Bowel Resection: A Guide for Nursing Students
Introduction
A bowel resection is a surgical procedure to remove a part of the small or large intestine. It may be necessary for conditions like colorectal cancer, bowel obstruction, Crohn’s disease, ulcerative colitis, diverticulitis, or trauma. Nursing students working in surgical and post-operative settings need to understand the procedure, potential complications, and appropriate post-operative care.
Types of Bowel Resection
There are several types of bowel resection based on the location and extent of the surgery:
• Small Bowel Resection: Removal of a section of the small intestine.
• Colectomy: Removal of part or all of the large intestine (colon).
• Hemicolectomy: Removal of the left or right portion of the colon.
• Proctocolectomy: Removal of the colon and rectum, often with an ileostomy.
These surgeries can be performed through open or laparoscopic techniques, with laparoscopic approaches generally leading to faster recovery and fewer complications.
Pre-Operative Nursing Care
Before surgery, nurses play a critical role in educating patients and preparing them physically and emotionally. Key aspects of pre-operative care include:
• Ensuring the patient is informed about the surgery and has signed consent.
• Educating the patient on post-operative expectations, such as the possibility of an ostomy.
• Administering bowel preparation if prescribed.
• Verifying NPO (nothing by mouth) status to reduce aspiration risk during anesthesia.
Post-Operative Nursing Care
Post-operative care focuses on pain management, monitoring for complications, and supporting recovery. Key areas include:
• Pain Management: Administering prescribed analgesics and using non-pharmacologic methods to alleviate pain.
• Wound and Ostomy Care: Monitoring the surgical site for signs of infection and, if applicable, educating the patient on ostomy care.
• Monitoring for Complications: These may include infection, bleeding, bowel obstruction, or anastomotic leakage. Nurses should regularly assess vital signs, bowel sounds, and observe for abdominal distension or changes in stool.
• Fluid and Nutritional Support: Monitoring hydration, electrolytes, and gradually advancing the diet as tolerated from clear liquids to soft foods.
• Early Mobilization: Encouraging ambulation as soon as feasible to reduce the risk of complications like deep vein thrombosis (DVT) and promote bowel motility.
Patient Education and Discharge Planning
Nurses should educate patients on self-care at home, signs of complications, dietary adjustments, and when to seek medical help. For patients with a new ostomy, education on ostomy care, including how to empty and change the pouch and skin care around the stoma, is essential.
Conclusion
Bowel resection is a major surgery that requires diligent pre- and post-operative care. Nurses play a vital role in managing pain, preventing complications, and educating patients for a successful recovery. With thorough knowledge of bowel resection care, nursing students can better support patients during their surgical experience.
Reference
Hinkle, J. L., & Cheever, K. H. (2017). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing. Wolters Kluwer.