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Patient with a colostomy

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What do I do first with a patient that's come back from surgery two hours ago for a sigmoid colostomy. patient has N/G tuve to low continous wall suction drainging dark brown drainage,a right central line with TPN infusing at 83mL/hr and an IV of Dextrose 5 percent in normal saline with a PCA (morphine sulfate) set to deliver 1 mg/6 min per patient demand.

assess surgical dressing and stoma

take the vital signs

assiss pain level

check N/G tuve and drainage

check IV site, TPN and PCA setting:banghead:

donsterRN, ASN, BSN

Specializes in Cardiac Care. Has 10 years experience.

Is this homework? What do YOU think is your priority?

racing-mom4, BSN, RN

Specializes in ICU/ER.

A) Call one of your classmates and ask what they would do!!!

Dont take this wrong--but really I dont know if the home forum is a place to post homework questions.

ohmeowzer RN, RN

Specializes in ob/gyn med /surg.

you need to think this out on your own. you have to have the critical thinking skills to know what to do first. think about it ... it's a very simple answer... call a classmate and discuss all those options and why... good luck in school

nursynurseRN

Specializes in TELEMETRY. Has 12 years experience.

What do I do first with a patient that's come back from surgery two hours ago for a sigmoid colostomy. patient has N/G tuve to low continous wall suction drainging dark brown drainage,a right central line with TPN infusing at 83mL/hr and an IV of Dextrose 5 percent in normal saline with a PCA (morphine sulfate) set to deliver 1 mg/6 min per patient demand.

assess surgical dressing and stoma

take the vital signs

assiss pain level

check N/G tuve and drainage

check IV site, TPN and PCA setting:banghead:

When I get post op patient d from PACU, the first thing I do is check the vitals.... Then I would check the surgical dressing and stoma. But in school I think YOU assess first... Weather that be to assess VS or Surgical Site. I think it also depends on the report you get and how awake and alert the patient is.. Hope this is helpful

PS is there a lock on on the PCA? cause if there is NO lock out I would check the order regarding these setting plus I wouls also assess the patient pain level and LOC

donsterRN, ASN, BSN

Specializes in Cardiac Care. Has 10 years experience.

Thread moved to Nursing Student Assistance Forums.

The idea here is to get the OP to think this through, not to spoon answers to her for her homework questions... The membership at AllNurses is a wonderful resource for help and assistance to all students, but we do not want to deprive them of the learning experiences provided in school. This is why posters are directed to their textbooks and educators.

P_RN, ADN, RN

Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89. Has 30 years experience.

Prioritizing a patient

VITAL SIGNS

Airway,

Breathing,

Circulation,

Drainage (foley, suction, hemovac)

PROBLEMS

Wind (Resp status, atalectasis, pneumonia),

Water (voiding status, IV patency and correct fluid),

Wound (dressing status),

Walking (ambulatory status) watch for DVT etc.

Wonder Drugs (assure abx are given as ordered)

Watch for change in comfort level (PCA MS at 1:6min=10 mg an hour.....or 40mg in 4 hours. Without a lockout that may be a little much for some smaller or sensitive patients. May want to watch this and ask for a lockout and some narcan if needed.

Other than that last one I learned these over 40 years ago, and they're still good.

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