SIM LAB ADMISSION Lou Thao Visit ^N 7 Scenario Post op colon
resection
Patient Name: Lou Thao
Visit #: 7
Scenario: Post op colon
resection
SLS: Medical Surgical GI # 24
Allergies: NKDA
Course Objectives (COs): By the end of the course, the student should be able to:
1. Identify competent nursing care for clients with chronic conditions, utilizing evidence-based
practice guidelines (SLO 1,2,5).
2. Differentiate care needs of the elderly adult experiencing alterations in health (SLO
2,3,5).
3. Acknowledge legal and ethical issues in healthcare (SLO 3).
4. Prioritize nursing care for patients with chronic alterations in health (SLO 1.2.4.5).
5. Develop an individualized teaching plan for the client with the goal of improving and
maintaining personal health (SLO 1,2,3,4).
6. Correctly calculate medication doses appropriate for the population (SLO 1,5).
THOROUGHLY ANSWER THE FOLLOWING COMPREHENSIVELY and submit by 0730 the
day before Simulation. Incomplete tickets will be returned for redo, and must be returned by the
following week’s simulation.
**ANSWERS MUST BE paraphrased AND CITE PROFESSIONAL source (Author, year, page).
Textbook and NANDA are preferred sources.
1. In your opinion, based on understanding (through research) Buddhism and health care,
how might Mr. Thao’s religion and culture affect health care decisions?
• In Buddhism, pain is seen as something that is unavoidable and should not be
treated by medical interventions. While pain management plays an important role
in the patient healing , their cultural beliefs need to be honored. Mr. Thao may
likely refuse pain management in the form of medications even if he is in severe
pain (Berkley Center for Religion, 2020).
2. In a fluid volume deficit, what is the overall effect on labs? Do they increase or
decrease? Why?
• Overall, I believe that there is a decrease in most labs but an increase in some
labs. This is because there is an imbalance in the intake and output, so this is how
the body tries to compensate (Harding et al, 2020, pg 276).
3. List 3 possible causes of fluid volume deficit in the post-operative colon resection patient.
1
, SIM LAB ADMISSION Lou Thao Visit ^N 7 Scenario Post op colon
resection
• Excessive urination, vomiting and diarrhea, and excessive sweating are three
possible causes of fluid volume deficit (Harding et al, 2020).
4. Paraphrase your understanding of the pathophysiology of third-spacing.
• Fluid will begin to fill primary areas with fluid, which are normal areas to be
filled with fluid. Then when those get too full that fluid will move on to the
second spacing, which is an abnormal accumulation of fluid. Then finally if fluid
is still being produced it will enter the third spacing. This is where fluid collects in
nonfunctioning areas of the body and becomes trapped and almost impossible for
that fluid to go anywhere. This fluid typically needs to be manually drained, as in
the case of ascites (Harding et al, 2020, pg 272).
5. Using evidence-based research, how long are absent bowel sounds expected throughout
in the post op GI patient? When do they return, in what order? How long is a low-grade
fever expected. When should the nurse become concerned?
• Bowel sounds should return within 2-3 days for a post op GI patient. Small
intestine motility will return firth within a few hours and the large intestine should
return in 2-7 days. A low-grade fever may be normal for the first 48 hours but
after that time frame the nurse should be concerned, as well as if bowl sounds are
absent for 3 days (Harding et al, 2020, pg 340).
6. Compare the symptoms of hemorrhage and third spacing following gastrointestinal
surgery. How are they alike and different?
• Third spacing is when the fluid is displaced within the body while hemorrhage is
when the body is losing total fluid volume. Both third spacing and hemorrhage
can lead to hypovolemia but as stated earlier, one is due to fluid absent in the
vasculature while the other is complete fluid loss (Harding et al, 2020).
7. Create 3 nursing diagnoses using template from
NURSING DIAGNOSIS TEMPLATE HERE
CITATION here (Ackely & Ladwig, 2020)
3 PRIORITY R/T pathophysiology AEB (of diagnosis) Plan with rationale (2 EACH).
Problem Nursing (of diagnosis) *Cannot (refers to the Plans apply to the cause (R/T)
Diagnosis (for be medical diagnosis. problem/risk, NOT of the problem
consideration in the Instead, use the R/T. This is the DO NOT CUT AND PASTE.
hour of Sim) pathophysiology. assessment data) THIS IS PLAGIARISM
. AND WILL NOT BE
ACCEPTED, PLAGIARISM
MAY RESULT IN
2
resection
Patient Name: Lou Thao
Visit #: 7
Scenario: Post op colon
resection
SLS: Medical Surgical GI # 24
Allergies: NKDA
Course Objectives (COs): By the end of the course, the student should be able to:
1. Identify competent nursing care for clients with chronic conditions, utilizing evidence-based
practice guidelines (SLO 1,2,5).
