Introduction
Hemicolectomy, a medical procedure that involves partial removal of the colon, is usually conducted to treat conditions such as diverticulitis, colon cancer, and inflammatory bowel disease. A proper hemicolectomy nursing care plan is crucial to ensure the patient’s safety and comfort during the postoperative period. This paper contains hemicolectomy nursing diagnoses and care plan. It aims to explain what knowledge and skills are vital to effectively care for patients who have undergone the procedure.
Hemicolectomy Nursing Diagnoses
Most common hemicolectomy nursing diagnoses are:
- Pain caused by surgical incision and tissue damage;
- Risk or infection from the surgery;
- Breathing difficulties caused by anesthesia and positioning during surgery;
- Risk of skin damage due to immobility;
- Reduced nutrition.
Hemicolectomy Nursing Care Plan
Hemicolectomy is a complex surgical intervention, and after it has been performed, pain is a regular symptom. According to Olson and Heise (2016), during a postoperative period, the most frequent complication is the suppuration of the operative wound of the abdominal wall. Also, the occurrence of the insolvency of intestinal sutures is possible. A plan of action for the nurse and the patient to engage in mutual goal setting for pain management may include the following stages:
- Remote radiation therapy to reduce the effects of acute pain.
- For the patient – observation and analysis of pain, its frequency and character (pulsating, acute, aching); for the nurse – the evaluation of information received from the patient.
- Locoregional anesthesia that is aimed at relieving patient’s severe discomfort.
- The analysis of the intensity of pain syndrome on a visual analogue scale from 1 to 10 points.
- Breathing exercises as a non-pharmacological method of care and part of middle range pain theory.
- In case of suspected peritonitis as one of the postoperative complications, taking antibiotics will help to avoid dangerous consequences.
TOUS for Nausea after Hemicolectomy
To make a plan for providing relevant medical care for nausea, it is possible to use the theory of unpleasant symptoms (TOUS) that is widely applied today. As Lee, Vincent, and Finnegan (2017) note, this concept proposes to isolate specific problems from the whole spectrum through appropriate interventions. In the context of nausea as the symptom in question, the care plan may include the following steps:
- Developing and introducing a symptom assessment scale.
- The analysis of the degree of nausea on the selected scale from 1 to 10 points.
- The diagnosis of related symptoms – vomiting, dizziness, or muscle weakness.
- Antecedent knowledge based on previous clinical observations.
- As intervention methods, both pharmacological techniques (antihistamines, absorbents), and sedatives (soothing natural remedies for neurotic nausea) may be utilized.
- As outcome measures for the intervention, prolonged nausea with related symptoms should be taken into account.
References
Lee, S. E., Vincent, C., & Finnegan, L. (2017). An analysis and evaluation of the theory of unpleasant symptoms. Advances in Nursing Science, 40(1), E16-E39. Web.
Olson, T. J. P., & Heise, C. P. (2016). Right hemicolectomy. In H. Chen (Ed.), Illustrative handbook of general surgery (pp. 395-411). Cham, Switzerland: Springer.