Providing nursing care: Colectomy A 55 year old diabetic male patient was admitted for a colectomy. On a previous appointment patient complained of rectal bleeding thought to have been brought on by hemorrhoids. A routine colonoscopy and CT were scheduled. During the procedure a cecal polyp with invasive moderately differentiated adenocarcinoma had been found. He also had a sigmoid colon polyp that after it was biopsied was found as a tubular adenoma. Patient was scheduled for a colectomy.
The article Development of abdominal wound dehiscence after a colectomy: a nursing challenge, states that to prevent wound dehiscence the nurse needs to take several factors into account when caring for a patient who has had a colectomy. Wound failure encompasses two basic elements: a decrease in the wound tensile strength and an increase in collagenolysis. Abdominal wound dehiscence is thought to result from cumulative predisposing and demographic, systemic, and mechanical factors (Johnson, 2009). Gender, age, nutritional status and overall health status play significant roles in patient care.
Risk factors also aid in predicting the development of dehiscence. Diabetes is a risk factor to take into consideration also. Management of dressing used to maintain physiological integrity, consistent measurement technique when measuring the surgical incision. 55 year old male patient with previous medical history of diabetes was admitted for a right colectomy. Date of care, September 29, 2009 patient was alert and open to discussion. I performed an assessment of the heart, lung, and bowel sounds. Heart and lung sounds present and clear.
Bowel sounds heard in all four quadrants. Abdominal incision site was intact with no redness; swelling, or drainage. Monitored blood sugar levels throughout day. Blood pressure remained high and patient was given medication to reduce level. The assessment that the article suggested and the assessment I performed were similar in that the surgical site was monitored and patient condition was taken into account when performing plan of care. The article also suggested measuring surgical site which I did not do and will take into account with future patients.