Nursing Management of Post-Operative Colorectal Cancer

Colorectal cancer is a malignant tumor arising in the epithelial tissue of the colon / rectum.

Colorectal tumors are generally adenocarcinomas that develop from adenoma polyp.

Cause of Colorectal Cancer is not known for certain, but there are predisposing factors consisting of:

• Age over 40 years
• Family history
• History of cancer in other parts of the body
• Benign polyps, colorectal polyps, adenomatous polyps, or adenomas villus
• Ulcerative colitis is more than 20 years
• Sedentary Life style, smoking, obesity.
• Eating habits of high cholesterol / fat and protein (meat) and low in fiber / Refined Carbohydrates that cause changes in faecal flora and the change of bile salts degradation or breakdown products of protein and fat which are carcinogenic.

Post-Operative of Colorectal Cancer

1. Routine care for the surgical client. Monitor vital signs and intake and output, including gastric and other drainage from the wound drain. Assess bleeding from abdominal and perineal incision, colostomy, or anus. Evaluation of the other wound complications and maintain the integrity of psychology.
2. Monitor bowel sounds and abdominal distension degrees. Surgical manipulation of the intestinal peristaltic manghentikan, cause ileus. Absence of bowel sounds and passage of flatus indication of the return of peristaltic.
3. Drugs reduce pain and provide a sense of comfort as checking the position change
4. Assess respiratory status, prop abdomen with a blanket or pillow to help cough
5. Assess the position and patency of NGT, linkage suction. When folded hoses, irrigation with sterile saline carefully.
6. Assess the color, number, and the smell of drainage and colostomy (if any) noted various changes or clot or bleeding bright red.
7. Avoid mounting rectal temperature, rectal suppository or other procedure might damage the anal suture line, causing bleeding, infection or impaired healing.
8. Maintain intravenous fluids when they do naso gastric suction
9. Giving antacid, histamine 2 receptor antagonists and antibiotic therapy is recommended. Depending on the procedure performed. Antibiotic therapy to prevent infection due to contamination of the abdominal cavity with bowel contents.
10. Encourage ambulation to stimulate peristaltic
11. Began teaching and discharge planning. Consult with a nutritionist for diet instructions and menus, give reinforcement teaching.

The purpose of post-operative care:

1. Wound care
2. Client education and home care considerations
3. Positive body image
4. Monitoring and management of complications

Read More : http://screware.blogspot.com/2013/06/nursing-management-of-colorectal-cancer.html

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Nursing Management : Pre-Operative of Colorectal Cancer

Nursing Management of Colorectal Cancer

Client care with bowel surgery:

A. Pre-Operative of Colorectal Cancer

• Ensure valid signs for the procedure. This is useful for patients and family members to understand the procedures and possible risks and advantages, should alternatives to the preparation procedure. Format signing consent for procedures especially as documentation that the client and the family agreed.
• Assess the client and family understanding about the procedure, clarification and interpret as needed. Give instructions on what to expect during the postoperative period, covering pain management, hose fitting NGT / IVFD, breathing exercises, reintroduction of oral intake of food and fluids. Clients are well prepared for preoperative usually not anxious and better able to support the post-operative care. Adequate preparation also reduced the need for narcotic analgesics and enhance client recovery.
• NGT installation. Although the installation is often done in an operating room just for surgery, preoperative NGT can be fitted to throw secretion and gastric emptying.
• Bowel preparation procedure. Antibiotic should kathartik oral and parenteral and enema / swallow can be given preoperatively to cleanse the colon and reduce the risk of peritoneal contamination by intestinal contents during surgery.

Pre-operative treatment goals:

1. Relief of pain
2. Increase activity tolerance
3. Provide nutritional measures
4. Maintain fluid and electrolyte balance
5. Lowers Anxiety
6. Prevent Infection
7. Client Pre-operative education

Read More : http://screware.blogspot.com/2013/06/nursing-management-of-colorectal-cancer.html

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Nursing Management for Diarrhea

Nursing Management for Diarrhea

Diarrhea is often caused an extraordinary event, such as the number of cholera patients a lot in a short time. But with the management of diarrhea fast, precise and quality, mortality can be reduced to a minimum.

