Case Study #3: Linda Brown

Hey nurses! 👋 We are back with our monthly case studies!! These case studies are a great opportunity to practice your critical thinking and earn CPD hours! You are able to claim CPD hours for the time spent researching the case and answering the critical thinking questions, along with any time that you spend on discussing around the case in the comments! 

Case Study #3_ Linda BrownCase Study: 

This month we are looking after Linda Brown. Lind is day 3 post-op from a partial bowel resection; she had to have an ostomy along with her resection.  

 

 

 

Patient Details: 

Name, DOB: Linda Brown, 05/03/1979

Allergies: None Known

Admission Reason: Partial Bowel resection D3 today. Formation of a stoma, patient has a colostomy bag in situ.

PMH: Bowel cancer, chemotherapy, anxiety, depression post cancer diagnosis. Family have a hx of Bowel cancer.

Diet: Tolerating clear fluids, to transition to light diet today

Social: Lives at home with husband and 2 daughters in a ground floor apartment.

Additional Information:

  • Height 160cm, weight 50kg. Average BMI
  • Linda received chemotherapy for her cancer last year, and since then has become more anxious and suffers from depression since her diagnosis. Linda has been very emotional and distressed since the surgery requiring a lot of reassurance and time with the nursing staff.
  • Alert and Oriented.
  • Independent with ADLs.
  • Patient is being reviewed daily by stoma nurse for support and education. Patient needs assistance with stoma care as not confident with stoma management yet.

Observations completed this AM by AIN:

Temp 36.9, RR 16, HR 90 and regular, BP 135/75, 02 Sats 99%

Critical Thinking Questions:

  1. What are the main concerns or issues arising in this scenario?
  2. What are possible issues that may arise with the formation of a new stoma?
  3. Identify and explain what you are including in a stoma assessment.
  4. What would you include in your patient education today?
  5. Linda is taking Endone PRN for pain, what are some side effects of taking this medication? 
  6. What are the requirements of a PRN medication order? (hint...what exactly does the doctor have to include in the order)

Remember, if you have any questions about the case or the above questions, post them in the comments below and we can have a discussion this week! We will be posting the answers to the Case Study on our blog next Friday!