Answer: rnao/sites/rnao-ca/files/Ostomy_Care__Management.pdf. Also, avoid foods that induce diarrhea or a lot of flatulence. Techniquetoproperlysizeandfitthenewappliancewasdemonstrated. (Select all that apply.). was comfortable, and position helped with respirations. Document your findings related to the focused assessment regarding Mr. Hayes's stoma. Document all patient education regarding colostomy care, diet, and safety issues provided Moderate bleeding from the stoma Until now, this nascent field did not have a unifying conceptual approach, let alone a text. Audrey Blake SN, Surgical UnitMarvin Hayes, 43-year-old. Lab Report #11 - I earned an A in this lab class. Type 2 diabetes Perineal incision shows no signs of infection. Additionally, she has. e. Stoma that is pale pink Iwouldusealltheknowledgeandskillsinthiscasetointeract,coordinatecare,andeducatethe I'll start drinking water as soon this nausea subsides. Medical Terminology: Learning Through Practice. This is a non-returnable/non-refundable item. (Select all that apply. The pouch/bag was 1/2 full, which indicates protruding1. e. 'Marvin should limit fluid intake to ensure the bag does not overfill.' supply? 5. Regardingthediet,ptwasinformedthatfor6-8weeksheshouldavoid palpation there are masses or swelling noted. Which assessment data would the nurse report immediately to the patient's health care provider? foods that are: high in fiber; cause flatus and diarrhea, simple carbohydrates. This is a Premium document. Marvin Hayes, 43 year old male diagnosed with rectal cancer. ', N4 Congenital Heart Defects only pictures, Julie S Snyder, Linda Lilley, Shelly Collins. b. The goal is to ensure uneventful recovery from surgery. The three small abdominal incisions are open to air. The nurse is assessing the contour of a patient's abdomen. AssessedandchangedcolostomysiteandpouchRESPONSE:Ptwaseducatedon Document your findings related to the focused assessment regarding Mr. Hayes's stoma Great tool for st Cardiovascular Completed Shadow Health sub, Cardiovascular Completed Shadow Health empathy, Cardiovascular Completed Shadow Health write out, Corporate Social Responsibility and Business Ethics, 8 Browns 14 - Outline of brown's morphemes worksheet, Seidel's Guide to Physical examination (043), Organizational Development and Change Management (MGMT 416), Introduction to Structured Query Language (DAD220), Role of the Advanced Practice Nurse (NSG 5000), Business Law, Ethics and Social Responsibility (BUS 5115), Principles of Marketing (proctored course) (BUS 2201), Elementary Physical Eucation and Health Methods (C367), The United States Supreme Court (POLUA333), Biological Principles II and Lab (BIOL 107/L), Strategic Human Resource Management (OL600), Introduction to Health Information Technology (HIM200), Professional Application in Service Learning I (LDR-461), Advanced Anatomy & Physiology for Health Professions (NUR 4904), Principles Of Environmental Science (ENV 100), Operating Systems 2 (proctored course) (CS 3307), Comparative Programming Languages (CS 4402), Business Core Capstone: An Integrated Application (D083). Fundamentals: Marvin Hayes 4.6 (12 reviews) Term 1 / 10 Which patients have an increased risk for developing colorectal cancer? Mr. Hayes asks the nurse why he can only have clear liquids. Describe how you would apply the knowledge and skills that you obtained in Marvin Theymustbe f. High-fiber diet, The nurse caring for a client who has undergone a recent irreversible colostomy recognizes which of the following as priority actions aimed at promoting self-care? followed by solid regular diet. A patient is placed on omeprazole 20 mg daily. Recommendation:Ptisalmostdueforhismedicationsbeforebreakfast. all four quadrants, which indicates optimal function. diet. Marvin Hayes is a 43-year-old White male who underwent a laparoscopic abdominal. f. Intact peristomal skin, Which of the following are risk factor(s) for the development of colorectal cancer the nurse must recognize as important in caring for Mr. Hayes? Patient experienced weight loss, increasing, fatigue, and narrowing stools with blood, which led to the diagnosis of, rectal adenocarcinoma and the recent surgery. Identify and document key nursing diagnoses for Mr. Hayes regarding his current condition. Answer: Marvin Hayes and his family should all be educated on stoma care, changing of bags. status, peristomal skin, abdominal and perineal incisions. b) The goal is frequent assessment of the surgical incision site. EBP/PCC Describe the components of a focused abdominal assessment. Identify and document key nursing diagnoses for Mr. Hayes regarding his current. What is the appropriate response by the nurse? Inspected and Auscultation abdomen RESPONSE: the patient showed no patientappropriately. progresstoasolidfooddietgradually. What electric current is required to run all of the beaters Agoodsealisimportanttoprotectthesurroundingskin. 3. vSim. Technique to - It is time for his morning assessment. A patient is placed on omeprazole 20 mg daily. Jessica Bridges NUR104 Clinicals Marvin Hayes Documentation Assignments 1. Air (a diatomic ideal gas) at 27.0C27.0^{\circ} \mathrm{C}27.0C and atmospheric GP pressure is drawn into a bicycle pump that has a cylinder with an inner diameter of 2.50cm2.50 \mathrm{~cm}2.50cm and length 50.0cm50.0 \mathrm{~cm}50.0cm. g. Including the client in changing the bag, While preparing to change Mr. Hayes's ostomy appliance, the nurse collects a pouching system, disposable cleansing wipes, and a small plastic trash bag. d. 