Reoccurring small bowel obstruction

[Ksm142]

I am doing a care plan for a patient that had a small bowel obstruction. I have already addressed the major concerns dysfunctional gastrointestinal motility , deficient fluid volume and deficient fluid and electrolytes and several others . I am attempting a box at proving she has deficient knowledge in how to prevent reoccurrence . When I ask her about her surgical history she cannot recal it all . She keeps saying she doesn't understand why this is happening to her . She continues to want to use narcotics which slows down the gut even more . She does have a in depth history of abd surgeries . Colostomy and colostomy reversal . Sigmoid resection . Previous obstruction . So I really need help organizing my supporting data into a better collective thought process .also she does not have any noted dementia or altered mental status. So I don't have any reason as to why she doesn't have a good recall of surgical history

[dishes, BSN, RN]

How did you obtain her indepth surgical history, was it in her admission history? How many healthcare professionals do you think have asked her about her medical/surgical history? If she has had to review her history with multiple staff members, as well as residents and students, maybe she is tired of talking about her past surgeries.

[Mia415]

I think knowledge deficit is always an appropriate care plan because what are you gonna do about it? You're gonna teach her! Patients always benefit from education. Patients don't need a "reason" to have a poor recall of their health history. This is true for younger patients too. Get comfortable with the idea that that's why we have medical records is because MANY patients are very unreliable at explaining their health history.

[AliNajaCat]

Look up the nursing diagnoses related to self-health maintenance and management and see what they suggest to you. NANDA-I 2015-2017. Sometimes the low-hanging fruit of "knowledge deficit" is really that of the student, LOL.

You can bet that this patient has had oodles of teaching in all those admissions. Now a good, thoughtful nurse would ask, "Why is this not taking? What will happen to her next? Is there something nursing can do about that?"