Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                
Scribd Logo
Upload

Welcome to Scribd!

  • 35 views

    Understanding Medical Surgical Nursing - 0843-0843

    Uploaded by

    Anas Tasya
    This document provides guidance on nursing care for patients who have undergone surgery for conditions affecting the liver, pancreas, or gallbladder. It outlines several key points: 1) Nurses should frequently change dressings around incision sites to protect the skin from irritating drainage and use skin barriers if bile is leaking. 2) Nurses should encourage patients to cough and take deep breaths after surgery to prevent complications and evaluate pain control if patients are reluctant. 3) The plan of care is successful if the patient reports tolerable pain, has no weight loss or excessive thirst, intact skin, and normal lab results. Discharge education focuses on diet.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Understanding Medical Surgical Nursing - 0843-0843

    Uploaded by

    Anas Tasya
    35 views1 page
    This document provides guidance on nursing care for patients who have undergone surgery for conditions affecting the liver, pancreas, or gallbladder. It outlines several key points: 1) Nurses should frequently change dressings around incision sites to protect the skin from irritating drainage and use skin barriers if bile is leaking. 2) Nurses should encourage patients to cough and take deep breaths after surgery to prevent complications and evaluate pain control if patients are reluctant. 3) The plan of care is successful if the patient reports tolerable pain, has no weight loss or excessive thirst, intact skin, and normal lab results. Discharge education focuses on diet.

    Original Title

    Understanding medical surgical nursing_0843-0843

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document provides guidance on nursing care for patients who have undergone surgery for conditions affecting the liver, pancreas, or gallbladder. It outlines several key points: 1) Nurses should frequently change dressings around incision sites to protect the skin from irritating drainage and use skin barriers if bile is leaking. 2) Nurses should encourage patients to cough and take deep breaths after surgery to prevent complications and evaluate pain control if patients are reluctant. 3) The plan of care is successful if the patient reports tolerable pain, has no weight loss or excessive thirst, intact skin, and normal lab results. Discharge education focuses on diet.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    35 views1 page

    Understanding Medical Surgical Nursing - 0843-0843

    Uploaded by

    Anas Tasya
    This document provides guidance on nursing care for patients who have undergone surgery for conditions affecting the liver, pancreas, or gallbladder. It outlines several key points: 1) Nurses should frequently change dressings around incision sites to protect the skin from irritating drainage and use skin barriers if bile is leaking. 2) Nurses should encourage patients to cough and take deep breaths after surgery to prevent complications and evaluate pain control if patients are reluctant. 3) The plan of care is successful if the patient reports tolerable pain, has no weight loss or excessive thirst, intact skin, and normal lab results. Discharge education focuses on diet.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    4068_Ch35_779-808 15/11/14 1:46 PM Page 805

    Chapter 35 Nursing Care of Patients With Liver, Pancreatic, and Gallbladder Disorders 805

    • Change dressings frequently to protect the skin around the • If the patient is reluctant to cough because of pain, evaluate
    incision site from irritating drainage. the pain medication regimen so that pain is controlled.
    • Protect the skin with a skin barrier product or bag such as • Assist the patient with splinting when coughing to make
    those used with colostomies if bile is leaking around the coughing less painful.
    T-tube site. An ostomy care nurse (if available) can be • Encourage the patient to walk as soon as able to help
    consulted for the best choice of dressing. A skin barrier mobilize secretions.
    can protect skin from breakdown due to contact with bile.
    EVALUATION. The plan of care for a patient with cholecys-
    Risk for Ineffective Breathing Pattern related to abdominal titis or cholelithiasis is successful if the patient reports tol-
    incision erable pain not greater than 2 on a pain scale of 0 to 10, no
    EXPECTED OUTCOME: The patient will have effective breath- weight loss, excessive thirst, urinary output greater than
    ing pattern as evidenced by a respiratory rate of 16 to 50 mL/hour; has moist mucous membranes, elastic skin tur-
    20 per minute, even, unlabored, depth within normal limits gor, intact skin with no w armth, redness, swelling, or pu-
    at all times. rulent drainage at the w ound site; no jaundice or itching;
    clear breath sounds; and a normal white blood cell count
    • Monitor respiratory rate, depth, and effort, and ability to
    (Table 35.7).
    cough effectively. The high abdominal incision can cause
    pain with deep breathing and coughing. PATIENT EDUCATION. Discharge education focuses on diet.
    • After surgery, encourage the patient to cough and deep Patients are put on high-protein, lo w-fat diets. Encourage
    breathe at every encounter. Instruct the patient in the obese patients to lose weight. After a cholecystectomy, fat
    proper techniques before surgery and give the opportunity should be slo wly reintroduced into the diet. Once the
    to practice. Deep breathing and coughing after any duodenum becomes accustomed to a constant infusion of
    surgical procedure helps prevent atelectasis and respira- bile, the patient’s individual tolerance for f at becomes the
    tory tract infections. only restriction for diet.

    TABLE 35.7 CHOLECYSTITIS SUMMARY

    Signs and Symptoms Epigastric/RUQ pain, especially after a fatty meal


    Elevated temperature, pulse, respirations
    Jaundice if common bile duct blocked
    Diagnostic Tests Ultrasound
    ERCP
    Radionuclide scan (hepatobiliary iminodiacetic acid scan [HIDA])
    WBC count elevated
    Therapeutic Measures Pain control
    Laparoscopic or open cholecystectomy
    Extracorporeal shock-wave lithotripsy
    Medications (see Table 35.4)
    Low-fat diet
    Priority Nursing Diagnoses Pain
    Risk for Deficient Fluid Volume
    Risk for Ineffective Breathing Pattern
    Risk for Impaired Skin Integrity

    Note. RUQ = right upper quadrant; WBC = white blood cell.

    You might also like