It is now postoperative day one, and you attend to Justin’s ECG on the ward. Following analysis of the rhythm strip you believe that the ECG is accurate and that Justin is in sinus rhythm.
What are the characteristics of normal sinus rhythm?
Learning Issue 1
It is now post-operative day three for Justin, and he has been allocated to your care. His recovery has been complicated by an inability to tolerate oral diet and fluids and you determine that Justin is experiencing a negative nitrogen balance.
What assessments could the nurse use to assess a patient’s readiness to return to diet and fluids?
Learning Issue 2
It is now post-operative day five for Justin. You join the daily colorectal team meeting, involving doctors, nurses, the stomal therapist, physiotherapy, the dietician and social work. During the meeting Justin’s potential for malnutrition is discussed. Enteral and parenteral nutrition some up as possible intervention; however there is some debate as to which would be best for Justin.
What are the advantages and disadvantages of enteral and parenteral nutrition?
Learning Issue 3
It is now day seven and Justin will be discharged home this afternoon. The wound / ostomy nurse arrives, and provides Justin with some specific discharge education relative to his colostomy, accompanied by some brochures to take home.
What discharge education would you provide to a patient with a newly formed colostomy?
Learning Issue 4
You enter Justin’s room after the wound/ostomy nurse has left, and find Justin crying. He is extremely distressed after performing stoma care. He says to you: ‘How can I go to the beach with my daughters now?’ and ‘This is so ugly, why would my partner be intimate with me?’
What is the nurse’s role in providing emotional support to a patient with a colostomy who is expressing body-image and intimacy concerns?