Surgery in gastrointestinal nursing

Surgery on the gastrointestinal tract is always invasive to some degree and, while minimally invasive procedures are now more common, for instance for biliary surgery, surgery is never without its risks to the patient and is rarely performed without heightening anxiety in the patient. In both regards nurses have a major role to play. Nurses can reinforce the explanations of the need for surgery given by surgical staff; these may not have been fully understood by an anxious patient. In terms of gastrointestinal surgery, good post-operative care is required with particular attention to the possible development of peritonitis. Frequently patients leave surgery with both drains and intravenous infusions and good fluid balance is an important aspect of post-surgical care in addition to monitoring for signs of post-surgical shock and infection.

Surgery may not always have a positive outcome for the patient; there may be bad news in terms of malignancy and in surgery of both the small and large intestines there may be the possibility of a stoma. Whether the latter is expected or not, nurses - and often specialist nurses - have a major role to play in helping the patient to adapt to having a stoma, sometimes permanently. The patient with a stoma, in addition to psychosocial care, will require help with stoma hygiene and the fitting of ostomy bags in order that they may return to a relatively normal life. Where surgery has not had a positive outcome or there is the likelihood of further surgery, the nurse is well placed to offer support and explanations.

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