Ostomies: Article Analysis

On 01/27/2016, I observed about 22 patients in Postanesthesia Care Unit. Some of the patients were observed after surgeries while others were observed after endoscopy. During my shift, I observed patients awaiting recovery for removal of kidney stones, malignant melanoma (removal of moles), Endometrial Biopsy (EBX), superficial femoral artery (SFA), Hernia repair, Oophorectomy (ovary removal surgery), Cardiorrhaphy (Ventricular repair), Cystolithalopaxy (bladder stone removal), gall stone removal, Ectopic pregnancy surgery, and leg surgery.

1. Name the circulatory system that carries blood from the heart to the lungs and back to the heart.

Surgeons rely on technology, from diathermy to the operating room lights, assistance and team work. The conscientious staff should always ensure that the equipment is functioning and reliable. Hospital acquired conditions are medical complications that has a negative impact on patients during their hospital stay. Medicaid or additional services are not reliable to pay the hospital for any conditions that were developing while in the hospital. Based on surveys through several studies, expertise shows that medical conditions and errors are preventable. The beginning process of surgery usually starts with the patients preparations. Healthcare providers will remove hair that is on the body to be operated on. Patients who are diabetics must have their blood sugar monitor. Before any surgical procedure, healthcare nurses must interview the patient if they are scheduled to have surgery. The steps are getting blood withdrawn for lab work, receiving and E.K.G and information on past medical history. This type of process is to make sure the patient is healthier enough to undergo surgery. The preoperative phase which is the first stage used to perform tests; however the results of testing may come out wrong due to a malfunction in the machine. This can lead to a surgical infections and errors during prep and procedures. The goal of perioperative care is to provide

These findings highlight the impact that a change in body image has on the ostomate. They suggest the need for further research into body image, to explore how ostomates adapt to change, so that healthcare services can be more individualized to patient needs. Understanding the individual’s experience of body image changes related to living with a stoma may help to inform clinical practices and direct the focus of education programs.

According to the Wound, Ostomy, and Continence Nurses Society, (WOCN), before focusing on the ostomy care, the nurse should establish a relationship with the patient and their family. A comprehensive assessment should be performed that focuses on all aspects of the patient’s wellness; physical, psychosocial, cultural and spiritual. The nurse informs the patient about dietary needs, bathing/showering, and returning to work (Cronin, 2005). In doing so, the nurse gains the patient’s trust and confidence helping ease them throughout the intervention process. The assessment allows the nurse to fully recognize the patient not as another client needing a procedure but as a person who is going to have questions, concerns, and needs (WOCN, 2010).

Reflecting on the past few days of clinical have been a huge eye opener for myself. Not only was I able to practice and refresh old skills but I was also able to introduce new skills and enhance those. Although only two shifts in, I felt I was able to further develop my experience with Ostomy care. To illustrate, I was able to care for a 60-year-old man who had a newly formed ileostomy on his middle lower quadrant. Throughout the day, we would spend time emptying it, cleaning it and talking about it. Multiple times, D.Z would complain how difficult it was to maneuver, clean and just simply live with. After witnessing his frustrations more then once, it eventually made me realize just how difficult this new adjustment would be for D.Z.

A stoma is an artificially creted hole in the abdomen that allows for the passage of stool and urine to exit the body. Self-care is vital when one has a stoma. Perisotomal self-care is very important and has been one of the main issues ostomates have experienced. The main characterisits seen with peristomal site complications are discoloration, erosian, and tissue overgrowth. Previous studies, to determine skin problems, with the use of SPSC have not been done. The hypothesis of this randomized controlled study is that those who use SPSC will have a lower percentage of periostmal skin problems (discolartion, erosion, and tissue overgrowth) than the CT group. To test out this study, 81 elgible patients were chosen. Some of the Elibiity requirements included those who were undergoing a colostomy or ilostomy, were 20-18 years of age, and understood why the study was being done. These particpants were chosen from a single tertiary hospital. The 81 participants were split into two groups, the SPSC (45 patients) and CT group (36 patients). Wound Ostomy Care Nurses educated the each group on how they would care for their ostomies. Those with Standarised Peristomal Skin Care (SPSC) use direct pouching on skin with powder if needed. Those with the crusting technique use an artificial skin memberane over

