2026 Summary Patient Care Rounds: Bowel Diversion Results (Miguel Flores)
,I. FULL CASE STUDY
A. PATIENT DEMOGRAPHICS
Demographic Detail
Name Miguel Flores
Age 58-65 years (varying case presentations)
Sex Male
Race/Ethnicity Hispanic
Occupation Retired school teacher
Setting Outpatient Clinic / Surgical Unit
Reason for Encounter Postoperative follow-up for bowel diversion surgery
Note on Case Variations: Miguel Flores appears in multiple nursing education
scenarios with variations in age (58-65 years), postoperative day (POD 2-10), and
surgical indication (colorectal cancer, diverticulitis, Crohn's disease). This
summary synthesizes the most common presentation: a 62-year-old Hispanic
male, POD 2 following partial colectomy with end colostomy for Stage II colon
cancer.
B. HISTORY OF PRESENT ILLNESS (HPI) — OLDCARTS Format
,Component Findings
Onset Postoperative day 2-5 following bowel diversion surgery
Location Abdomen (surgical site), stoma site
Duration Symptoms developing since surgery
Dull aching pain at surgical site (4-5/10), mild abdominal bloating, anxiet
Character
about stoma management
Aggravating
Movement, getting up from chair, anxiety
Factors
Relieving Factors Rest, pain medication, sitting upright
Radiation None
Timing Pain constant with movement; bloating worsens throughout day
Severity Pain 4-5/10; mild bloating
Associated Mild nausea (controlled), moderate stoma output (~400 mL/day),
Symptoms occasional skin irritation around stoma
Chief Complaint: "I'm here for my check-up. My stoma looks okay, but I've been
having trouble managing the pouch and feel a bit bloated."
C. PAST MEDICAL HISTORY (PMH)
, Condition Details
Colorectal Cancer Stage II colon cancer — indication for surgery
Type 2 Diabetes Mellitus Managed with oral medications
Hypertension Managed with oral medications
Hyperlipidemia Managed with oral medications
Past Surgical History (PSH):
• Partial colectomy with end colostomy (current, 2-5 days ago)
• Laparoscopic abdominoperineal resection (alternate scenario)
Allergies:
• (Not specified in available records — assume NKDA)
Medications:
• Oral hypoglycemics (for diabetes)
• Antihypertensives
• Statins (for hyperlipidemia)
• PRN analgesics (Tylenol) for pain
• Antiemetics PRN for nausea
Immunizations:
• (Not specified; standard postoperative protocol applies)
D. FAMILY HISTORY
,I. FULL CASE STUDY
A. PATIENT DEMOGRAPHICS
Demographic Detail
Name Miguel Flores
Age 58-65 years (varying case presentations)
Sex Male
Race/Ethnicity Hispanic
Occupation Retired school teacher
Setting Outpatient Clinic / Surgical Unit
Reason for Encounter Postoperative follow-up for bowel diversion surgery
Note on Case Variations: Miguel Flores appears in multiple nursing education
scenarios with variations in age (58-65 years), postoperative day (POD 2-10), and
surgical indication (colorectal cancer, diverticulitis, Crohn's disease). This
summary synthesizes the most common presentation: a 62-year-old Hispanic
male, POD 2 following partial colectomy with end colostomy for Stage II colon
cancer.
B. HISTORY OF PRESENT ILLNESS (HPI) — OLDCARTS Format
,Component Findings
Onset Postoperative day 2-5 following bowel diversion surgery
Location Abdomen (surgical site), stoma site
Duration Symptoms developing since surgery
Dull aching pain at surgical site (4-5/10), mild abdominal bloating, anxiet
Character
about stoma management
Aggravating
Movement, getting up from chair, anxiety
Factors
Relieving Factors Rest, pain medication, sitting upright
Radiation None
Timing Pain constant with movement; bloating worsens throughout day
Severity Pain 4-5/10; mild bloating
Associated Mild nausea (controlled), moderate stoma output (~400 mL/day),
Symptoms occasional skin irritation around stoma
Chief Complaint: "I'm here for my check-up. My stoma looks okay, but I've been
having trouble managing the pouch and feel a bit bloated."
C. PAST MEDICAL HISTORY (PMH)
, Condition Details
Colorectal Cancer Stage II colon cancer — indication for surgery
Type 2 Diabetes Mellitus Managed with oral medications
Hypertension Managed with oral medications
Hyperlipidemia Managed with oral medications
Past Surgical History (PSH):
• Partial colectomy with end colostomy (current, 2-5 days ago)
• Laparoscopic abdominoperineal resection (alternate scenario)
Allergies:
• (Not specified in available records — assume NKDA)
Medications:
• Oral hypoglycemics (for diabetes)
• Antihypertensives
• Statins (for hyperlipidemia)
• PRN analgesics (Tylenol) for pain
• Antiemetics PRN for nausea
Immunizations:
• (Not specified; standard postoperative protocol applies)
D. FAMILY HISTORY
