(^324) Medical-Surgical Nursing Demystified
NURSING INTERVENTION
- Monitor intake and output.
- Monitor stool output, frequency.
- Weigh patient regularly.
- Sitz bath.
- Vitamin A & D ointment or barrier cream applied to skin.
- Witch hazel to soothe sensitive skin.
- Monitor for toxic megacolon (distended and tender abdomen, fever, elevated
WBC, elevated pulse, distended colon). - Teach home care for new ostomy patients or refer to enterostomal therapist
for education:- Teach proper skin care of perianal area to avoid skin breakdown.
- Avoid fragranced products which can be irritating.
- Teach dietary modification, and which foods to avoid.
- Teach medication use, schedule, and side effects.
- Teach importance of follow-up care.
- Teach wound care for postoperative patients.
Crucial Diagnostic Tests
Gastroscopy
This test is used to diagnose peptic, gastric, or duodenal ulcers and to obtain
biopsies and specimens for H. pyloribacteria. An informed consent is obtained
prior to any anesthesia. An endoscope is passed through the mouth to allow visual-
ization of the pharynx, esophagus, lower esophageal sphincter, stomach, pyloric
sphincter, and duodenum. Biopsies can be obtained at this time. Bleeding, ulcers,
lesions, and polyps can be visually assessed. The back of the throat will be anesthe-
tized to allow passage of the endoscope.
Before the test—The patient will be NPO.
After the test—Monitor vital signs. Assess for return of gag reflex. The patient
remains NPO until the gag reflex returns.