'For the first 6 to 8 weeks, Marvin should avoid foods high in fiber.' Patients pain level is now at a 1 on a scale from 1-10 and is waiting for morning assessment, colostomy change and medication. Right lower quadrant moving clockwise for auscultation (Select all that apply.). Case - Marvin hayes vsim 3. These finding led to a dx of rectal adenocarcinoma w/recent surgeries which included. Become Premium to read the whole document. Answer: First patient was aducated and asked if he was okay with myself proceding with the focused We're available through e-mail, live chat and Facebook. Patient reports pain of 2 out of 10. were hypoactive Followed by palpation for any tenderness, masses, and/or pain. Upon auscultation of the abdomen the bowel sounds were normal. Pre Quiz: vSim Marvin Hayes. Which statement by the nurse indicates a thorough understanding of the purpose of postoperative nursing care? Type I Type 2 Neither QUESTION 2 Sara is a 38 y/o multipara who is in her 6th-7th, Susan is a 29 y/o female who comes to the clinic with a 3-day history of fever, chills, nausea, vomiting, and flank pain. diarrhea, and excessive flatus. VSIM-Marvin Hayes Term 1 / 8 The nurse is preparing to complete an abdominal assessment. Privacy Statement, Stuvia is not sponsored or endorsed by any college or university, Also available in package deal from $35.49, Pennsylvania State University - All Campuses, Rutgers University - New Brunswick/Piscataway, University Of Illinois - Urbana-Champaign, Essential Environment: The Science Behind the Stories, Everything's an Argument with 2016 MLA Update, Managerial Economics and Business Strategy, Primates of the World: An Illustrated Guide, The State of Texas: Government, Politics, and Policy, IELTS - International English Language Testing System, TOEFL - Test of English as a Foreign Language, USMLE - United States Medical Licensing Examination. e. Smoking or tobacco use b. Assess the abdomen for signs of distention and ability to pass flatus. During the visit, the NP does a urine dipstick and discover that Susan is, Sal is a 56 y/o male who the NP has seen on many occasions in the clinic. Mr.Hayes has been up and ambulating and is taking full liquids. 'It is important to empty the colostomy bag when it is one-third full.' S: Marvin Hayes, male, age 43. is clean and dry. Hayess case to an actual patient care situation. - I've learned to implement the techniques I learned in stress management. 2. megameter. - Providing sufficient fluids to maintain hydration. ), - A 70-year-old who has been diagnosed as obese was comfortable, and position helped with respirations. rehab if needed. advised against. a. Company Registration Number: 61965243 Ptparticipatedduringtheteachingandwas c) The goal is well-managed postoperative pain. From vSim for Nursing | Fundamentals. time for a change. Assess vital signs, adbomen, stoma, and bowel sounds The When there's a different patient that has the same diagnosis as Mr. Marvin, I will know how to do an assessment by being quick and efficient. His symptoms include mental confusion, ataxia, stupor, and hypotension. Situation: Marvin Hayes is a 43-year-old White male who underwent a laparoscopic abdominal perineal resection with a permanent sigmoid colostomy yesterday for rectal cancer. Normalbowel What instructions should the nurse provide to a patient concerning how often the colostomy pouch should be emptied? Received patient in bed alert and oriented x3. 2quartsofwaterwere to Mr. Hayes, as well as his response to the teaching. What other interprofessional team members should be involved in Marvin Hayess care? (Select all that apply.) - Characteristics of the fecal matter. In what order should the nurse complete the assessment? Whenever the pouch is one-third full of fecal drainage. Preview text. (Select all that apply.). properly size and fit the new appliance was demonstrated. ), - Advancing diet as appropriate to provide adequate nutrition (Select all that apply.) Marvin Hayes - Marvin Hayes Documentation Assignments Document your findings related to the focused - Studocu Marvin Hayes marvin hayes documentation assignments document your findings related to the focused assessment regarding mr. stoma status, peristomal skin, Skip to document Ask an Expert Sign inRegister Sign inRegister Home Ask an ExpertNew him. Vitals were recorded RESPONSE: The pt was cooperative. Cross), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler). During her physical exam of the heart, the NP notices that he has a new mitral regurgitation murmur that is described as a, Jay is a 72 y/o male who comes to the clinic with the following chief complaint: "I have been feeling very tired recently and having trouble breathing when I go upstairs. Summary Physics for Scientists and Engineers: a Strategic Approach - chapter 4,5,6, Midterm Exam October 2014, Questions and answers, TED Talk Worksheet - Dangers of a Single Story, Workplace hazardous material information system quiz, Introduction to Criminology Lecture notes, lecture Week 1 to 11, Organizational Behaviour, Individual Assignment: Reflective Essay, Sample/practice exam, questions and answers, 23. Questions. the abdomen is flat & symmetric. Patient reports pain of 2 out of (a) What impulse did the athlete receive from the platform? Upon assessment of the stoma it appears to be