My Case Study Patient

So, I have been following my case study patient for about 3 weeks now,and the last time I see her will be Friday, before I leave New Bern. She has been in the hospital for 4 weeks. She is definitely an interesting case. She came in with abdominal pain, and they did an exploratory laparotomy, and found her sigmoid colon to be perforated from severe diverticulitis, so they had to resect it and make a colostomy. They also found an incarcerated ventral hernia, which is where the contents of the abdomen protrude through the abdominal cavity and into the abdominal wall, through weak spots in the abdominal muscles. It is incarcerated when it is unable to be pushed back in. All the blood supply was cut off to the area so the parts of her small intestine that were in the hernia were ischemic and had to be resected as well.

She went from tube feeding/clear liquids to TPN all of a sudden a few weeks ago, and it took me a while to go through the chart to actually find why. Turns out they believed she either had an obstruction or an ileus post surgery. From what I can tell, it was proven she had neither but the TPN was never discontinued, despite 2 notes to the doctor from me and one from another RD, since the patient was able to eat orally during this time period. Hmm. Then her wound dehisced (when it breaks opens along the suture line), so back to the ICU with her. So it has been an interesting journey. She just ripped out her NG tube, so we'll see where her diet goes from here...