Clinical Outcome Study
69 years old, female (I.W.) patient admitted to Cambridge Rehabilitation and Healthcare Center after a 20-day LOS at Acuity Hospital in Willingboro. This followed a prior stay at Virtua Camden with admitting diagnosis of Acute on Chronic Respiratory Failure, Perforated Bowel with Fistula and Dysphagia. She has a history of Bipolar and Schizoaffective Disorder, COPD and DM. Patient arrived with Right-Sided Colostomy, Left-Sided Fistula and a Wound Vac to her abdomen.
Monitor Fluid Balance and proper nutrition: 1200ml Fluid Restriction, Daily Weight Monitoring, Glucerna, Ensure and Magic Cup.
Wound Healing: Abdominal wound 13.3 x 3.3 x 2.7
Education on Wound treatment and Colostomy Training
Aspiration Precautions: Admitted on Puree Solids and Nectar Thick Liquids
Maintain Adequate Oxygenation: Admitted on 3 lpm
Medication Management: Lasix 40mg BID, Spironolactone 50 mg BID, Hydralazine 25mg Q12, Insulin, Coreg
Monitor Labs: BBG’s TID, BMP
Upon admission, Patient required maximum assistance with all self-care tasks and was unable to ambulate. Patient Actively participated in Therapy for several weeks, progressed slowly but at a steady pace until upon discharge, she was independent with all self-care tasks, able to ambulate 300 feet with a rolling walker and ascend/descend 5 stairs independently.
Patient’s Abdominal Wound was Resolved, Oxygen Therapy was weaned and Weights remained stable throughout stay. Patient had no unplanned hospitalizations while in Cambridge’s Care.
Patient returned home with her sister and home health. Her PCP in the community is Dr. Thomas Lee. It was recommended to follow up with Pulmonary and Sleep Associates of South Jersey for Sleep Study Evaluation.