From Postoperative Ileus to Palliative Care: A Case Report

Abstract

Aim: Postoperative ileus is a common complication that increases the length of hospital stay and causes morbidity and mortality. In this study, palliative care needs of a patient, who had ileus in the late period after abdominal surgery and therefore had a colostomy, are discussed. Case report: In this 90 years old/male patient, N.Ö., colostomy was opened due to ileus formation in the late period after abdominal surgery. The patient, who was hospitalized in the intensive care unit for 27 days, was followed up at home after discharge. The pressure ulcer that developed in the intensive care unit has become a pressure ulcer that cannot be staged at home. The patient, whose general condition was impaired, was admitted to the palliative care service on 27.07.2022. The patient was admitted to the unit as confused with contractures in his arms and legs, pain, malabsorption, and fluid-electrolyte imbalance. It was determined that he had acidosis and secretion-related respiratory problems. As a result of the applied nursing interventions, oral R 1-2 was started, the pressure ulcer regressed to stage 2, his appetite and oxygen saturation increased, and his pain and secretions decreased. However, no reduction in contractures has been observed and the risks associated with providing/maintaining a safe environment remain. Inferences: As a result of the care and follow-up given to the patient, it was determined that there was a significant decrease in the symptoms observed when the patient was admitted to the clinic. In the content of the discharge training prepared in line with the nursing care plans to inform the patients and their relatives, it is important to include information about the causes, signs, and symptoms of ileus.