mariakate004

Hi everyone, I'm new to this website and new to nursing too. We have care plan discussions every week within my course; however, I am having trouble with this week's care plan. So any insight from the experts would be great:) Here is the case study info: The patient is a 50-year-old male who has undergone a laparotomy and subsequent hemicolectomy of the ascending colon for cancer under general anesthesia. PMHx - mild HT treated with diet and exercise -diet controlled TYPE 2 DIABETES -smokes 30 cigarettes a day (33 years) - weight 130 kg. Medication - nil known allergies Investigation: serology - CBP - raised white cells, Hb 110 -LFT - normal - UEC - raised urea, normal creatinine - C-reactive protein - raised - BGL - 7mmol - CXR - Clear - AXR - loops of gas in the small bowel Social history -Married, and his wife is in a wheelchair -three teenage children -sole income earner for the family -------- Post-op orders -routine post-op observations -NBM -NGT on 4/24 aspirations and free drainage (aspiration to be replaced with N/saline) -anti-emetics for nausea and vomiting PRN, IV metoclopramide, 10mg 8/24 PRN -IVT - 3 liters over 24 hours alternating compound sodium lactate with N/saline - O2 via nasal specs @ 2L/min - IV antibiotics: - IV metronidazole 500mg/100ml TDS - IV gentamycin 240 mg daily - IV cephazolin 1g TDS Analgesia - S/C morphine 2.5 - 5mg 2/24 - paracetamol 1g 6/24 PR -wound drain (haemo vac) -rest in bed for 24 hours, then mobilize as tolerated -------- On return to the ward Observations: - T 38 - BP 140/80 - PR 108 - RR 26 - Sa02 95% Now the discussion will focus on the diagnoses and interventions in the first 48 hours after surgery - looking at each of the body's systems (I.e., respiratory, cardiovascular, neurological, renal, gastrointestinal, metabolic, immune, integumentary). If anyone has any input, it would be much appreciated.