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I: Fei Hong is a 70-year-old female.

S: Fei was recently diagnosed with bowel cancer and an open colectomy with stoma formation was completed on her one (1) day ago. Fei has a nasogastric tube (NGT) insitu and is fasting. She will commence NG feeds later this shift after review by the surgical team. Fei has an ileostomy and has been assessed as being MRSA+, requires contact precautions for all nursing care.

B: Medically, Fei Hong has some hearing and sight impairment, and wears glasses and bilateral hearing aids, but is on no regular medications, other than PRN (as required) pain relief. 

Socially, she lives with her daughter Yu Yan, son-in-law George and their children – three-year-old twins – and Yu Yan’s 17-year-old son Jason from a previous relationship. 

Fei Hong has no other extended family as she immigrated to Australia 16 years ago to help her daughter raise her son. She speaks little English and is Buddhist. 

A: Fei Hong’s current observations are: 

Temp 36.1
BP 105/68
Respirations 18
HR 64
Height: 156cm
Weight: 46kg. 
BMI of 19
Pain 4/10

Fei states that she is anxious about recovering from surgery and how to care for her stoma. 

R: continue post-operative care, two (2) hourly observations, assess, monitor, and treat pain, and gentle mobilization. One person assists with ADLs

 

1. Fei has a newly formed ileostomy. Outline the nursing care required for emptying and changing an ostomy bag, while ensuring privacy, dignity, and being culturally respectful. Include in your response the education you would provide to Fei on caring for the stoma and emptying and changing the ostomy bag. 

 

2. Fei has been fasting since her surgery and requires nasogastric feeds, however, the nasogastric tube inserted in the Operating Theatre has fallen out and you are required to insert a new one and commence the feeds. Outline the process required to insert a nasogastric tube and commence nasogastric feeding. 

 

3. Fei has been diagnosed with MRSA+. Describe the infection control measures required to care for a client with this condition. Include in your response if this condition requires contact, airborne, or droplet precautions and what this involves.

 

 

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