Problem Formulation

1. What Definition of Diarrhea?
2. What Etiology of Diarrhea?
3. How Pathophysiology of Diarrhea?
4. What Are the Clinical Symptoms of Diarrhea?
5. What are the Complications of Diarrhea?
6. How Nursing Care Plan of Diarrhea?

Purpose

1. Knowing the Definition of Diarrhea.
2. Knowing the etiology of diarrhea.
3. Knowing the pathophysiology of diarrhea.
4. Know the Clinical Symptoms Diarrhea.
5. Knowing the Complications of diarrhea.
6. Knowing Nursing diarrhea.

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Nursing Management of Varicella

Nursing Management of Varicella

Patients should be isolated from others, as well as for their daily needs. such as:

• Isolation to prevent transmission.
• Nutritious diet (high in calories and protein).
• If a high fever, compress with warm water.
• Strive to avoid infection of the skin such as the provision of antiseptic in the water.
• Strive to vesicles did not rupture
  • Do not scratch the vesicles.
  • Long nails should not be allowed.
  • If want to dry off, just a towel on the skin and do not rub.

The provision of drugs to reduce symptoms such as itching, fever, weight is required in order to reduce the level of disease. Antiviral drug, is recommended within 48 hours of patients complaining of symptoms of varicella.

Giving varicella zooster immuno-globulin (VZIG) is given less than 96 hours after exposure, namely on:

• Women with pregnancy.
• Children with impaired immune systems.
• Newborns whose mothers contracted varicella within 5 days before delivery or 48 hours after birth.
• Premature infants 28 weeks of age or younger with a parent without a history of previous varicella.

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Cesarean Section Pain Management

Cesarean Section Pain Management

Pain Management

• Assess comprehensively about pain, including: location, characteristics and the onset, duration, frequency, quality, intensity / severity of pain, and precipitation factors.
• Observation of non-verbal cues of discomfort, especially in the inability to communicate effectively.
• Give analgesics in accordance with the recommendation.
• Use therapeutic communication so that patients can express pain.
• Assess the patient's cultural background.
• Determine the impact of the expression of pain on quality of life: sleep patterns, appetite, activity of cognition, mood, relationships, jobs, role responsibility
• Assess the individual's experience of pain, a family with chronic pain
• Evaluation of the effectiveness of the actions that have been used to control pain.
• Provide support to patients and families.
• Provide information about pain, such as: the causes, how long the case, and precautions.
• Control of environmental factors that may affect patient response to discomfort (such as room temperature, irradiation, etc.).
• Instruct patient to monitor his own pain.
• Teach the use of non-pharmacological techniques (such as relaxation, guided imagery, music therapy, distraction, application of heat and cold, massase).
• Evaluate the effectiveness of measures to control the pain.
• Modification of pain control measures based on patient response.
• Increase the sleep / rest.
• Instruct the patient to discuss precisely the experience of pain.
• Tell your doctor if action is not successful or event of a complaint.
• Inform other healthcare team / family members as non-pharmacological measures carried out, for a preventive approach.
• Monitor patients for pain management convenience.

Provision of Analgesic

• Determine the location of pain, characteristics, quality, and severity before treatment.
• Give the right medicine to the principle 5.
• Check the history of drug allergy.
• Involve the patient in the electoral analgesics to be used.
• Select the appropriate analgesic / analgesic combination of more than one if it has been prescribed.
• Make a selection of analgesics based on the type and severity of pain.
• Monitor vital signs before and after administration of analgesics.
• Monitor adverse drug reactions and medication.
• Document the response after the administration of analgesics and their side effects.
• Perform actions to reduce analgesic effects (constipation / stomach irritation).

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