간호 실습 시나리오(외과수술 전 간호

Summary

The patient, Na-Susul, is admitted for a colon resection surgery scheduled for the following day. Medical staff, including a nurse and doctor, work together to prepare the patient for surgery. The doctor explains the procedure and obtains consent, while the nurse explains preoperative preparations to both the patient and the caregiver.
Nurses check the patient's vital signs and instruct them on fasting and enema procedures. They also conduct an antibiotic skin test to ensure there is no adverse reaction. During the preparation, the nurse assures the patient and caregiver, providing guidance on managing discomfort and postoperative care. Finally, the nurse performs a glycerin enema, carefully explaining each step to minimize discomfort, and offers aftercare instructions to the patient.

Characters

Nurse 1(Kim Hana), Nurse 2(Kim Dool), Doctor, Caregiver, Student Nurse

Scenario Details

Doctor: (knocks) Mr. Na Susul? Tomorrow at 8 AM, we have a scheduled low anterior resection surgery, which involves removing part of the colon. (pointing to LLQ) This area here is called the descending colon, and we’ll be removing part of it, including the tumor, and then reconnecting the remaining sections. Since we’ll preserve the anal sphincter, you won’t need a stoma. Please sign the surgery and anesthesia consent forms.

Nurse 2: Student Nurse, could you take the patient's vitals (respiratory rate, pulse, blood pressure, temperature)? (Brings necessary supplies such as NPO signs and educational materials.)

Nurses 1 & 2: (after hand sanitizing) Hello, we are your assigned nurses, Kim Hana and Kim Dool. May I confirm your name?

Patient: Na Susul.

Nurse 1: Mr. Na Susul, I’ll check your hospital bracelet. Okay, confirmed. You’re scheduled for a colon resection tomorrow, so we’re here to provide some information. Did the doctor already explain the surgery and did you sign the consent form?

Patient: Yes, I did.

Nurse 1: Great. You heard which part will be operated on? Let me verify the surgery area. (lifts gown slightly to check). The surgery time is set for 8 AM, but it may start earlier or later depending on the operating room and the surgeons' schedule. Please understand that it might be a bit inconvenient. Although it’s natural to feel anxious, please remember that our medical team will do their best, and if you have any questions, feel free to ask us. If you feel very anxious or can’t sleep tonight, let us know, and we can provide some medication.

Student Nurse: (after hand sanitizing) Mr. Na Susul, I’ll check your blood pressure and pulse now. (takes vital signs)

Nurse 1: First, let me explain the preparations for the surgery. Caregiver, please listen as well. Since you’re having a colon resection, we need to empty the bowels to minimize complications. Starting from midnight tonight, you must fast, including no water. You’ll also need to continue fasting right after the surgery, so you may feel very thirsty, but please try to endure it. I’ll hang a fasting sign by your bed. We’ll also perform an enema and antibiotic skin reaction test (AST) soon—is that okay?

Patient: Yes, that’s fine.

Nurse 1: Here are some educational materials. Please take a look together. If you have dentures, hearing aids, or any worn items, please remove them, as well as any accessories like bracelets or watches, and even glasses or contacts. Nail polish must be removed, too. I’ll leave the gown for the surgery here. Tomorrow morning, wear only the gown without any underwear. You may wash your face and brush your teeth, but please avoid applying lotions or anything to your lips. Keep valuables with a caregiver or in the provided storage.

Caregiver: What about my father’s medications?

Nurse 1: He’s not taking aspirin, right? That’s important because it can increase bleeding risk. He doesn’t need his liver medicine either, and because he’ll be fasting, we won’t give him his diabetes medication, as it could cause low blood sugar. He should take only his blood pressure medication with a minimal amount of water. After surgery, he can resume his medications, but details will be discussed with his doctor.

Caregiver: Understood.

Nurse 1: You must also be worried, but please trust us and continue providing support to Mr. Na Susul as you always have.

Nurse 2: (prepares for antibiotic skin test)

Hand sanitizes and gathers supplies (disinfectant swabs, distilled water, 10cc and 1cc syringes, cefazolin vial).
Withdraws 5 ml distilled water with a 10cc syringe, injects it into the vial, mixes, and prepares 1cc with 0.1cc cefazolin.

Nurse 2: Student nurse, we mix it three times like this. (Prepares syringe and heads to the patient)

Nurse 2: Could you state your name again? I’ll check your bracelet. We’ll now do an antibiotic skin test, injecting a small amount under your skin to see if you react to this antibiotic. It may feel like a bee sting or slight shock.

(Performs intradermal injection and marks with pen.)

Nurse 2: Don’t rub the area, and we’ll observe for 15 minutes. Let us know if it itches or becomes red or swollen.

