal Bowel End Brought to Abdominal Wall
  ◆ Loop Stoma
     • Loop of Bowel Outside Abdomen with Bridge Under
       It
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




          Colostomy Types
 Double-Barrel Stoma
  ◆ Temporary Ostomy
  ◆ Both Ends of Colon Outside Abdominal Wall,
    Form Two Stomas
  ◆ Proximal Stoma Is Functioning Stoma
  ◆ Distal Stoma Is Mucous Fistula
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




   Preoperative Ostomy Care
 Wound Ostomy Continence Nurse
  ◆ Marks Site
  ◆ Emotional, Physical Support
 Teaching
 Bowel Prep
 Antibiotics
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




         Nursing Diagnoses
 Deficient Knowledge
  ◆ Appliance Change
  ◆ Daily Care and Hygiene
  ◆ Dietary Considerations
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




  Nursing Diagnoses (cont’d)
 Body Image Disturbance
 Sexual Dysfunction
 Ineffective Therapeutic Regimen
  Management
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




  Nursing Diagnoses (cont’d)
 Risk for Injury
  ◆ Peristomal Skin Irritation
  ◆ Peristomal Hernia
  ◆ Stomal Prolapse
  ◆ Stomal Necrosis
  ◆ Ileostomy Blockage
 Understanding Medical Surgical Nursing, 3rd Edition
                                          Linda S. Williams / Paula D. Hopper




  Postoperative Ostomy Care
 Data Collection
  ◆ Vital Signs
  ◆ Stoma
     • Pink To Red, Moist = Normal
     • Bluish = Inadequate Blood Supply
     • Black = Necrosis
 Understanding Medical Surgical Nursing, 3rd Edition
                                     Linda S. Williams / Paula D. Hopper




      Postoperative Ostomy
          Care (cont’d)
 Data Collection
  ◆ Skin Around Stoma Monitored for Irritation
     • Stoma Shrinks over Weeks
 Ostomy Care
  ◆ Appliance Change
 Teaching

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:22
posted:7/27/2011
language:English
pages:87