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Questions and Answers
What might an increase in abdominal tenderness or a rigid, boardlike abdomen indicate after gallbladder surgery?
Which nursing intervention is most appropriate during acute pain episodes related to cholelithiasis?
What advice should a nurse give a patient regarding fat intake to help manage pain associated with gallstones?
What position should the patient be placed in to decrease pressure on the inflamed gallbladder?
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Which analgesic is generally discouraged for pain management in these patients unless no other options are available?
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What sign might suggest an infectious process in a postoperative patient?
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Which nursing action is essential to help prevent atelectasis after an open cholecystectomy?
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Which position should a nurse place a postoperative patient in to enhance lung expansion?
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What is a key benefit of ambulation for a postoperative patient after gallbladder surgery?
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How should a nurse manage an elevated temperature in a postoperative patient?
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Study Notes
Pre-operative Abdomen Assessment
- Assess the abdomen every 4 hours.
- Increased abdominal tenderness or a rigid abdomen could indicate a ruptured gallbladder.
Post-operative Nursing Interventions
- Similar to other patients who have had abdominal surgery.
Pain Management
- Pain can be severe.
- A combination of interventions might be necessary.
- Discuss the relationship between fat intake and pain with the patient.
- Teach ways to reduce fat intake.
- Fat in the duodenum stimulates gallbladder contractions, which can cause pain if there are gallstones.
- Withhold oral food and fluids during episodes of acute pain.
- A nasogastric tube can be inserted and connected to low suction to empty the stomach and reduce chyme in the duodenum.
- Administer an opioid analgesic for moderate to severe pain. Avoid meperidine due to potential toxicity and poor pain control.
- Place the patient in Fowler’s position to decrease pressure on the inflamed gallbladder.
Postoperative Care: Open Cholecystectomy
- An inflamed gallbladder can rupture, releasing contents into the abdomen.
- This can cause peritonitis, a serious infection of the abdominal lining.
- Open cholecystectomy (laparotomy) carries a high risk of pulmonary infection due to the large incision.
- Vital signs should be monitored every 4 hours.
- Changes in vital signs, especially an elevated temperature, may indicate infection.
- Encourage coughing and deep breathing every 1-2 hours to prevent lung complications.
- Splint the incision with a pillow while coughing to minimize pain.
- Fowler's position helps promote lung expansion and reduces the risk of respiratory infections.
- Encourage ambulation as tolerated to aid in lung expansion and airway clearance.
- Antibiotics may be administered pre- and postoperatively to prevent infection from gallbladder contents.
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Description
Test your knowledge on post-operative nursing interventions for abdominal surgery. This quiz covers pain management strategies, including the relationship between fat intake and gallbladder pain. Assess your understanding of proper monitoring and care techniques to ensure optimal recovery.
