Question

Client Profile Mars. Dolan is a 46-yearold female who presented to the emergency department three days ago with complaints of abdominal pain, fever, and diarrhea for almost two weeks. Upon examination in the emergency room, Mrs. Dolan was found to be dehydrated with a potassium (K⁺) level of 2.8mEq/L, erythrocyte sedimentation rate (RSR) of 37 mm/hr, and white blood cell (WBC) count of 16,000 cells /mm³. She tras positive for a tirinary tract infection and an abdominal/ pelvic computed tomography (CT) scan confirmed the diagnosis of diverticulitis. Mrs. Dolan was admitted to the hospital. She was started on intrayenous (IV) fluids with potassium chloride (KCl) supplementation. She was also prescribed IV antibiotics and morphine sulfate for pain management. She has been nothing by mouth (NPO) since admission three days ago. Case Study After three days of IV fluids, antibiotics, and bowel rest, Mrs. Dolan's K⁺ level is 3.7mEq/L, ESR is 30 mm/hr, and WBC count is 15,000cells/mm³. Her vital signs are blood pressure (BP) 114/68, radial pulse/heart rate (HR) 102 , respiratory rate (RR) 18 , and temperature of 109∘F(39.4∘C). Mrs. Dolan has a follow-up abdominal/pelvic CT scan. The CT scan reveals that Mrs. Dolan's diverticultitis has not responded to conservative medicat management and an abscess has developed. Surgical intervention is necessary and she is scheduled for surgery the next morning. Questions

1. Briefly discuss the potential complications
2. Which assessment findings are of associated with acute diverticulitis. education regarding each of the following: stoma Mrs. Dolan's case? assessimen, shin protection, pouch care, diet, medications,
3. Describe Mrs. Dolan's preoperative care needs. sexuality issues, and community nesources.
4. What are the potential complications associated with abdominal sungery that Mrs. Dolan should be for the client living with a colostomy. informed of prior to giving consent for the surgical procedure?
5. Describe the purpose of the following advance directive alternatives: living will, heali care proxy,durable power of attorng.
6. During the immediate postoperative phase of Mrs. Dolan's care, what should the nurse assess? 7. What is a sloma and how are the following three7. What is a sloma and how are the following three types of stomas surgically created: end stoma, double-barrl stoma, and loop stoma?
8. Generate two to three key points to address when providing Mrs. Dolan with colostomy care
9. Prioritize three nursing diagnoses appropriate
10. It has been three weeks since discharge, and Mrs. Dolan and her husband are eating at a Mrs. Dolan is trying to decide between the following three meal choices:
(a) corned beef durable power of attorng. and cabbage,
(b) spaghetti with tomato sauce, and
(c) salmon with baked potato. Which meal should Mrs. Dolan chose in order to follow the nurse's instructions regarding appropriate diet guidelines?

Answer 1

Mrs. Dolan is experiencing complications from acute diverticulitis, including an abscess. Preoperatively, she requires careful monitoring and management of her fluid and electrolyte balance. Postoperatively, she needs to choose meals that are less likely to irritate her condition, such as salmon with baked potato.

Step-by-step explanation:

Potential Complications of Acute Diverticulitis

Acute diverticulitis can lead to several complications, such as abscess formation, perforation, peritonitis, fistula formation, and obstruction. Mrs. Dolan has developed an abscess, one common complication, indicating her condition is severe and requires surgical intervention.

Assessment Findings in Mrs. Dolan's Case

In Mrs. Dolan's case, the concerning assessment findings include dehydration, low potassium levels, elevated white blood cell count (indicative of infection), and high erythrocyte sedimentation rate. Her condition has not improved significantly with conservative management, and she now has a high fever, which is a serious and potentially life-threatening symptom.
Preoperative Care Needs

Mrs. Dolan's preoperative care includes managing her fluid and electrolyte balance, continuing antibiotic therapy, pain management, and preparing her for the possibility of a colostomy post-surgery
Complications of Abdominal Surgery

Possible complications of abdominal surgery, which Mrs. Dolan should be informed about, include infection, bleeding, thrombosis, anesthesia risks, and potential colostomy care.

Colostomy Care Education

Mrs. Dolan needs to be educated on stoma assessment, skin protection, pouch care, diet, medications, sexuality issues, and resources available in the community.Diet Guidelines for Mrs. Dolan

Following surgery and with a colostomy, diet remains crucial. Mrs. Dolan should choose foods that are less likely to cause blockage or irritation. Of the meal choices provided, option c: salmon with baked potato is the most appropriate as it is less likely to cause issues compared to the high fiber in corned beef and cabbage or the potential acidity and skin in spaghetti with tomato sauce.