Nursing Care Plan Post Laparoscopic Surgery †MyAssignmenthelp.com

Question: Discuss about theNursing Care Plan Post Laparoscopic Surgery. Answer: As the patient has undergone a laparoscopic surgery, the most vital postoperative problem or risk factors for the patient are infection. According to the case study the patient has a large dressing covering his surgery wound, which increases the potential risk for the patient obtaining infection. Hence the first problem chosen for the patent is the risk for infection (Klabunde et al., 2016). Another potential risk for the patient post the laparoscopic surgery is relapse of bowel obstruction. It has to be understood in this context that the patient had already been suffering from extreme constipation and bowel obstruction prior to the surgery due to a tumour obstruction in the recto sigmoid region of the colon and multiple lesions in the liver. Now as the patient has a stoma, a common complication that occurs in such cases is the retraction of the bowel back into the abdomen either causing severe bowel incontinence, or diarrhoea (Meyerhardt et al., 2013). The third patient problem identified from the case study is the anxiety, a very common occurrence in patients undergoing postoperative care. Given the fact that the patient has been suffering from acute hypertension for the past eight years only escalate the possibility of the patient suffering from greater anxiety due to his surgery and the possibility of further complications in the future. Cancer diagnosis is also extremely difficult for the patient to undergo and anxiety is a vital patient problem keeping the cancer diagnosis in account (Verberne et al., 2015). Nursing care plan: Nursing diagnosis (from NANDA-I) Goal Nursing interventions Rationale Evaluation/ expected outcome 1) Risk for infection at the surgical wound site Mr. Jones does not acquire infection in his wound site, and any evident sign and symptom of infection is not shown by him (Verberne et al., 2015). The patient will be comfortable and will receive meticulous infection control policy The surgical wound site of the patient will be cleaned as per guidelines as frequently as possible. Thenursing professional will diligently abide by five moments of hand hygiene while handling the patient every time. The patient will engage in hand- washing and personal hygiene as well. Frequent and periodical assessment and monitoring of the surgical wound site to check for any sign of infection such as redness, swelling, and tenderness in the wound site, pain in the wound site, or presence of exudates discharging from the wound site. Diligently adhering to aseptic techniques for wound cleaning and wound dressing Complying to the five minutes of hand hygiene policy and teaching the patient adequate hand- washing requirements as well (Verberne et al., 2015). Incorporating protein rich and calorie rich food in the diet plan for the patient and encouraging him to drink 2 to 3 litres of water a day. Infection in the surgical wound site is a very common post operative complication; periodic critical assessment of the wound site will help in earliest diagnosis of any infection if the patient acquires it. Maintaining aseptic technique while wound dressing and wound management will exponentially decrease the risk of contamination, and avoid any potential transmissions. The components of five moments of hand hygiene will effectively eradicate the most of the pathogens; hence regular hand washing is known to minimize the risk of infection. Protein and calorie rich food will enhance the innate immunity of the patient and the water intake will detoxify his body and negate the risk for urinary tract infection (Wagner et al., 2013). The patient remains free of infection, and does not show any signs or symptoms of infection (Verberne et al., 2015). The surgical wound of the patient remains free of any infectious agents and the wounds at an expected pace. The patient understands the benefits of hand hygiene and performs hand hygiene successfully along with the care professionals. The patient remains free of infection throughout his stay. 2) Bowel obstruction and/or diarrhoea. The patient will achieve improved bowel improvements. The patient will not feel bloated nor will experience any pain sue to bowel obstruction (Van Cutsem et al., 2014). The colostomy of the patient will be functional throughout his stay in the facility. Assessment and analysis of the onset or pattern for diarrhoea in the patient. Observation of the stool frequency and characteristics. Observation for associated factors of bowel incontinence, like fever, abdominal pain, cramping, or bloodied stool. Management and prompt changing of the stoma and periodic clearing (Meyerhardt et al., 2013). Encouraging the patient to remain on bed rest and restricting food intake that