The structure that furnishes the axis for the rotation of the head from side to side is the:

The purpose of the study was to determine the efficacy of a specialized diet in the late postoperative stage of a 68-year-old patient who had underwent several bowel resections; this patient had, but was not diagnosed with, protein-energy malnutrition, as well as intestinal insufficiency and high-output ileostomy. Due to postoperative complications and a weight loss of 8.2 kg, the patient was re-admitted to the hospital 8 months after the last resection. For a total of 133 days at the hospital, she was given parenteral and enteral nutrition support as well as an oral diet. The oral diet was low in insoluble fiber, fat, lactose, and concentrated sweets, and was high in soluble fiber and complex carbohydrates. However, the patient continued to

In the last five years, Enhanced Recovery After Surgery (ERAS) pathways for colorectal resection have been thrust into spotlight with evidence of expedited recovery time and improved postoperative outcomes1–5. However, there exists little uniformity in the recommendations and results of published ERAS pathways, and there is some evidence suggesting that the wrong cocktail of bundle elements can increase Surgical Site Infection (SSI) rates6. This inconsistency can be attributed to a lack of consensus on the efficacy of some common bundle elements, such as preoperative antibacterial showering, maintenance of normothermia, and high intraoperative Fraction of Inspired Oxygen (Fi02) 7–15. Such dissonance in studied ERAS efforts

S.P. should be up out of bed post-op day 1 and wearing TED hose continuously, as well as wearing SCDs overnight in bed. Constipation prevention should e achieved by administering scheduled doses of Colace. Proper nutrition should be encouraged to include plenty of protein to ensure proper wound healing and avoid development of pressure ulcers (Lewis, Dirksen, Heitkemper, Bucher, & Camera, 2011). S.P. should practice coughing and deep breathing throughout her hospital stay to avoid lung congestion and occurrence of pneumonia infection, educating the patient about smoking cessation assistance can be helpful as well.

Patients with a new ostomy need psychosocial support regardless of their background or culture. It is a change that affects an image. This patient needs education and ostomy care training by wound, ostomy, and continence nurses’ society (WOCN) certified nurse. Studies have shown that when patients consult a WOCN-certified nurse, there is a reduction in complications and readmission (Hendren et al., 2015, p. 381). A WOCN-certified nurse is consulted to educate Mr. S. Based on his needs, home health care will be considered upon discharge. Mr. S. also needs a follow-up appointment with a general surgeon for reversal operations evaluation. Regarding the timing of ostomy reversal surgery, studies suggest it is safe to perform reversal surgery as early as three weeks or later (Hendren et al., 2015, p.

I was able to apply successfully and remove the ostomy device. I placed the device in the location where a descending colostomy bag would be placed, and inside the bag, I put a simulated fecal material to resemble what it normally would be.

On my second day of clinical experience this week I focused a lot on time management and documentation for a full patient load, and also on the admission and discharge process. After taking report on all three of our patients, I began my initial morning assessments. It was clear that our 8-year-old post-operative appendectomy was ready to be discharged. My priorities were assessing her incision sites and ensuring the presence of bowel sounds, as well as making sure she did not have a fever and was tolerating a general diet. After completing my assessment and documenting in the computer, we

For the instruments they need in a short amount of time, the scrub tech will let them sit in Prolystica for ten minutes which is a presoak and cleaner. Once they are done presoaking they are rinsed off in the sink and thoroughly rinsed and soaked in hot water for an additional 10 minutes. Then they take a blower to completely dry any excess water on the instruments, this takes an additional 15 minutes. Once they have gone through this process they are then put into a steamer and sterilized. “Air exchange in the operating room is extremely important because it helps to prevent any potential contamination so you can not excessively leave or enter the OR” (Watson, 2016). The patient is put in a different bed when they are operated on and the do not get back into their original bed until their wounds have been completely covered up. The temperature in the operating room has to stay in between 66-68 F with a humidity percentage of 70 for infection control. They clean off every machine with RTU Enzymatic Wipes that are engineered to remove any bio-burden. They use Hibiclens or CHG (2% Chlorahexidine Gluconate) with IPA (70% v/ v Isopropyl Alcohol) on the patients to prep the skin.