A. Pre-Operative of Colorectal Cancer
- Ensure valid signs for the procedure. This is useful for patients and family members to understand the procedures and possible risks and advantages, should alternatives to the preparation procedure. Format signing consent for procedures especially as documentation that the client and the family agreed.
- Assess the client and family understanding about the procedure, clarification and interpret as needed. Give instructions on what to expect during the postoperative period, covering pain management, hose fitting NGT / IVFD, breathing exercises, reintroduction of oral intake of food and fluids. Clients are well prepared for preoperative usually not anxious and better able to support the post-operative care. Adequate preparation also reduced the need for narcotic analgesics and enhance client recovery.
- NGT installation. Although the installation is often done in an operating room just for surgery, preoperative NGT can be fitted to throw secretion and gastric emptying.
- Bowel preparation procedure. Antibiotic should kathartik oral and parenteral and enema / swallow can be given preoperatively to cleanse the colon and reduce the risk of peritoneal contamination by intestinal contents during surgery.
Pre-operative treatment goals:
- Relief of pain
- Increase activity tolerance
- Provide nutritional measures
- Maintain fluid and electrolyte balance
- Lowers Anxiety
- Prevent Infection
- Client Pre-operative education
B. Post-Operative of Colorectal Cancer
- Routine care for the surgical client. Monitor vital signs and intake and output, including gastric and other drainage from the wound drain. Assess bleeding from abdominal and perineal incision, colostomy, or anus. Evaluation of the other wound complications and maintain the integrity of psychology.
- Monitor bowel sounds and abdominal distension degrees. Surgical manipulation of the intestinal peristaltic manghentikan, cause ileus. Absence of bowel sounds and passage of flatus indication of the return of peristaltic.
- Drugs reduce pain and provide a sense of comfort as checking the position change
- Assess respiratory status, prop abdomen with a blanket or pillow to help cough
- Assess the position and patency of NGT, linkage suction. When folded hoses, irrigation with sterile saline carefully.
- Assess the color, number, and the smell of drainage and colostomy (if any) noted various changes or clot or bleeding bright red.
- Avoid mounting rectal temperature, rectal suppository or other procedure might damage the anal suture line, causing bleeding, infection or impaired healing.
- Maintain intravenous fluids when they do naso gastric suction
- Giving antacid, histamine 2 receptor antagonists and antibiotic therapy is recommended. Depending on the procedure performed. Antibiotic therapy to prevent infection due to contamination of the abdominal cavity with bowel contents.
- Encourage ambulation to stimulate peristaltic
- Began teaching and discharge planning. Consult with a nutritionist for diet instructions and menus, give reinforcement teaching.
The purpose of post-operative care:
- Wound care
- Client education and home care considerations
- Positive body image
- Monitoring and management of complications
Read More : http://screware.blogspot.com/2013/06/nursing-management-of-colorectal-cancer.html