Discharge planning
For discharge, it is necessary to brief the patient on how to take the prescribed medications outlined in the schedule, follow-up appointment at the hospital. Considering that Ann had just been operated on, it was also appropriate to include family or friends to brief them on matters such as mobility and toileting issues related to the patient (Francis 2011, p. 8).
A new trend is for nurses to use technology to keep in touch with patients (Stanhope & Lancaster 2014, p. 404). In this case, the patient or her family members should maintain contact with nurses via cell phones or email to help them adhere to the post–colorectal cancer healthcare plan. In this way, the patient can also report any unusual experience during
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(2013, p.12) emphasised the importance of nursing care for patients after hemicolectomy to promote rapid recovery and quicker discharge from the hospital. They reported that the greatest postoperative complication for hemicolectomy patients is pain management; postoperative patients therefore require scheduled pain management to control severe pain and pain intensity. This may involve both pharmacological and non-pharmacological interventions, as non-pharmacological have been reported to increase the efficacy of pharmacological pain management interventions. Isaacson et al. (2013, p.12) recommended massage, repositioning, ensuring a calm environment and allowing the patient to listen to music.
Isaacson et al. (2013, p.12) reported that hemicolectomy patients face the risk of infection at the surgical site. Nurses should not remove the surgical dressing before 24–48 hours post-surgery. Moreover, the surgical site should be kept dry and clean after removal of the dressing.
The authors also mentioned that postoperative patients might have activity intolerance. In this case, cancer may have emotionally weakened the patient. Therefore, adequate rest should be allowed for the patient to recover and to prevent fatigue. In addition, nurses should educate the patient to empower her to engage in self-care. The nurse should arrange follow-up visits at the time of
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Show MoreThe next day WKR1 follow-up with her primary care physician and was placed on seven days RD.
The applicant did not properly annotate the enclosed application requesting a possible discharge upgrade. However, the Army Discharge Review Board considered, the applicant for a possible upgrade as instructed in pertinent part by Department of Defense Instruction 1332.28 which stipulates that a request for review from an applicant without an honorable discharge shall be treated as a request for a change to an honorable discharge unless the applicant requests a specific change to another character of discharge. The applicant states, in effect, she wishes for her Certificate of Release or Discharge from Active Duty (DD Form 214) to accurately reflect her character of military service.
Even though TJC and many others believe bedside reporting is conducive to patient
The applicant requests an upgrade of his under other than honorable conditions discharge to general, under honorable conditions. The applicant contends his discharge was not handled fairly. The applicant states, in effect, it all started with one incident in which he had inappropriate relationship, disrespect a senior NCO, and he pursued Uniform Code of Military Justice (UCMJ) actions through the chain of command. The applicant contends he was trying to move forward, but the unit chose not to transfer him due to his rank reduction.
It is important to remember that many of the treatments associated with HSAs are only meant to prolong survival, and not to cure the disease. It is important to ensure good quality of life is achieved for these patients. Post-operatively, the patient should be closely monitored. Routine checks of temperature, heart rate, respiration rate (TPR), mucous membrane color and capillary refill time should be performed. Bandage changes may be necessary, pain must be managed and blood work should be performed to evaluate electrolytes and complete blood counts.
Benefit-risk of epidural analgesia - post-operative period Epidural analgesia is also widely used during the post-operative period and has been shown to be superior to systemic opioid analgesia for the control of postoperative pain (23). Other beneficial or harmful side effects of TEA during the postoperative period were investigated in a systematic review and meta-analysis including 125 trials, with a total of 9044 patients, analyzing various outcomes (24). In the group receiving TEA vs. systemic opioids the major outcome was a reduced mortality rate (2-3.1% in the epidural group vs. 3.2-4.9% in the control group (OR >0.60)). The main adverse effects of TEA to be mentioned are pruritus, urinary retention, motor blockade and hypotension.
Transition of care is vital part of recovering from any type of surgery. It can be detrimental to the patient’s health if all of the necessary steps and parties involved are not in proper sequence. Transition of care is a vulnerable time for all patients, but especially older patients and those with comorbidities. Transition of care is the coordination of care of patients transferring from different levels of care which include hospital admission through discharge, skilled nursing facilities, long-term care facilities, assisted living facilities, home health care agencies, primary care physicians, specialist, and care takers at home (National Transitions of Care Coalition, n.d.). This paper will outline the downfalls of transition of care
The patient is given educational handout with information on their new diagnosis and medications while in the hospital. The discharge instructions are reviewed with the patient and family member before the patient can go home. During the time that the discharge instructions are reviewed, the patient could be anticipating going home and experiencing a mixture of emotions before being discharge. There could be some excitement, sadness or nervousness based upon their acceptance of the diagnosis while in the hospital. Some of the discharge instructions could be retained or lost in their memory once the patient Is discharged from home.
We, as nurses, must keep the communication open with the patient throughout their hospital stay, so the patient remains abreast of what is going on with their care. With the enhanced recovery program, patients don’t have to ask for their pain medication, the medication is on a set schedule. When patients are made aware that the nurse will bring the medication without the patient having to ask for it, decreases patient anxiety. When patients are less anxious, they are able to become more knowledgeable about their care, and teaching is much easier for the nurse
Each patient represents a specific case who has different background, personality, preference and conditions. Thus, it is important for practitioner to learn from each patient and document it for future reference. Scene
The purpose of the study was to test the effect of rocking chair motion on POI duration, total pain medication received, and time of discharge in patients with cancer recovering from abdominal surgery (Massey, 2010, p. 60). To help determine the effectiveness of rocking chair motion both genders were used. A randomized control trial sample was used to conduct this study at The University of Texas M.D. Anderson Cancer Center between July 2005 and February 2007. The inclusion criteria consisted of the following: patients 21 years and older, abdominal surgery for gastrointestinal cancers, receive patient controlled epidural or IV analgesia, cognitively intact, speak English, tolerate rocking or sitting in chair, and were able to ambulate (Massey, 2010, p. 60).
By facilitating the patient’s history, one is able to generate a series of hypothesis about the nature of the patient’s concern which will be tested by asking for more detailed information (Bickley,
Towards the end of the procedure the nurse counted all sponges and needles with the scrub to make sure that no equipment was left within the patient. The nurse also continued to document information such as the length of the surgery and the amount of blood lost throughout the procedure. Lastly, the circulating nurse cleaned the room and then transferred the patient into a hospital bed to be transferred to the post-anesthesia care unit. Ignatavicius and workman (2013) addressed that these are all responsibilities of the circulating nurse (p.
It is very easy to get wrapped up in the day to day tasks that we complete as nurses. But in order to give our patients the best possible care, we must look at our day through a holistic lens. The following essay will outline the theory as created by the “lady with the lamp” Florence Nightingale. We will look at the different components that are important to a patient’s health and outline on to incorporate these components into current practice.
The observation was undertaken by two Observer One (the author) and Observer Two (an ex clinician