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Chapter 8: Problem 165

A 54-year-old man is admitted to the hospital for a colostomy related to a recent diagnosis of colon cancer. During the preoperative period, what is the most important aspect of this client's nursing care? 1\. Assure the client that he will be cured of cancer. 2\. Assess understanding of the procedure and expectation of bodily appearance after surgery. 3\. Maintain a cheerful and optimistic environment. 4\. Keep visitors to a minimum, so that he can have time to think things through.

Short Answer

Expert verified
The most important aspect is Option 2: assessing the client's understanding and expectations regarding the procedure and bodily changes post-surgery.

Step by step solution

01

Understanding the Options

First, we should understand what each option is suggesting. Option 1 suggests giving assurance of a cure; Option 2 implies evaluating the patient's understanding and expectations regarding the surgery and body image; Option 3 is about creating a positive atmosphere; and Option 4 suggests limiting visitors to give the patient time alone.
02

Determining the Core Need

Evaluate which option addresses the fundamental preoperative nursing care need in this scenario. The patient's psychological and educational readiness for surgery, especially with regard to a change in body image due to a colostomy, is crucial. Option 2 addresses assessing the understanding and expectations of the procedure and its impact on body image, which is critical preoperatively.
03

Identifying Risks and Boundaries

Analyze each option for potential risks or impractical promises. Option 1 is problematic because nurses cannot guarantee a cure for cancer, making it an unrealistic promise. Option 3, while supportive, does not target the patient's specific need for coping with body image changes. Option 4 negates the potential benefits of social support during a critical time, which is often needed.
04

Evaluating the Best Practice

Based on nursing best practices, preoperative care must prioritize informed consent and psychological preparation. Ensuring that patients understand the procedure and its outcomes, particularly regarding changes in bodily appearance, is fundamental. Therefore, Option 2 stands out as the most comprehensive and person-centered approach.

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Key Concepts

These are the key concepts you need to understand to accurately answer the question.

Patient Education
In preoperative nursing care, educating the patient plays a pivotal role. It's important for patients to thoroughly understand their upcoming procedure to reduce anxiety, foster cooperation, and ensure a smooth recovery. Preoperative education extends beyond the immediate needs and includes Information regarding:
  • The surgical procedure and what it entails, including risks and potential outcomes.
  • Instructions on pre-surgery dietary and medication restrictions.
  • Postoperative care and what to expect during recovery.
  • Implications on body functions and appearance, especially in procedures like a colostomy.
Beyond mechanical aspects, clear communication ensures that 漏patients are well-prepared emotionally and physically. They also become empowered participants in their care journey.
Psychological Preparation
Psychological preparation is crucial before surgery, especially for procedures that alter body image or functions. A patient's emotional and mental state can significantly impact recovery. To aid psychological readiness:
  • Provide space for addressing concerns and fears about surgery and its aftermath.
  • Encourage discussions about apprehensions and clarify any misunderstandings.
  • Support patients through honest, empathetic communication, helping them process changes and accept outcomes.
  • Incorporate family or support networks in discussions, thus enhancing comfort and reassurance.
A well-prepared mind can handle stress better, impacting overall recovery positively.
Informed Consent
Informed consent is a fundamental principle in healthcare. It's more than just a formality; it represents a collaborative understanding between the patient and healthcare provider. Key elements of informed consent include:
  • Ensuring patient awareness of the surgery's purpose, benefits, and risks.
  • Discussing alternative treatments and their respective consequences.
  • Confirming understanding, ensuring the patient can articulate what the procedure involves.
  • Respecting the patient's right to decline or seek additional information.
Informed consent respects patient autonomy, enabling decisions that align with their values and needs.
Body Image
Body image concerns often come to the forefront with procedures that visibly alter appearance or bodily functions, such as a colostomy. Supporting a patient's adaptation involves several steps:
  • Open, honest discussions about how surgery will impact appearance and bodily function.
  • Providing resources, such as support groups, to share experiences and coping strategies.
  • Encouraging a focus on health and recovery, shifting perspective from loss to adaptation.
  • Assistive therapies, like counseling, which can prove beneficial in adjusting a patient's self-perception.
Addressing body image concerns preemptively can facilitate psychological adjustment and foster a positive post-surgery recovery experience.

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Most popular questions from this chapter

Paula is a 32-year-old seeking evaluation and treatment of major depressive symptoms. A major nursing priority during the assessment process includes which of the following? 1\. meaning of current stressors 2\. possibility of self-harm 3\. motivation to participate in treatment 4\. presence of alcohol or other drug use

When planning care for a patient in a healthcare facility, the nurse must be aware that a nosocomial infection: 1\. occurs only in immunocompromised hosts. 2\. occurs in at least 30 percent of patients in a given hospital. 3\. usually is present within a community but is not always clinically apparent. 4\. is acquired in a health care facility.

Nursing care for the client undergoing chemotherapy includes assessment for signs of bone marrow depression. Which finding accounts for some of the symptoms related to bone marrow depression? 1\. Erythrocytes 2\. Leukocytosis 3\. Polycythemia 4\. Thrombocytopenia

Which of the following nursing interventions would not be appropriate for a patient just admitted with vaginal bleeding in the third trimester of pregnancy? 1\. careful admission history 2\. specific assessment of amount of bleeding 3\. vaginal examination to determine progress of cervical dilation 4\. vital signs every 15 minutes

The prognosis for fetal survival following abruption placentae is less than 50 percent. For infants who survive, there is a high degree of morbidity. Knowing this, nursing intervention should focus on which of the following? 1\. monitoring maternal physiologic status 2\. monitoring maternal and infant physiologic status 3\. providing emotional support regarding the imminent delivery of a deceased or defective baby 4\. administering tocolytic agents to arrest labor
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