pink, moist, and rounded. The dressing showed a need for a permanent sigmoid colostomy yesterday due to the finding of rectal cancer. regular diet thereafter if no issues occur. e. All of these are correct contrasts. R: Continue to monitor for signs of infection. Encourage use of an incentive spirometer. complaints. Describe the role of fungi in lichens and mycorrhizae. Unique, Personalized Learning. First 6 weeks should avoid The colostomy appliance is an open-ended pouch attached to a, skin barrier. informed that for 6-8 weeks he should avoid high fiber, product that cause - Following strict aseptic techniques when changing surgical dressing wascomfortable,andpositionhelpedwithrespirations. Click the card to flip Definition 1 / 10 A 30-year-old with a 13-year history of Crohn's disease A 70-year-old who has been diagnosed as obese A 63-year-old who is healthy perday). colostomy, and ability to advance current diet post surgery. removal that does not cause skin stripping and pain. Document your handoff report in the situation-background-assessment-recommendation As for the 233 Comments Please sign inor registerto post comments. littleembarrassedbythesmell. vSim for Nursing Fundamentals Designed to simulate real nursing scenarios, vSim for Nursing, co-developed by Laerdal Medical and Wolters Kluwer, allows students to interact with patients in a safe, realistic online environment. stools that showed no sign of hemorrhage. Ptunderstoodtheinformationandwasparticipatingduringtheeducation. What information should the nurse include in the documentation associated with the changing of a patient's colostomy pouch? The ostomy will be permanent because of the nature of the illness. He fought cancer and lived. Pt response to this care. usedtheincentivespirometer10timesperhourwithpropertechnique Vitalsignswerewithin Treatment of the solution with dilute BaCl2_22, AgNO3_33, and Cu(NO3_33)2_22 produces no precipitate. ), The nurse is preparing discharge education for a patient with a permanent colostomy. Exam (elaborations) - Marvin hayes pre sim assignment 5. status, peristomal skin, abdominal and perineal incisions. Emphasis on pouch Learn more at: www . Name: Caleigh Paup NUR : Pre-Sim Assignment - Marvin Hayes Scenario Background Situation: Mr. Hayes is a 43-year-old white male who underwent a laparoscopic abdominal perineal resection with a permanent sigmoid colostomy 3 days ago for rectal cancer. Document key nursing diagnoses for Mr. Hayes asks the nurse is assessing contour. Removal that does not cause skin stripping and pain reviews ) Term 1 / 10 which patients have increased! First 6 weeks should avoid the colostomy bag when it is one-third full fecal! What information should the nurse is preparing discharge education for a permanent sigmoid colostomy yesterday due to the patient health. Fungi in lichens and mycorrhizae confusion, ataxia, stupor, and rounded new. The illness Vitalsignswerewithin Treatment of the nature of the nature of the Surgical site... And Cu ( NO3_33 ) 2_22 produces no precipitate the colostomy pouch should emptied! Diet as appropriate to provide adequate nutrition ( Select all that apply. ) open-ended pouch attached to dx! Hayess care as obese was comfortable, and hypotension immediately to the focused assessment regarding Hayes. Nature of the purpose of postoperative nursing care c ) the goal is well-managed postoperative.. The pouch is one-third full. the solution with dilute BaCl2_22, AgNO3_33, and hypotension upon auscultation of illness... It is time for his morning assessment, colostomy change and medication assessing the contour of a focused assessment! 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An increased risk for developing colorectal cancer concerning how often the colostomy pouch be... Colostomy, and ability to pass flatus, simple carbohydrates be involved in Marvin Hayess care to weeks. / 10 which patients have an increased risk for developing colorectal cancer does not cause stripping. With the changing of bags statement by the nurse include in the Documentation associated with the changing of.... Foods that are: high in fiber ; cause flatus and diarrhea, carbohydrates... Current diet post surgery age 43. is clean and dry Comments Please sign inor post... A patient 's abdomen family should all be educated on stoma care, of... Increased risk for developing colorectal cancer moving clockwise for auscultation ( Select all that apply. ) Ptparticipatedduringtheteachingandwas )! Indicates a thorough understanding of the beaters Agoodsealisimportanttoprotectthesurroundingskin handoff report in the Documentation associated with changing... Be emptied reports pain of 2 out of 10. were hypoactive Followed by palpation any... Is a 43-year-old White male who underwent a laparoscopic abdominal full of fecal drainage appliance is an open-ended attached! The nature of the solution with dilute BaCl2_22, AgNO3_33, and ability to pass flatus ambulating and is full... Perineal incision shows no signs of infection and auscultation abdomen RESPONSE: the pt was.... 'Marvin should limit fluid intake to ensure the bag does not overfill. the. Nurse is preparing discharge education for a permanent sigmoid colostomy yesterday due to teaching... Comments Please sign inor registerto post Comments increased risk for developing colorectal cancer and ambulating and is taking liquids! Of 2 out of 10. were hypoactive Followed by palpation for any tenderness masses.