Question: Colostomy Care Teaching Overview Jesus Garcia Is A 28 Year Old Hispanic Male With A History Of Ulcerative Colitis, He Was Directly Admitted To The Medical Unit On Tuesday Evening With A Diagnosis Of Dehydration Fifteen Days Ago. Jesus Underwent A Partial Colectomy With Creation Of A Transverse Colostomy. Jesus Girlfriend Virginia Has Been Taking Care …

Colostomy Care Teaching Overview Jesus Garcia is a 28 year old Hispanic male with a history of ulcerative colitis, He was directly admitted to the medical unit on Tuesday evening with a diagnosis of dehydration Fifteen days ago. Jesus underwent a partial colectomy with creation of a transverse colostomy. Jesus girlfriend Virginia has been taking care of him since discharge and reports that Jesus has resisted participation in colostomy core. Virginia needs to retum to her full time job and is concerned about how Jesus will manage without her at his side. During the second day of admission, the colostomy bag begins to leak. Jesus is frustrated with the leaking bag and anxious about all aspects of colostomy care. (See SBAR for bedside shift report) (See doctor’s orders) Colostomy Care Teaching Follow-up Questions: 1. What is the correlation between Jesus’ diagnosis and his recent colostomy? 2. The anatomical position of an ostomy determines the consistency of the ostomy output. What stool characteristics would you expect from Jesus’ transverse colostomy? 3. What factors might affect Jesus’ reaction to the new colostomy and contribute to his anxiety and concerns? 4. What are the important components of a colostomy assessment? Patient Report Catholic Religion: O, Sat: 989 Tues 1910 SBAR Hand-Off Current day Wednesday 1300 and time: Admission day Tuesday 1845 Situation Name: and time! Jesus Garcia Age: 28 Provider: Sex: Male Ethnicity: Hispanic Michael Lev, MD Admission Dehydration diagnosis Background pertinent medical Ulcerative colitis 15 days post-colectomy with transverse colostomy history: Pertinent Uves with girlfriend social history: Allergies: No known allergies Code status: Pull code vital signs Time: 1100 IT: 98.2 F BP: RR: 18 88 122/70 P: (most recent): (36.0 C) Oxygen Mode: Room ar LPM: Not applicable therapy: Pain: Rating: 0/10 Time: Most recent pain medication Morphine Other recent Ondansetron 4 mg IV every 6 hours for nausea and vomiting medication: Mesalamine 800 mg PO 3 times daily IVS: Normal Fluid: Site: Right Type: 10-gauge PIV Assessment intact, forearm patent saline with 40 mg potassium chloride per 1000 ml at 100 ml/hr Drains and Site: Abdomen Type: Colostomy Assessment: Colostomy pouch dry and intact tubes: Wounds: Site: None Type: Not applicable Assessment: Not applicable ADLS: Diet: As tolerated Activity: As tolerated Restrictions: Isolation: Standard precautions Fallriskt Moderate Assessments: Neurologic Alert and oriented x 4 Cardiac: IS1, S2 no murmurs Respiratory: Lung sounds clear GI/GU: Colostomy present, liquid brown stool, stoma pink Integumentary: Dry and intact; peristomal skin intact with no breakdown Ortho/Mobity: Ambulates without difficulty Psychosocial: Patient expresses arodety related to colostomy Other: None Labs and AM lab work indicates resolving dehydration diagnostics: Assessment Nurse’s Patient hydration status has improved after fuld and antiemetic administration. Patient states that he is worried about going home with the colostomy and taking care of it once his girlfriend Virginia goes back to assessment: work, Continue with hydration plan. Engage patient in colostomy teaching, ecommendation Plan of care: Tests/results None pending: Orders None pending completion: None Other: Care & tomyعملم1 Verified By/Initials Action Time m JT Provider Orders Signature 1). 0.9% normal saline 1000 ml bolus IV x 1 over 1 hour now frue 20:00 2). Follow bolus with continuous IV infusion of M Levin, MD 0.9% normal saline with 40 mEq/L potassium chloride at 100 mL/hr Admission orders 1). Code status: Full code 2). Admit to medical unit: 3). Diagnosis: Dehydration, history of colectomy with tranverse colostomy 4). Wound/ostomy consult 5). Complete blood count now and in the moming 6). Comprehensive metabolic panel and lipids now and in the morning 7). Diet: Clear liquid diet; advance as tolerated. Tue 19:00 8). Record intake and output. 9). Daily weights M Levin, MD 10). Vital signs every 8 hours and as needed 11). Activity as tolerated 12). Start peripheral IV now. 13). 0.9% normal saline 1000 ml bolus IV x 1 now . 14). Ondansteron 4 mg IV every 6 hours PRN for nausea and vomiting 15). Morphine 4 mg IV every 4 hours PRN for 20 ЈТ pain 16). Mesalamine 800 mg PO 3 times daily