2. Differentiate care needs of the elderly adult experiencing alterations in health (SLO
2,3,5).
3. Acknowledge legal and ethical issues in healthcare (SLO 3).
4. Prioritize nursing care for patients with chronic alterations in health (SLO 1.2.4.5).
5. Develop an individualized teaching plan for the client with the goal of improving and
maintaining personal health (SLO 1,2,3,4).
6. Correctly calculate medication doses appropriate for the population (SLO 1,5).
THOROUGHLY ANSWER THE FOLLOWING COMPREHENSIVELY and submit by 0730 the
day before Simulation. Incomplete tickets will be returned for redo, and must be returned by the
following week’s simulation.
**ANSWERS MUST BE paraphrased AND CITE PROFESSIONAL source (Author, year, page).
Textbook and NANDA are preferred sources.
1. In your opinion, based on understanding (through research) Buddhism and health care,
how might Mr. Thao’s religion and culture affect health care decisions?
• In Buddhism, pain is seen as something that is unavoidable and should not be
treated by medical interventions. While pain management plays an important role
in the patient healing , their cultural beliefs need to be honored. Mr. Thao may
likely refuse pain management in the form of medications even if he is in severe
pain (Berkley Center for Religion, 2020).
2. In a fluid volume deficit, what is the overall effect on labs? Do they increase or
decrease? Why?
• Overall, I believe that there is a decrease in most labs but an increase in some
labs. This is because there is an imbalance in the intake and output, so this is how
the body tries to compensate (Harding et al, 2020, pg 276).
3. List 3 possible causes of fluid volume deficit in the post-operative colon resection patient.
1
, SIM LAB ADMISSION Lou Thao Visit ^N 7 Scenario Post op colon
resection
• Excessive urination, vomiting and diarrhea, and excessive sweating are three
possible causes of fluid volume deficit (Harding et al, 2020).
4. Paraphrase your understanding of the pathophysiology of third-spacing.
• Fluid will begin to fill primary areas with fluid, which are normal areas to be
filled with fluid. Then when those get too full that fluid will move on to the
second spacing, which is an abnormal accumulation of fluid. Then finally if fluid
is still being produced it will enter the third spacing. This is where fluid collects in
nonfunctioning areas of the body and becomes trapped and almost impossible for
that fluid to go anywhere. This fluid typically needs to be manually drained, as in
the case of ascites (Harding et al, 2020, pg 272).
5. Using evidence-based research, how long are absent bowel sounds expected throughout
in the post op GI patient? When do they return, in what order? How long is a low-grade
fever expected. When should the nurse become concerned?
• Bowel sounds should return within 2-3 days for a post op GI patient. Small
intestine motility will return firth within a few hours and the large intestine should
return in 2-7 days. A low-grade fever may be normal for the first 48 hours but
after that time frame the nurse should be concerned, as well as if bowl sounds are
absent for 3 days (Harding et al, 2020, pg 340).
6. Compare the symptoms of hemorrhage and third spacing following gastrointestinal
surgery. How are they alike and different?
• Third spacing is when the fluid is displaced within the body while hemorrhage is
when the body is losing total fluid volume. Both third spacing and hemorrhage
can lead to hypovolemia but as stated earlier, one is due to fluid absent in the
vasculature while the other is complete fluid loss (Harding et al, 2020).
7. Create 3 nursing diagnoses using template from
NURSING DIAGNOSIS TEMPLATE HERE
CITATION here (Ackely & Ladwig, 2020)
3 PRIORITY R/T pathophysiology AEB (of diagnosis) Plan with rationale (2 EACH).
Problem Nursing (of diagnosis) *Cannot (refers to the Plans apply to the cause (R/T)
Diagnosis (for be medical diagnosis. problem/risk, NOT of the problem
consideration in the Instead, use the R/T. This is the DO NOT CUT AND PASTE.
hour of Sim) pathophysiology. assessment data) THIS IS PLAGIARISM
. AND WILL NOT BE
ACCEPTED, PLAGIARISM
MAY RESULT IN
2
