Care of the Patient with Altered Gastrointestinal Function - Term Paper Example

Start to write your assignment below the line. Please note:As indicated in Assessment 1 information, a cover sheet, title andcontents pages are not required Before you begin take a minute to fill in your details in the footer to ensure your document is identifiable. To access the footer, double click on the grey writing “Last name….” at the bottom of the page above. Once you have done that, double click here to come back to this page. Information about the requiredline spacing and font size and type is in the Assessment 1 information document in the Assessment 1 folder on NUR250Learnline. Take a minute to check that this document meets those requirements. It is recommended you don’t copy from another document onto this template. Type your assignment directly onto this template. Submission of your assignment means you have read and understood the University policies and procedures related to academic integrity Assessment 1 presentation guidelines Clinical presentation is based on the curative care component for a patient. Essentially, it is vital since it gives the patient hope to receive palliative care, psychological support and prevention (Broek et al. 2014). Evidently, effective presentation requires that a nurse is well aware of the historical treatments are diagnosis of the intended patient to take care of (Broek et al. 2014). A nurse taking a shift from a previous nurse to take care of patients in the hospital have to be well versed with the historical information of the admitted patients. This is to help a continued accurate care and treatment for the patients. Nigel was admitted three days ago with acute abdomen which forced him to undergo laparotomy. He is in a critical condition and on the verge of losing hope. As such, there various aspects that are expected to be noted from Nigel at first sight based on his condition. Specifically, the first thing to see from Nigel on his bedside is the nasal prong oxygen in situ which is set at an interval of 2liters per minute. Additionally, 2 intravenous lines one for fluids and one for medications are expected to be seen. Sounds of the nasal prong oxygen in situ are expected to be heard from a distance. Nigel has been undergoing acute pain in the whole night. Consequently, complains as results of abdominal pain are expected to be heard while approaching Nigel’s bed. It is expected to see and hear the fore mentioned aspects from the patient based on the following reasons. Firstly, it the 3rd morning since his operation and over the night he had an increased abdominal pain, rigidity and rebound tenderness of the abdomen. Secondly, he is nil by mouth as such it expected that two tubes have to be inserted. Lastly, breathing problems have to be solved by use of nasal prong oxygen (Berstsias et al. 2015). Nursing management is a vital aspect in all kinds of treatments. A nurse taking over a shift to continue taking care and protection to patients has to have both professional and personal ethical conduct to handle patients (Staveski, 2013). Essentially, proper nursing management gives hope of life to patients about their various conditions. In this regard, a nurse is expected to show high level of nursing management to all patients. Consequently, assessment and monitoring of Nigel’s condition will be based on the historical treatment and conditions that have been taken for the last three days. Specifically, his current medication will be administered to him as prescribed by the doctor. The medication will be administered in relation to close supervision to identify any change from Nigel. Generally, the medications aimed at reducing the acute pain that has been noticed throughout the night, allow free circulation of air in the whole body from the nasal prong oxygen, allow penetration of food and fluids from the two tubes and ensure proper colostomy drainage. Additionally, the medication has to protect infections from the wound (Staveski, 2013). As such, the nurse will be assessing and monitoring for acute temperature reduction or increase, acute pain and increased drainage from the colostomy (Staveski, 2013). These will be assessed and monitored through temperature checks, complains from the patient about pain increase from various parts and the amount of urine and other waste products from colostomy. Apparently, some of the potential complications that will be monitored for from Nigel will be changes in neurologic or cardiovascular that can hinder proper gas circulation, poor PO intake, vomiting and nausea (Staveski, 2013). Appearance of any of these complications will show a potential change in the patient’s body. Constant temperature check, proper gas circulation, checks on pain potentiality and proper drainage from colostomy will be the fundamental strategies that will be used to notice changes in Nigel’s condition. Identification of any of the fore mentioned changes will either show improvement or deterioration of Nigel’s condition. Specifically, lack of drainage from colostomy, consistence vomiting, increased pain and decrease in neurologic or cardiovascular will show deterioration of Nigel’s condition. On the other hand, proper drainage from colostomy, absence of vomiting, decrease in pain and proper neurologic or cardiovascular will show improvement in the patient’s condition. Positive changes in the patient will show that laparotomy that was done on Nigel will heal him. Deterioration of his condition will call for changes in medication to help