Describe a double barrel ileostomy and explain

Reference no: EM133310525

Case Study:

Question 1: You enter Brandon's room to perform your assessment. His mother is at his bedside. Brandon keeps his eyes closed during your assessment and opens them briefly when instructed. He obeys commands but is not oriented to the date.

a. Would you perform a Glasgow Coma Scale or a Mini-Mental Status exam on Brandon based on case?

b. Why did you choose the above tool and what does this tool assess?

Question 2: You take Brandon's vital signs and find the following. T 38.8 HR 86 RR 16 BP 108/68 Sp02 96% on room air

a. Are these findings normal? Which, if any are not and how do they compare to a normal finding?

b. What are two interventions you would conduct based on these findings?

Question 3: While assessing Brandon's IV site, you observe it is patent, dry and intact, with no signs of complications.

Based on the order of IV NS 125 ml/h, what is the drop factor you expect the IV to be infusing at?

The drop factor for your tubing is 10 gtt/ml.

Question 4: you now want to assess Brandon ostomy

A. Describe a double barrel ileostomy and explain why Brandon has this formof ileostom

B. what type of effluent would you expect.

Question 5: While assesing the ostomy, you observe it to be bright red and protuding 1 inch from the abdomen, There is a pouch on and you note 100ml of brown and red liquid in the effluent bag.

Question: Are these finding normal Explain why they are or not normal

Question 6: Next you assess Brandon's dressing on his right arm and observe purulent drainage on the current dressing.

a. Describe purulent drainage. Is this a normal finding?

b. The laceration is 10 cm long and you know from the chart that it is quite deep. List and describe three findings, other than purulent drainage, that might indicate Brandon's wound is infected.

Question 7: When you leave Brandon's room, the physician assigned to Brandon's care asks

you how he is doing. What findings do you report to Brandon's physician?

Question 8: It Is time to for Brandon's medication. He opens his eyes when bring the medication to his bedside and notices the subcutaneous needle of Fondaparinux 2. 5mg.He asks you why he still needs that needle everyday. You know Fondaparinux is a low-molecular weight heparin (LMWH).

a. What do you tell Brandon is the indication for this medication and why he would be receiving it?

b. Brandon's mother is surprised and frightened by your response. She asks what else they can do to prevent or treat the condition you told them is the reason for the fondaparinux.

Question 9: Next you want to administer Brandon's Cefazolin 1 gm.

The IV manual states you can give Cefazolin 1 gm in a normal saline 50ml bag over 15 minutes.

The Cetazolin vial shows a concentration of 500mg/ml.

a. How many mL of Cefazolin would you insert into the normal saline 50ml bag?

b. At what rate would you set your IV pump in mi/hr to administer the medication over 15 minutes?

Question 10: While emptying Brandon's ostomy, you notice he refuses to watch the procedure and is is staring at the wall to his right side,

You mention his mother mentioned Brandon's girlfriend wanted to visit later.

Brandon responds with " No way, I don't want her to see me like this. She's going to

be grossed out. She should just move on" How do you respond to Brandon?

Reference no: EM133310525

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