GL 2007: Nursing and/or Collaborative Interventions Used

Project Case Study
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1.0 Introduction of the Case Study and its Significance
The case study is about pre-operative care of a patient who is going through bowel resection for colon cancer. The patient is male aged 74, Mr. Arthur Barrett, who has a history of change in bowel habit. He decided to seek medical attention after noticing rectal bleeding. He also reported occasional constipation and diarrhoea as well as changes in bowel habits and. The general practitioner (GP) referred Mr. Barrett for colonoscopy after finding out that this patient was anaemic. Results of the colonoscopy indicated that the patient has left-sided colon cancer and a bowel resection was scheduled afterward.
Mr. Barrett has co-morbidities such as Type 2 diabetes which is diet-controlled and osteoarthritis. He also has chronic obstructive pulmonary disease (COPD) since the past fifteen years. The son of the patient died last year in a farming accident and his wife died 3 years prior due to cancer of the breast. He has one daughter although she resides away from him. He is a grieving elderly man who lacks social support. He has anxiety and possibly depression that is related to loneliness and recent loss of son and wife, his cancer diagnosis, living with a colostomy, as well as capacity to care for himself after discharge. Even so, he is not so much as anxious as he is sad for the loss of wife and son, and daughter who is away.
This case is significant since fighting cancer is generally a very hard experience for any patient to undergo. The case is particularly of note given that it focuses an elderly patient with several co-morbidities that include osteoarthritis, type 2 diabetes, as well as chronic obstructive pulmonary disease (COPD) all of which are not uncommon conditions amongst patients aged 65 years and above. Adding cancer to these already existing conditions is very difficult for Mr. Barrett, and this combination is by and large common. It is quite demanding to provide care to a patient with such intricate health issues as Mr Barrett.
Complex cases can be difficult for new graduate nurses. If a nurse focuses on the reason for the patient’s admission, for instance surgical operation, he or she can easily overlook important factors that will affect the patient’s risk for complications and recovery. Mr Barrett’s case is complicated by his co-morbidities and his psychosocial history. This case allows one to consider the importance of looking past the “reason for admission” and addressing these factors in an effective and appropriate manner.
2.0 Nursing and/or Collaborative Interventions Used
A number of nursing and/or collaborative pre-op interventions were used. The patient met with anaesthetist, surgeon, and stoma therapy nurse pre-operatively to be provided with information with regard to his upcoming surgical operation. The physiotherapist provided the patient with information and exercises related to coughing, breathing and mobilising post-operatively. This was reinforced and the patient was encouraged to practice these every hour.
Enoxaparin sodium was administered to protect him from thromboembolism. Information regarding leg exercises ...