Need help on care plan...asap!

[Ashley Anne]

I am doing a post-op care plan on a pt. who has Colorectal Ca. and has had a sm bowel resection as well as an infected portal catheter that was removed. She has an abd catheter w/ increased amts of drainage as well as a FC. And low wall suction NG tube.

I have to do a whole care plan with just that. Im not sure what meds to use...PCA (Demerol) and ABX (but not sure which abx..Keflex?? Broad Spectrum abx???) I have done some research about Sm. Bowel resection surg. and some of them say the pt. will have a temporary colostomy and some say they wont. Im also not sure about the abd cath. Where does that go? Does its just drain the abd. cavity?

Any input or help would be greatly appriciated!!! Thanks!

[cougarnurse]

Pain, body image (related to colostomy if there is one, or even post-op)......will the patient be getting chemo or radiation? Potential for dehydration secondary to drainage is quite possible. Depending on how much bowel removed could cause nutritional problems.....

'Cat'

[airm8t23]

Hi ashley, have u looked at at risk for infection? Some of the antibiotice i've seen have been ancef x3 days or zosyn is another one. if the patient develops an infection you may have ineffective thermoregulation so of course look at tylenol and dont forget the parameters the doctor has set. I've never seen a pt come out of abdominal surgury with a PCA at least not on my floor. Also dont forget pepcid espcially with the whole sugical senario because im sure the pt is NPO at least for now they are at higher risk for ulcerative damage. Also an anti emetic while they are NPO I usually see phenergan. Does this help at all?
Mac

[AmandaWIRN]

Choosing which medications the patient should be on should NOT be part of a nursing care plan- this is outside of the scope of practice for nursing! A nursing care plan (not that we use them in the real world...) should include NURSING diagnoses & NURSING interventions, NOT medical diagnoses or medical interventions.

[cougarnurse]

Mind you, mentioning the meds in relation to the Care Plan is possible. At risk for infection: [ABT] as ordered....... Pain (thus Tylenol).....

[AmandaWIRN]

I agree it would be appropriate to put "give antibiotics as ordered" or "medicate as needed for pain," but nursing instructors shouldn't be expecting students to choose which antibiotics are appropriate to give the patient.