Assignment: Care Plan Right Colectomy.
Module 05 Written Assignment- Care Plan You are the nurse receiving report on your patient that was admitted as an emergency earlier in the day. A 64-year-old female underwent a right colectomy. The right side of her colon was removed due to cancer. She has a history of smoking & no other health problems. She is currently being transferred to you in PACU. She has a midline incision with a Penrose drain, a stab wound w/ a Jackson Pratt drain to incision. She also has a NG tube, attached to intermittent suction. She is alert, riented and can move all 4 extremities. BP is 110/68, Respiratory rate is 14, O2 stats are at 93% w/ additional oxygen given via nasal cannula. All labs are normal. You are asked to change the dressings daily and document the drainage. What precautions will you take to prevent this patient from obtaining a nosocomial infection? Please answer the questions and develop a care plan for a patient that will be having an elective surgery. Please use the provided format for building your care plan. You will need to use your nursing reference materials as you build this care plan. Go to ATI website for care plan – go to integration materials – scroll down to active learning templates – choose systems disorder Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.
Right colectomy refers to the resection of a portion of the distal ileum, cecum, ascending colon, and proximal to mid-transverse colon. Extended right hemicolectomy refers to extension of the distal resection margin to include the distal transverse colon up to the splenic flexure.
The techniques used to perform right and extended right colectomy are reviewed here. Left colectomy is presented separately. (See “Left colectomy: Open technique”.)
The colon and rectum occupy the retroperitoneal and intraperitoneal spaces, in close approximation to solid organs (figure 1). The ascending and descending colon are retroperitoneal, while the transverse colon, which extends from the hepatic flexure to the splenic flexure, is intraperitoneal. The sigmoid colon continues from the descending colon, ending where the teniae converge to form the rectum.
Arterial supply — The right colic artery and the ileocolic artery provide the principle blood supply to the right colon (figure 2). The marginal artery of Drummond and the arc of Riolan provide collateral blood vessels. Typically, the blood supply of the transverse colon is excellent provided the marginal artery is not damaged. Variability in the arterial anastomoses occurs, which is an important point when performing a segmental resection. Two sites of tenuous perfusion are the splenic flexure (Griffith’s point) and distal descending colon (Sudeck’s point). (See “Overview of intestinal ischemia in adults”, section on ‘Intestinal vascular anatomy’.)
Venous and lymphatic drainage — The venous drainage of the right colon is through the superior mesenteric vein (figure 3). The lymphatics drain via the corresponding arterial supply
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