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Competencies in Nursing

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NURSING DIAGNOSIS
*Risk for Dysfunctional Gastrointestinal Motility r/t colon resection a/e/b lack of bowel sounds
Goal: Patient will pass flatus and have normal bowel sounds by POD 3
Nursing Interventions: 1. Maintain NPO status until bowel sounds return and patient begins to pass flatus 2. Administer antibiotics, analgesics and antipyretics as prescribed 3. Assess pain – intensity, location, quality 4. Encourage use of Incentive Spirometer 5. Assist OOB to chair and with early ambulation to help with peristalsis 6. Observe for dumping syndrome 7. Monitor bowel sounds and abdomen distention 8. Consult with dietician for nutritional counseling when diet can be resumed 9. Monitor daily lab values ensuring glucose levels are done and evaluated (elevated blood glucose levels can cause delayed gastric emptying) 10. Maintain bowel regime as prescribed to minimize risk for constipation. 11. Educate patient for signs and symptoms of constipation and obstruction and notify provider if no BM within 3 to 5 days of discharge.

*Acute Pain r/t postoperative surgical procedure a/e/b numeric pain 8/10
Goal: Patient will verbalize adequate relief of pain within 1 to 2 hours of administration of analgesic
Nursing Interventions: 1. Encourage use of Incentive Spirometer 2. Acknowledge and convey acceptance of the patient’s pain experience 3. Assess pain routinely asking patient to identify intensity, location, duration and quality of pain 4. Administer analgesics as prescribed and evaluate within 1-2 hours of administration for relief 5. Monitor frequency of analgesics and patient’s acceptable comfort level. 6. Monitor for changes in general condition that may need a change in pain relief method 7. If on PCA, monitor for complications of sedation, respiratory distress, urinary retention, N/V 8.

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