What are the teaching needs for this patient?

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Pt has a history of HTN, CHF.. was diagnosed and tx for colon cancer & had the remaining tumor removed. She now has an ostomy bag. What would be the nursing interventions for each teaching needs?

I'm a 2nd semester nursing student, just starting med surg. I haven't learned how to empty and change an ostomy bag yet so I don't think I should add that.

Any suggestions? She does know how to use an inspirex, and I did encourage fluid intake.

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Specializes in Trauma, Orthopedics.

1. Just because you haven't learned it yet doesn't mean it isn't an option. You are going to learn something new every single day of your career.

2. What's your reasoning for encouraging fluid intake in a CHF patient?

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The usual : knowledge deficit - related to illness, surgery, pain - teaching pain medication, constipation - especially with all narcotic pain medication, wound care, regular ambulation to prevent skin issues, pneumonia, and so on, mood, self-image....

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BUN was high, and she had very dark amber colored urine.

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Specializes in Assistant Professor, Nephrology, Internal Medicine.

How was the GFR and creatinine?

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How was the GFR and creatinine?
GFR and creatinine were within norm. limits
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Specializes in Medical-Surgical/Float Pool/Stepdown.
1. Just because you haven't learned it yet doesn't mean it isn't an option. You are going to learn something new every single day of your career.

2. What's your reasoning for encouraging fluid intake in a CHF patient?

I'll up the ante and ask does the Pt have an ileostomy or colostomy..?

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Colostomy. Pt has had no stool output so I haven't had a chance to learn how to remove it.

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Specializes in Medical and general practice now LTC.

Moved to the General Student discussion forum

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Specializes in SICU, trauma, neuro.

Odds are, teaching ostomy care would be the RN's responsibility. If you don't know how yet, you'd ask for help from your intructor...or as a new RN, from an experienced staff RN, charge RN, or WOCN (certified wound-ostomy-continence nurse.)

Warning signs about the ostomy -- what as the RN are you assessing for, what would you advise the pt to seek attention for? Those should be in your med-surg book for you to look up.

Body image stuff...odor control, sex life. One tip I learned for the sexually active post ostomy is to wrap a nice scarf around the torso to conceal the stool bag.

Re: the fluids, you may not know being so new into med surg, but lots of times CHF pts have fluid restrictions...say, 1.5 or 2 liters per day. You can look up the rationale for that too.

You'll want to keep an eye on those renal labs; is pt dry, or is she going into renal failure?

I have to go, but hopefully that gives you some things to think about.

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