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Ed's Nov.27-Dec.3

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1 Ed's Nov.27-Dec.3 on Mon Dec 05, 2011 10:00 pm

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Chapters 9-14

My last patient in clinical was a man age 60 years. I communicated with him as a grown man. I treated him with respect and as the strong able bodied person he was. This is how he wanted to be treated. I offered my assistance and did not take it personally when he said he was able to do it on his own. In the book Marcus talked about smiling. I can't speak for others but smiling is just something I do. He is right who wants an old sour puss nurse Ratchet attending to you like she or he would rather be somewhere else. Smiling is best done naturally not forced. The one negative thing Marcus mentioned that I did during maternity clinicals was do speak the dreaded "I know how you feel,"statement. As soon as I walked out of the room however I knew I did not handle the conversation well. I shared to much. I felt like I had infringed on this mothers moment of importance. My job was to listen and be apart of the birth of her child. Her child and what she was feeling was the most important topic at this time, not my experiences. I will always remember this.

Hirschsprung's Disease

Assessment-In the newborn careful observation for the passage of meconium. Tell parents to report to physician if no stool is past if the patient leaves the hospital in 24hrs. Need of a thorough history of weight gain, nutritional intake, and bowel elimination habits.

Interventions-Monitor temperature.Report elevations immediately.Sign of infection. Monitor white blood cell count. Possible sign of infection. Assess patient's physical symptoms of pain and administer medication as prescribed. Patient is free of pain.

Pre-op Surgical Management- Patient is generally restricted to clear fluids the day before surgery. Rectal irrigations my be performed to evacuate bowel. Provide support for child and family.

Post-op surgical Management- Maintain intravenous fluids and nasogastric tube. Monitor intake and output. Administer pain medications as prescribed. Assess for return of bowel function.bounce

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