Friday, August 13, 2010

Nursing Management of Anorectal disease

  • Reassure the patient.
  • Relieving constipation.
  • Reducing anxiety.
  • Relieving pain.
  • Promoting urinary elimination.
  • Monitoring and managing complications.
  • Promoting home and community based care teaching patients
  • Self care
Relieving Constipations:
  • Encourages intakes of at least 2 liters of water daily to provide adequate hydration.
  • Encourage high fiber foods to promote bulk in the stool and to make ti easier to pass fecal matter through the rectum.
  • Bulk laxative such as meta mucilage and stool softeners are administered.
  • The patient is advised to set aside a time for moving the bowel and to need the urge to defecate as promptly as possible.
  • Relaxation exercise before defecating to relax the abdominal and perineal muscles which may be constricted or in spasm.
  • Analgesic before a bowel movement is beneficial.
Reducing Anxiety:
  • Reassure the patient.
  • Patients privacy should be maintained.
  • Soiled dressings are removed from the room promptly to prevent unpleasant odors; room deodorizer may be needed if dressings are foul smelling.
  • Identify the social needs, psychological needs and care according to them.
Relieving Pain:
  • Patients are encouraged to assume a comfortable position.
  • Floating pad is put under the buttocks when sitting which help to decrease the pain, as may ice and analgesics ointments.
  • Warm compress is given which promote circulation can relieve soreness and pain by relaxing sphincter spasm.
  • 24 hrs after surgery, topical anesthetic agents is used which may be very beneficial in relieving local irritations and soreness.
  • Topical Anesthetics (i.e. suppositories) astringents, antiseptics, tranquilizers and anti emetics are used as prescribed.
  • To relieve o edema - wet dressing saturated with equal parts of cold water and witch hazel is used (when wet compress are used continuously, the petrolatum is applied around the anal area to prevent skin execration.
  • Patient is instructed to assume a prone position at intervals because this position promotes dependent drainage of o edematous fluid.