Kellie Burke1
1Stomal Therapy Nurse (cred), Canberra Hospital Yamba Drive Garran ACT 2605 kellie.burke@act.gov.au
INTRODUCTION: This case study presentation will discuss the various surgical and stomal complications experienced by a 68 year old female, Mrs S, following surgery and stoma formation for management of a partial bowel obstruction. The focus of the discussion will be the stomal therapy nursing interventions, coupled with multi-disciplinary team input, which was required to best manage the patient’s complications in order to achieve both physical and psychological comfort for her and her family.
BACKGROUND: Mrs S has a background history of Stage 4 Colorectal Cancer with liver metastases which was first diagnosed in 2008. She also has Type 2 diabetes mellitus. The patient presented to the Emergency Department in 2015 with abdominal pain, nausea, vomiting and constipation following chemotherapy. She was diagnosed with a partial bowel obstruction due to an omental mass. Conservative management of the bowel obstruction failed. After consultation with her family, Mrs S opted for full active treatment, which resulted in a bowel resection and formation of a double barrel end ileostomy.
During a three month period Mrs S was re-admitted on three separate occasions experiencing:
- Mucocutaneous separation
- High stoma output with resultant dehydration
- Abdominal collections and,
- Sepsis
CONCLUSION: Post-operative surgical and stoma complications can often require re-admission to health care facilities. In the case of Mrs S her complications can be attributed to the adverse effects of adjuvant therapy, co-morbidities, residual and recurring malignant disease.
Biography
Kellie Burke is a Credentailed Stomal Therapy Nurse and a member of the AASTN Education and Professional Development Committee. She works as the Clinical Nurse Consultant Stomal Therapy Nurse in Canberra Hospital, a 650 + bed tertiary referral and trauma centre.
Kellie also holds a Masters Degree in Advanced Practice Nursing and is currently working towards a Diploma of Leadership and Management.
She is also a busy mother to 2 teenage boys, 4 dogs and one cat. When she has spare time she enjoys cooking, fishing and travelling.