IMPLEMENT AND MONITOR NURSING CARE FOR CLIENTS WITH ACUTE AND CHRONIC HEALTH PROBLEMS

Case Study 3

Peter Weir is a 39 year old man who has been admitted electively for a bowel resection and temporary colostomy required as a result of complications of Crohn’s disease. You have been assigned him and as you are rostered on for the next 4 days on late/early, early/late shifts, will be providing a great deal of his care. You will be required to admit him to the ward, prepare him for surgery and you will be looking after him immediately post op and during the first few days back on the

ward. His male partner of 15 years, Ross, is very supportive and is there when you admit him but for some reason he interjects and does not let Peter answer questions, instead he answers for him.

1.    You have made a care plan for Mr Weir and the first two nursing diagnoses are:

a)    Knowledge deficit – care of colostomy (he is worried about how he will care for the colostomy as he has never had this procedure before). He requires education on the procedure related to changing his bag and cleaning. Explain what you will tell him.

b)    Body Image Disturbance – He says “This is so disgusting!”, “I hate this!”, “I can never go out again!” reflecting a negative view of his physical appearance. What will you say to him to reassure him?

2.    What possible reasons could there be for why Mr Weir’s partner is answering for him and not letting him answer himself?

3.    What is consent and what is the role of an Enrolled Nurse in relation to this?

4.    Review the ANMC competencies for an Enrolled nurse and identify which one of these domains relates to the area of consent, provide an explanation?

5.    Does Ross have a legal and moral right to:

a) stay in Peter’s room all day and all night

b) to advocate for him

c)  to make requests on his behalf?

Explain each of these answers.