can precipitate diarrhoea. Irritable bowel incontinence of obstruction in most cases can lead to chronic diarrhoea, assessment of possible onset will serve in early detection and preventative management. Stool characteristic assessment will help in understanding the severity of the complication and arrive at more reasonable clinical judgment. The assessment of associated factors will reveal important information regarding etiology of the complication. Prompt stoma management will reduce the risk of infection and blockage (Mayer et al., 2014). Bed rest will decrease intestinal motility and increase the metabolic rate and restricting diet will help in controlling the onset of diarrhoea. The patient will avoid relapse to bowel obstruction and will avoid the risk of diarrhoea as well ()Meyerhardt et al., 2013. The colostomy of the patent will be free of infection and the patient will remain comfortable. 3) post operative and post diagnostic anxiety The patient understands and accepts the cancer diagnosis and participates optimistically in the care planning. The patient expresses the contributing factors to his anxiety (Lin et al., 2014). Patient shows depth of understanding about his medical condition and post operative precautions. Patient shows expected level of functionality and positivity and remains comfortable. Explaining the patient the details of his medical condition and helping him cope with cancer diagnosis with positivity. Establishing mutually respectful interpersonal relationship to ensure that the patient understands recovery scopes and prognosis. Engaging the patient in active care planning and helping him understand the recovery scope. Using state trait anxiety inventory to assess the level of anxiety. Administration of relaxing, stress relieving activities (Klabunde et al., 2016). Patient education will help him understand the prognosis more clearly and overcome cancer diagnosis with positive reinforcements. Mutually respectful intercommunication will allow the patient to feel comfortable in communicating his grievances. Engaging the patient in care planning will increase the sense of value, control and optimism. Anxiety assessment and stress relief activities will help the patient overcome the anxiety effectively (El?Shami et al., 2015). The patient will be able to communicate his fears. The patient will understand his recovery scope and be optimistic. The patient will be free of stress and will participate in care planning. References: El?Shami, K., Oeffinger, K. C., Erb, N. L., Willis, A., Bretsch, J. K., Pratt?Chapman, M. L., ... Stein, K. D. (2015). American Cancer Society colorectal cancer survivorship care guidelines. CA: a cancer journal for clinicians, 65(6), 427-455. DOI: 10.3322/caac.21286 Klabunde, C. N., Han, P. K., Earle, C. C., Smith, T., Ayanian, J. Z., Lee, R., ... Potosky, A. L. (2013). Physician roles in the cancer-related follow-up care of cancer survivors. Family medicine, 45(7), 463. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3755767 Lin, K. Y., Shun, S. C., Lai, Y. H., Liang, J. T., Tsauo, J. Y. (2014). Comparison of the effects of a supervised exercise program and usual care in patients with colorectal cancer undergoing chemotherapy. Cancer nursing, 37(2), E21-E29. doi: 10.1097/NCC.0b013e3182791097 Mayer, D. K., Gerstel, A., Walton, A. L., Triglianos, T., Sadiq, T. E., Hawkins, N. A., Davies, J. M. (2014, May). Implementing survivorship care plans for colon cancer survivors. In Oncology nursing forum (Vol. 41, No. 3, p. 266). NIH Public Access. doi: 10.1188/14.ONF.266-273 Meyerhardt, J. A., Mangu, P. B., Flynn, P. J., Korde, L., Loprinzi, C. L., Minsky, B. D., ... Benson III, A. B. (2013). Follow-up care, surveillance protocol, and secondary prevention measures for survivors of colorectal cancer: American Society of Clinical Oncology clinical practice guideline endorsement. Journal of Clinical Oncology, 31(35), 4465-4470. DOI: 10.1200/JCO.2013.50.7442 Van Cutsem, E., Cervantes, A., Nordlinger, B., Arnold, D. (2014). Metastatic colorectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of oncology, 25(suppl_3), iii1-iii9. DOI: https://doi.org/10.1093/annonc/mdv204 Verberne, C. J., Zhan, Z., van den Heuvel, E., Grossmann, I., Doornbos, P. M., Havenga, K., ... Bosscha, K. (2015). Intensified follow-up in colorectal cancer patients using frequent Carcino-Embryonic Antigen (CEA) measurements and CEA-triggered imaging: Results of the randomized CEAwatch trial. European Journal of Surgical Oncology (EJSO), 41(9), 1188-1196. DOI: https://doi.org/10.1016/j.ejso.2015.06.008. Wagner, E. H., Ludman, E. J., Aiello Bowles, E. J., Penfold, R., Reid, R. J., Rutter, C. M., ... McCorkle, R. (2013). Nurse navigators in early cancer care: a randomized, controlled trial. Journal of Clinical Oncology, 32(1), 12-18. DOI: 10.1200/JCO.2013.51.7359