improve the situation (Staveski, 2013). When assessing and determining the temperature of a patient, various fundamental aspects have to be considered by the nurse. However, temperature assessment and determination in patients varies from nurses. Essentially, the method used to determine the temperature of a patient has to be valid and the equipments used have to be satisfied to show consistent results (Ganio et al. 2014). Some of the acceptable equipments and methods of temperature assessment include but not limited to the following. Firstly, there is use of oral method (Gump, 2014). This method is widely used but some of the nurses underestimate it. It is the most accurate method. Secondly, there is temporal artery temperature measurement which commonly used in normothermic paediatric patients (Gump, 2014). It is measured using probes and electronic thermometer. Thirdly, there is auxiliary temperature measurement which relates to temporal method since they were first used in paediatric patients (Gump, 2014). Fourthly, there is tympanic temperature measurement which involves meta-analysis. Lastly, there is use of chemical thermometers. This method relates to auxiliary since there way of performances relates (Malone, 2015). Temperature assessment depends on the place on the body where the temperature measurement is done. Additionally, the cardiac rhythm of an individual will determine the correct time to show the accurate temperature of the body. In this regard, the accepted time frame to determine the temperature of patient is during the mid hours of the day (Malone, 2015). This however varies depending on the location of the patient. Cardiac rhythm, various activities of the body, natural rhythms, and the environmental conditions are some of the factors that might hinder accurate temperature assessment in a patient (Malone, 2015). Consequently, based on the above findings it is valid to determine the temperature body of a medical surgery. Essentially, temporal artery measurement is one of the best methods to be used in determining the accurate temperature of a surgical patient (Bridges & Thomas, 2009). As such, determining of the temperature from a patient undergoing surgical operations will be done using either an electronic thermometer or rectal probes. The equipments will be placed on the arteries of the patient undergoing sugary and their temperature will be shown. Patient-controlled analgesia (PCA) is normally assumed to entail on-demand, irregular, IV administration of opioids in patients (Grass, 2015). The patient under PCA is on a sophisticated technique in which in which various dosages are administered to various patients. In this regard, Nigel has been prescribed an opioids infusion using a patient controlled analgesic device because the dosage is programmed and he can easily push a demand button to determine the amount of opioid and other IV dosages. This patient controlled analgesia was prescribed to him so as to be able to personally control the dosage of the opioids and other drugs. The amino-glycoside antibiotics are widely used in treatment of various infections. Some of these infections include stern gram-negative infections such as pneumonia or bacteria and infective endocarditic. As such, this dosage was prescribed to Nigel because it was aimed at killing bacteria from his abdominal part after laportomy surgery was done (Barnason et al. 2012). Essentially, after surgical operation bacterial infection might occur in the wound. Administering amino-glycoside antibiotic to Nigel will prevent these infections (Barnason et al. 2012). Metoclopramide is hydrochloride with 4-amino-5-chloro and other essential components. Specifically, it stimulates motility of the upper gastrointestinal tract without causing gastric, biliary and pancreatic secretions (Murphy et al. 2012). Consequently, the dosage was prescribed to Nigel to prevent stimulation and secretion of gastric, biliary and pancreatic secretions from the digestive tract. This was done to prevent infection of the colostomy section post surgical operation. Additionally, Nigel was feeding from fluids that were to be absorbed directly into his body. As a result, the dosage was to block any hindrances of these fluids from being absorbed (Murphy et al. 2012). The nurse has a responsibility to ensure that the three prescribed medications are administered accordingly to Nigel. In this regard, the nurse has the responsibility to ensure that all the dosages are administered at the correct time and in the correct state. Additionally, monitoring Nigel is another obligation bestowed to the nurse taking over the shift. As such, the nurse will have to monitor for proper gas circulation, reduced pain, proper healing of the wound and proper movement of the fluids inserted in the Nigel. This will be vital to determine if Nigel is responding positively to the today’s three medication prescribed. It is generally assumed that when the gastrointestinal is functioning properly, all other fluids and electrolytes in the body of a human being will function properly. However, lack of gut functioning calls for an expensive method of balancing fluids and electrolytes in the body of a human being. This feeding is referred to parenteral nutrition (Thorson et al. 2013). Essentially, Nigel’s gut is not functioning properly. Consequently, the gastrointestinal organs are not function properly. Evidently, Nigel is at a higher risk of experiencing fluid volumes and electrolyte deficit. This is because the gastrointestinal organs are not able to