Question

A patient underwent surgery 3 days ago for colorectal cancer. The patients critical pathway states that he should participate in a teaching session with the wound ostomy nurse to learn colostomy self-care. The patient appears depressed and refuses to look at the colostomy or even make eye contact. How should the nurse proceed?

1) Postpone the teaching session until the patient is more receptive.
2) Follow the critical pathway for patient teaching about ostomy care.
3) Administer a prescribed antidepressant and notify the physician.
4) Explain to the patient the importance of skin care around the ostomy site.

Answer 1

The nurse should postpone the teaching session until the patient is more receptive.

Step-by-step explanation:

In this scenario, the patient is showing signs of depression and refusal to participate in the teaching session for colostomy self-care. The nurse should proceed by postponing the teaching session until the patient is more receptive. Patient education is most effective when the individual is in a state of emotional readiness to learn. By recognizing the patient's emotional state and postponing the session, the nurse can create a more supportive learning environment for the patient.

Answer 2

The nurse should administer a prescribed antidepressant, notify the physician of the patient's mental state, and ensure the patient understands the importance of skin care around the ostomy site. The nurse should be ready to provide the teaching session when the patient is more receptive.

Step-by-step explanation:

In the case of a patient who has undergone surgery for colorectal cancer and is now facing the challenge of learning how to care for a new colostomy, it is crucial for the nurse to balance adherence to critical care pathways with sensitivity to the patient's emotional state. If the patient appears depressed and is reluctant to engage with the colostomy or participate in learning self-care, it is important for the nurse to take a compassionate approach. The most appropriate next step would be to administer a prescribed antidepressant and notify the physician of the patient's current mental state before proceeding with teaching. This acknowledges the emotional difficulty the patient is experiencing and ensures that their mental health is being addressed as part of their overall care plan.

While postponing the teaching session could be considered, it might delay essential care. Therefore, the nurse should offer support, explain the importance of skin care around the ostomy site to prevent complications such as infection, and prepare to re-engage the patient in the teaching at an appropriate time, all while closely monitoring the patient's emotional well-being. Communication with the physician is vital to adjust the care plan, as needed, based on the patient's readiness to learn and participate in their own care.