Risk:
Family hist,
Ulcerative Colitis
Diet: high red meat, low fiber diet
Alcohol, smoking, obesity
Nursing Assessment:
Hematochezia, melena
Constipation/diarrhea
pencil/ribbon like stools
Feeling of incomplete evacuation
Anorexia, weakness, weight loss
Lab:
Fecal Occult blood
DRE: detect mass
Double contrast Barium enema
Sigmoidoscopy, colonoscopy
Med Management:
Radiation
Chemotherapy: 5-FU, leucovorin
Surgery: resection with anastomosis; Colostomy
Nursing Management:
Prepare for surgery: Colostomy
Neomycin, cathartics, enema
Diet: Low residue or liquid (1-2 days)
Post-Op care:
I and O, IV, NGT
Teaching: Stoma Care:
Wash skin area (not stoma) with soap and water
Protective barrier (Stomahesive/Karaya):
Empty 1/3 full: drain, squeeze type bottle with warm water
Change appliance 2-3 days
Stoma: moist pink not dusky blue
Colostomy Irrigation: distal colon/rectum
Time: Same per day, one hour after meal
Solution: 500 to 1L lukewarm tap water.
Position: Sitting CR or side of bed
Cath Tip: Not over 4 inches; without force
Height: 12-18 inches/bag bottom at shoulder
Cramps: stop temp: 25-45 min return flow.
Diet:
Odor causing: Fish, eggs,garlic,cheese, asparagus, onions, spices
Gas causing:Cabbage,broccoli,onions, mushrooms,corn,peas
Hardens stool: Hard-boiled eggs, liver, meat, cheese, rice, bananas, chocolate
Proctoscopy and Sigmoidoscopy: visualization of the rectum and sigmoid colon
Colonoscopy- visualization of the colon
Clear liquid-noon
NPO after midnight, bowel cleansing
Midazolam (Versed) IV for sedation
Glucagon may be given )relax muscles
Monitor for signs of perforation/peritonitis, bleeding
Fever, Guarding, abdominal distention and pain, restlessness, tachycardia
Categories:
Nursing Management,
Oncology
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