Nurse 2: (after 15 minutes) Checking now. Any itching? Okay, you’re fine.

Medical Asepsis!

Wash hands.
Prepare the materials needed for the glycerin enema (glycerin, lukewarm water, thermometer, 50cc enema syringe, enema catheter, lubricant, disposable gloves, tissue, tray, waterproof pad, sheet, hand sanitizer).
Measure the temperature of the water with a thermometer to prepare lukewarm water (37.7–40.5℃).
Remove the plunger from the 50cc enema syringe and, while covering the syringe opening with your hand, pour in a 1:1 mixture of glycerin and lukewarm water to prepare the enema solution.
Reinsert the plunger into the syringe, open the end of the enema catheter, connect the syringe to the catheter, and push the plunger to fill the catheter with the enema solution.
Squeeze lubricant onto the tray and gather all necessary supplies.
Once the supplies are prepared, bring them to the patient and introduce yourself as their nurse.
Ask open-ended questions to confirm the patient's identity, such as their name and registration number, and verify this against their wristband.
Explain the purpose and procedure of the enema to the patient, encouraging them to ask any questions.

Nurse 1: Could you please tell me your name? I’ll check your wristband. As I mentioned earlier, we’re going to perform an enema. Since this is a bowel surgery, we need to clear any impurities from your intestines before the operation. I apologize for any discomfort this might cause. I’ll cover you with a blanket to ensure as little exposure as possible, so please don’t worry. I’ll also close the curtain. (closes the door and pulls the curtain closed). If you don’t mind, could the caregiver step outside for a moment? Mr. Na Susul, I’ll lower the bed rail and raise the bed height slightly.

Adjust the bed to a suitable height, lower the rail on the working side (usually the side of the dominant hand), and raise the opposite rail. Adjust the lighting as needed.
Sanitize hands.
Arrange the bedding, folding the sheet so that only the lower body is exposed.

Nurse 1: Please hold the opposite bed rail with your right hand and bend your right knee to turn onto your left side. (Sims' position). I’ll place a pad underneath in case any enema solution or waste leaks.

Place a sheet and waterproof pad under the patient’s buttocks and lower back.
Place the supplies on the waterproof pad and put on disposable gloves.

Nurse 1: Please lower your lower garment slightly to expose the buttocks. This will only take a moment. Could you please lie back and try to relax?

Gently lower the patient’s lower garment to expose the buttocks, then use the non-dominant hand to gently part the buttocks to expose the anus.

Nurse 1: Try to stay relaxed and take deep breaths through your mouth.

Patient: (takes deep breaths)

Nurse 1: I’ll insert the tube now. You may feel a slight urge to defecate, but it’s best to hold off to avoid contamination. I appreciate your patience.

Apply lubricant to 10–15 cm of the enema catheter’s tip.

Nurse 1: If you could say “Ahh” or bear down slightly as if you’re about to have a bowel movement, that would help to gently open the anal area.

Insert the catheter gently, directing the tip toward the patient’s navel, and advance it slowly to a depth of 7.5–10 cm.
Once the catheter is in place, press the syringe plunger slowly to inject the enema solution, keeping the tube in place until all the solution has been administered.

Nurse 1: I’ll begin injecting the enema solution now. It might be slightly uncomfortable, so please let me know if it’s too much.

Explain that the patient may feel discomfort while the solution is administered.

Nurse 1: All the solution is in now. We’ll need to remove the tube. Could you bear down gently, like before?

Once all the solution is injected, remove the enema catheter gently, wrapping it in tissue, and place it on the tray.

Nurse 1: (wipes the anal area with tissue) There, all done.

Remove the sheet and waterproof pad, dispose of the used materials, and remove gloves.
Pull up the patient’s garment and cover them with the sheet.

Patient: I feel a bit full, kind of like my belly is inflated.

Nurse 1: Yes, the enema solution in your bowel may cause a feeling of fullness. That’s normal, so don’t worry. You’ll need to stay in bed and hold the solution for 15 to 30 minutes. If you feel a strong urge to go before then, let us know so we can bring a bedpan to you. Going too early may mean that we’d need to redo the enema. Caregiver, please monitor the patient and help as needed. Once you’ve passed the stool, please let the nurses’ station know.

Patient and Caregiver: Thank you for your help, nurse.

Nurse 1: Of course. If you feel uncomfortable or need assistance, please don’t hesitate to contact us at the nurses' station.

Gather the used supplies and sanitize hands.
Record the results of the glycerin enema procedure.

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간호 실습 시나리오(외과수술 전 간호_영어)

Summary

Characters

Scenario Details

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