Nursing care of patients with Enterocutaneous Fistula: 2 case studies

Abstract

     This study was case study aimed to study and make a comparison to provide the nursing care guidelines for patients with septic shock. This was study of two case studies. Two patients with septic shock were selected. Data were collected from medical records. The concept of Gordon’s 11 Functional Health Patterns was employed. The related literature was reviewed from documents, textbooks, academic works, articles and related research to find out patients’ problems, formulate nursing diagnosis to plan nursing practice, make a summary and evaluate nursing outcomes.The first case study was a 65 yearsold, with a history of CA sigmoid colon and history of brain surgery. He had severe abdominal pain 3 hours before coming to the hospital and was admitted to the surgery ward. Khon Kaen Hospital Had surgery. Explore laboratory with lysis adhesion with repair colon with repair small bowel with temporary closure. After surgery, the patient had more abdominal pain. The wound was leaking. The doctor assessed the patient as having Small bowel perforation. Had a second surgery: Abdominal toilet with temporary closure. closure with tube enterostomy with Vacuum dressing. The vacuum dressing was changed a total of 86 times. The patient received total parenteral nutrition along with antibiotics. and management of secretions The patient was safe and was able to go home. Total treatment was 281 days. The second case study was a 34 yearsold, with a history of Sigmoid Colon Cancer invading the bladder S/P Loop transvers colostomy with Ureterostomy. Abdominal wound has food secretions leaking out all the time. Along with having a fever 2 days before coming to the hospital, when first admitted, blood pressure was 84/47 mmHg, she had septic shock and was admitted to the surgical ward. Khon Kaen Hospital has Urinary tract infection, Severe malnutrition, Hypokalemia, Hypoalbuminemia and Anemia. Patients receive Partial parenteral nutrition along with antibiotics. and management of secretions The patient is safe. Refer back to the community hospital for a total of 21 days of treatment.