SCENARIO OVERVIEW:
Mei Sato (pronouns: she/her/hers) was directly admitted to the medical unit on Tuesday evening
at 1700 with a diagnosis of dehydration. Mei has a history of colon cancer. Fifteen days ago, Mei
underwent a partial colectomy with creation of a transverse colostomy. Mei’s daughter (Katie)
has been taking care of her since discharge and reports that Mei has resisted participation in
colostomy care. Katie needs to return to her full-time job and is concerned with how Mei will
manage without her daily assistance. The scenario takes place Tuesday at 1900. During this
scenario, students will have an opportunity to manage care for a patient with fluid and electrolyte
imbalances, assess and manage colostomy care, insert an IV and administer medications, and
assist the patient to cope with issues of self-care and health literacy.
1. Review the Social Determinants of Health (SDOH) questionnaire. For each of the 5 domains,
create a list of resources and nursing interventions that can be performed to support a client
experiencing challenges.
i. Economic Stability
ii. Neighborhood & Built Environments
iii. Healthcare Access & Quality
iv. Social & Community Context
v. Education Access & Quality
1. Social Determinants of Health (SDOH): Resources and Nursing Interventions
Economic Stability
Potential Challenges: Loss of caregiver support, possible financial strain related to medical
supplies and follow-up care.
Resources:
Hospital case management or social work
Insurance-covered ostomy supply vendors
Financial assistance programs (e.g., cancer support organizations)
Nursing Interventions:
Refer Mei and her daughter to a case manager or social worker to assess financial concerns and
eligibility for assistance programs.
Assist in arranging insurance-covered colostomy supplies and ensure prescriptions are in place
before discharge.
Provide information on community or nonprofit resources that assist patients with cancer-related
expenses.
ii. Neighborhood & Built Environment
Potential Challenges: Safety and accessibility of the home environment for self-care and
hydration management.
, Resources:
Home health nursing services
Occupational therapy home safety evaluations
Nursing Interventions:
Assess Mei’s home environment (via patient and caregiver report) for barriers to safe colostomy
care and hydration.
Initiate a referral for home health nursing to assist with ostomy care education and monitoring
after discharge.
Collaborate with occupational therapy if adaptive equipment is needed to promote independence.
iii. Healthcare Access & Quality
Potential Challenges: Limited understanding of colostomy care, difficulty navigating follow-up
care without caregiver support.
Resources:
Wound, Ostomy, and Continence (WOC) nurse
Primary care and oncology follow-up services
Nursing Interventions:
Request a WOC nurse consult for specialized colostomy teaching and troubleshooting.
Ensure follow-up appointments are scheduled before discharge and clearly explained to Mei and
Katie.
Use teach-back methods to confirm understanding of colostomy care, hydration needs, and
medication administration.
iv. Social & Community Context
Potential Challenges: Decreased caregiver availability, emotional resistance to self-care,
potential isolation.
Resources:
Cancer support groups
Ostomy support groups (in-person or virtual)
Nursing Interventions:
Assess Mei’s emotional response to her colostomy and reduced caregiver support.
Encourage participation in support groups to normalize experiences and reduce isolation.
Involve Katie in education sessions while also promoting Mei’s gradual independence in self-
care.
v. Education Access & Quality
Potential Challenges: Health literacy barriers related to ostomy care and fluid management.
Resources:
Multilingual educational materials
Visual aids and demonstration tools
Mei Sato (pronouns: she/her/hers) was directly admitted to the medical unit on Tuesday evening
at 1700 with a diagnosis of dehydration. Mei has a history of colon cancer. Fifteen days ago, Mei
underwent a partial colectomy with creation of a transverse colostomy. Mei’s daughter (Katie)
has been taking care of her since discharge and reports that Mei has resisted participation in
colostomy care. Katie needs to return to her full-time job and is concerned with how Mei will
manage without her daily assistance. The scenario takes place Tuesday at 1900. During this
scenario, students will have an opportunity to manage care for a patient with fluid and electrolyte
imbalances, assess and manage colostomy care, insert an IV and administer medications, and
assist the patient to cope with issues of self-care and health literacy.
1. Review the Social Determinants of Health (SDOH) questionnaire. For each of the 5 domains,
create a list of resources and nursing interventions that can be performed to support a client
experiencing challenges.
i. Economic Stability
ii. Neighborhood & Built Environments
iii. Healthcare Access & Quality
iv. Social & Community Context
v. Education Access & Quality
1. Social Determinants of Health (SDOH): Resources and Nursing Interventions
Economic Stability
Potential Challenges: Loss of caregiver support, possible financial strain related to medical
supplies and follow-up care.
Resources:
Hospital case management or social work
Insurance-covered ostomy supply vendors
Financial assistance programs (e.g., cancer support organizations)
Nursing Interventions:
Refer Mei and her daughter to a case manager or social worker to assess financial concerns and
eligibility for assistance programs.
Assist in arranging insurance-covered colostomy supplies and ensure prescriptions are in place
before discharge.
Provide information on community or nonprofit resources that assist patients with cancer-related
expenses.
ii. Neighborhood & Built Environment
Potential Challenges: Safety and accessibility of the home environment for self-care and
hydration management.
, Resources:
Home health nursing services
Occupational therapy home safety evaluations
Nursing Interventions:
Assess Mei’s home environment (via patient and caregiver report) for barriers to safe colostomy
care and hydration.
Initiate a referral for home health nursing to assist with ostomy care education and monitoring
after discharge.
Collaborate with occupational therapy if adaptive equipment is needed to promote independence.
iii. Healthcare Access & Quality
Potential Challenges: Limited understanding of colostomy care, difficulty navigating follow-up
care without caregiver support.
Resources:
Wound, Ostomy, and Continence (WOC) nurse
Primary care and oncology follow-up services
Nursing Interventions:
Request a WOC nurse consult for specialized colostomy teaching and troubleshooting.
Ensure follow-up appointments are scheduled before discharge and clearly explained to Mei and
Katie.
Use teach-back methods to confirm understanding of colostomy care, hydration needs, and
medication administration.
iv. Social & Community Context
Potential Challenges: Decreased caregiver availability, emotional resistance to self-care,
potential isolation.
Resources:
Cancer support groups
Ostomy support groups (in-person or virtual)
Nursing Interventions:
Assess Mei’s emotional response to her colostomy and reduced caregiver support.
Encourage participation in support groups to normalize experiences and reduce isolation.
Involve Katie in education sessions while also promoting Mei’s gradual independence in self-
care.
v. Education Access & Quality
Potential Challenges: Health literacy barriers related to ostomy care and fluid management.
Resources:
Multilingual educational materials
Visual aids and demonstration tools