process the required fluids and electrolytes to maintain a balanced fluid volume of the body. His gut is not functional due to the colostomy operation that was done to him. As such, he is feeding to a limited volume of fluids and electrolytes which can drop at any time. The nurse has to ensure that Nigel maintains the volume of fluids and electrolytes in his body. This fundamental since they it will ensure proper body functioning of the patient. Additionally, a balanced volume of fluids and electrolytes in the body of Nigel is important because it will help boost the immune system and maintain the osmolality of the internal system of the body. Maintaining a balanced fluid and electrolyte volume will help in quick cure of the Nigel’s condition and restore his potential health (Marinella, 2012). There are specific strategies that need to be applied to ensure that Nigel maintains a balanced volume of fluids and electrolyte. Firstly, the nurse has to ensure that the fluids fade from the tubes are parenteral nutritious to ensure a balanced volume of fluids and electrolytes. Nutritious fluids that are externally fed to Nigel through the tubes have to be balanced in terms of nutrition content. Secondly, the nurse has to ensure that the osmolality formula is used to ensure that the patient does not face imbalance of this two vital components. The formula helps in balancing the amount of fluids and electrolytes needed in the body of Nigel. There are various indicators that will show that Nigel has developed a deficit of electrolyte of fluid. Some of these indicators are; improper functioning of the intestinal organs, pale skin, and dehydration, failure of gas circulation and lack of absorption of the mineral salts. This signs will indicate that Nigel has a deficit of fluid and electrolyte in the body therefore a proper solution has to be taken. Caring for someone like Nigel has greatly changed my perception about bed driven patients. Essentially, this patients need to be taken care of in a special manner. I have leant that caring for such patients needs close monitoring and supervision. Additionally, it is vital for one to have both professional and personal good ethical conducts to handle such patients (Jones & Bartlett, 2015). The fundamental role and scope for a registered nurse in caring for a patient with gastro-intestinal function is to observe accuracy in dose administration. Essentially, I have come to notice that I nurse has to be well versed with various dosage administration techniques to ensure proper caring (Jones & Bartlett, 2015). For instance, observing and ensuring that Nigel does not develop a deficit of fluid and electrolyte volumes is a challenging aspect that requires professional skills to achieve. I think I have to do more studies and research in dosage administration in patients suffering from gastro-intestinal function. This is because it was my first time to take of such a patient and some dosage administration techniques were a challenge to me. To add on the acquired experience as a result of taking care of Nigel further studies or learning on dosage administration on gastro-intestinal function patients is vital to me. References Ackerman, B. H., Vannier, A. M. & Eudy, E. B. (2014). Analysis of Vancomycin Time-Kill Studies with Staphylococcus Species by Using a Curve Stripping Program to Describe the Relationship Between Concentration And Pharmacodynamic Response. Journal for Antimicrob Agents Chemother Barnason et al. (2012). Clinical Practice Guideline: Non-invasive Temperature Measurement in the Emergency Department Full Version. Accessed from https://www.ena.org/practiceresearch/research/CPG/Documents/TemperatureMeasurementCPG.pdf on 23rd August 2015 Berstsias, G., Cervera, R. & Boumpas, D.T. (2015). Systemic Lupus Erythematosus: Pathogenesis and Clinical Features. Accessed from http://www.eular.org/myUploadData/files/sample%20chapter20_mod%2017.pdf on 23rd August 2015 Broek, I., Harris, N., Henkens, M. & Mekaoui, H. (2015). Clinical guidelines: Diagnosis and treatment manual. International Nursing Journal vol.9 pp.77 Ganio, S.M., & Brown, M. C. & Casa, D.C. (2015). Validity and Reliability of Devices That Assess Body Temperature during Indoor Exercise in the Heat. Journal of Athletic Training Grass, J. A. (2014). Patient-Controlled Analgesia. Western Pennsylvania Hospital and Allegheny General Hospital Medical Journal Gump, D.W. (2014). Vancomycin for Treatment of Bacterial Meningitis. Rev Infect Dis.;3 suppl:S289–292. Jones, w. & Bartlett, E. (2015). Fluid and Electrolyte Disturbances Associated with Tube Feedings. Accessed from http://samples.jbpub.com/9780763781644/81644_CH12_179_190.pdf on 23rd August 2015 Malone, A. M. (2015). Enteral Formula Selection: A Review of Selected Products Categories. Nutrition Issues in Gasroenterology series p.44 Marinella, M. A. (2012). Re-feeding syndrome: An Important Aspect of Supportive Oncology. Journal of Supportive Oncology,7(1), 11–16 Murphy, J. E., Gillespie D.E. & Bateman, C.V. (2012). Predictability of vancomycin trough concentrations using seven approaches for estimating pharmacokinetic parameters. Am J Health Syst Pharm.2006;63(23):2365–2370 Staveski, S. (2014). Patient Care Guideline: Bedside Nursing Management of the Pediatric Patient Requiring ECMO. Lucile Packard Children’s Hospital Medical Journal Thorson, M. A., Bliss, D. Z., & Savik, K. (2013). Re-examination of risk factors for non-Clostridium deficit associated diarrhea in hospitalized patients. Journal of Advanced Nursing, 62(3),354–364 Read More