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The Medical Surgical Floor Recovering From His Transverse Colostomy Five Days

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A week after initial admission, the patient is on the medical surgical floor recovering from his transverse colostomy five days ago. At 1200 vital signs are as follows, temperature 99.1; pulse 96; respirations 18; blood pressure 141/69; pulse ox is 94% on 1L NC in AM. The patient appears acutely ill and lays in bed with his eyes closed even when family comes into the room to check on him. He is alert and oriented to person, but not place or situation. He appears lethargic and is slow to respond to questioning, this appears to be due to recent administration of pain medication. Pupils are equal round and reactive to light and grips are week bilaterally in hands. Abdomen is firm, distended, and non-tender. Colostomy site appears to be …show more content…

R.H. has a large, active family in the area who assist in his care and plan of treatment as much as possible, and provide daily visits. Prior to the most recent hospital admission, the family reports he was an active man who lived alone, and was quite capable of caring for himself and his house. He has a wife who suffers from dementia and is cared for by their children. He meets with his primary care doctor as well as a home health nurse frequently to monitor his condition and review treatment options. Additionally, the patient is a non-practicing Catholic, with a close group of friends and other support systems within the community. Even with the high level of support he has, the patient is still at an increased risk for ineffective coping due to the sudden onset of his symptoms. Due to his continued weakness and confusion related to high levels of pain medications, much of the decision making is left up to his family, particularly his eldest daughter causing stress for the whole family. Because of his self-care deficit, which will likely extend after discharge, he will likely require extensive rehabilitation as well as being required to live either with family members or in a care facility. The patient and family will need to be continually monitored for ineffective coping for the duration of his hospital stay, as well as following discharge. His extensive medical history and the cancer

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