28TH CASE SCENARIO. (NURSING)ACUTE CHOLECYSTITIS.

Age/Sex 54years old man.

Name Mike Hubby.

Attending doctor: Dr. Hessey Rub.

CODE STATUS: Full Code.

Location : Medical/ Surgical.

Admitting Diagnosis: Acute Cholecystitis.

This is inflammation of the gallbladder, a small digestive organ beneath the liver. Signs and symptoms are pain in upper middle area radiating around to the back,jaundice, Nausea and Vomiting, flatulence, bloating, belching, intolerance to fatty foods.

Treatment:

S/P Cholecystectomy which is the removal of gallbladder. T- tube inserted for drainage from bile duct.

Complications:

Hemorrhage,pneumonia, Thrombophlebitis, urinary retention, ileus.

Pre- OP Nursing Responsibilities:

MEDICATIONS:

0.9NS at 75ml/ hour Left forearm. Patent/Clean/ Dry.

Zosyn 3.375gm IV Q8hrs.

Zofran 4mg IV Q4hours prn nausea/Vomiting.

Dilaudid 0.5mg IV Q3hours prn pain (Morphine contraindicated causes spasm for sphincter of oddi)

Nitroglycerin to relax smooth muscle,NG Tube for abdominal decompression. IV fluids.

Post-OP Responsibilities.

Change position Q2hours.

Check breath sounds and vital signs Q4hours.

Intake and output Q4hours.

Antiembolic stockings.

28TH CASE SCENARIO B.

A 56years old man comes to the Emergency room complaining of nausea and vomiting and severe right upper quarant pain.His body temperature is 101.3°F(38.5C) and an abdominal xray reveals an enlarged gallbladder. He is given a diagnosis of Acute Cholecystitis and is scheduled for surgery. After administering an analgesic to the patient, the nurse recognizes that assessing the patient’s fluid and electrolyte status is the top most priority.

The nurse performs a postoperative assessment on a patient who has had a cholecystectomy. In order to adequately assess the patient for bowel sounds, the nurse should?.

Answer:

Divide the abdomen into four quadrants, auscultate each area with a stethoscope for at least five minutes if no sounds are heard.

Published by edochie99

A Registered Nurse with over twenty years of hospital experience, an author with Masters Degree in Nursing,also Bachelor Degree in Nursing,graduated in 1996 from USC,University of Southern California.MSN in 2009 University of Phoenix.

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