A nurse is assessing a client who is postoperative following a cholecystectomy
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Note that this is a guideline only and does not replace the need for clinical judgment on an individual basis. Definition of terms
AssessmentInitial assessment - PACUWhen admitting a patient to PACU patient identification and handover should occur utilising the Handover Flowsheet. Post-operative orders must be communicated both verbally and documented in the EMR. Post-operative orders are additional to the operation report. Clinical handover should highlight any issues throughout the intra-operative period, acknowledge the process for escalation of care, should this be required and allow for clarification of any instructions before accepting care of the patient.
Observations continue at least 15 minutely, or more frequently as clinically indicated
Continuous Oximetry monitoring should be initiated for all patients admitted to PACU Patients are ready to transfer to the ward once they meet the PACU ‘Discharge Criteria’ (see below) and ‘Ready for Discharge’ both of which are timestamped on EMR. PACU ‘Discharge Criteria’
Management once transferred to an Inpatient Unit
When transferring care from PACU to the ward, patient identification and handover should occur utilising the Handover Flowsheet. Initial patient assessment should include:
The time frame for routine post anaesthetic observations should commence once the PACU nurse has deemed the patient ‘Ready for Discharge’. See special considerations for how to locate this on EMR. Frequency of routine post anaesthetic observations:
Routine post anaesthetic observations should include:
Consider the need for continuous pulse oximetry and/or cardio-respiratory monitoring as indicated by patient’s condition.
For further information regarding modification on the MET criteria please see the Medical Emergency Response Procedure. Ongoing observationAt the completion of the RPAO’s, the type and frequency of clinical observations must reflect the clinical status, therapies and interventions being delivered to the child and be consistent with requirements of other individual guidelines and procedures.
Note, other children may require hourly observations and continuous monitoring as clinically indicated. Observation frequency can be ordered in the EMR.
Escalation of careIf you are concerned about the child for whom you are caring, please refer to the Medical Emergency Response Procedure. If immediate review is required in a deteriorating child, call a MET (dial 22 22 and state building, level, ward and room number). Special Considerations
Companion documentsEvidence tableRoutine Post Anaesthetic Observation Guideline Evidence Table Please remember to read the disclaimer The development of this nursing guideline was coordinated by Stacey Richards, Nursing Research, CNC, and approved by the Nursing Clinical Effectiveness Committee. Updated November 2019. Which dietary advice will the nurse give a patient after a cholecystectomy?Most patients are concerned about what they can eat after the cholecystectomy. You are permitted to eat what you would like. Most patients find that a bland diet of such foods as: toast, rice, bananas, soups, pasta etc. are the easiest to digest initially.
What is post cholecystectomy?Introduction. Post-cholecystectomy syndrome (PCS) is the term used to describe the persistence of biliary colic or right upper quadrant abdominal pain with a variety of gastrointestinal symptoms, which are similar to the features experienced by an individual before cholecystectomy.
Which patient finding is a contraindication for a cholecystectomy?General anesthesia with muscle relaxation is required when a laparoscopic cholecystectomy is performed. Therefore, one contraindication to the procedure is the inability to tolerate general anesthesia. Others include end-stage liver disease with portal hypertension, precluding safe portal dissection, and coagulopathy.
What is a cholecystectomy quizlet?cholecystectomy. a surgical procedure to remove the gallbladder.
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