Nishad Singh- age 68- ED – sudden onset rectal bleeding w/ 2 bloody stools
•Tired & dragging…this AM worse than usual”
•Mildly anxious-tender LLQ
•BP 133/88, P 104 reg
•RR 20, SaO2- 98% on room air
•In ED – 200mL BBB with small amount fecal material
•Now sweaty & light-headed -BP 120/76, P 120
•CT shows mass in sigmoid
•3 more bloody stools > BP 100/72, P 134
•Bolus 1000mL LR, 1unit RBCs ASAP
•To OR ASAP for colon resection
1.What factors will affect your pre-op assessment of Mr. Singh?
2.Describe how you might perform the assessment as well as provide physical care. What modifications, if any, would you make to his assessment?
1.What aspects of pre-op teaching should you stress when caring for Mr. Singh?
2.A bowel preparation is typically part of pre-op preparation for colon surgery. Do you think this will be done for Mr. Singh? Why or why not?