preview

Postoperative Ileus Case Study

Better Essays
Open Document

1. Discuss potential postoperative laparoscopic abdominal surgery complications. Include assessment findings, diagnostic evaluation, and nursing measures designed to prevent these complications from occurring. Postoperative nursing care after a laparoscopic cholecystectomy includes monitoring for complications such as bleeding, making the patient comfortable, and preparing the patient for discharge. Assessment findings for poor wound healing include redness, tenderness, swelling, purulent drainage, pain, and fever. Monitoring white blood cell count is a way to see if there is a presence of a bacterial infection. Maintaining good fluid intake and nutrition promotes fast and good wound healing. The carbon dioxide can irritate the phrenic nerve …show more content…

It is normal for a patient to have absent or diminished bowel sounds after a postoperative ileus. Then nurse should ask the patient if they fell nauseous or feel like vomiting because if they do it should be addressed with antiemetic or prokinetic drugs. The nurse should assess for pain and avoid the use of opioid analgesics this will help by not prolonging but minimizing the duration of a postoperative ileus. The nurse should provide the patient with IV fluids until they can tolerate oral fluids to prevent dehydration and for the purpose of maintain fluid and electrolyte balance. The nurse should encourage early ambulation to promote peristalsis. Also, the nurse needs to assess the patient regularly to make sure they pass gas or have a bowel movement because this indicates the return of peristalsis which is a short term goal set for the patient. Once bowel sounds have returned the nurse should encourage the patient to resume to a normal diet to allow the return of normal peristalsis. Now, if the patient is not able to pass gas or have a bowel movement Bisacodyl (Dulcolax) suppositories may be given to stimulate peristalsis and promote the passage of gas or bowel …show more content…

When checking for orthostatic changes in vital signs the nurse should measure the serial blood pressure and take the pulse of a patient in the supine, sitting, and standing positions. The nurse should first start by placing the patient in the supine position and allowing the patient to rest for 2 to 3 minutes before taking the blood pressure. Next, the nurse should place the patient in the sitting position with their legs dangling off the side of the bed. Then the nurse should allow the patient to rest for 1 to 2 minutes before measuring the blood pressure once again. Lastly, the nurse should reposition the patient to the standing position and should allow 1 to 2 minutes of rest before proceeding to the last blood pressure measurement. Orthostatic changes in the patients pulse and blood pressure need to be monitored closely because they can indicate signs of dehydration concerning the gastrointestinal system. Usually while the patient is in the standing position the systolic blood pressure will decrease 10 mm Hg, and the diastolic blood pressure will increase a bit. Now, when the systolic blood pressure decreases by 20 mm Hg, the diastolic blood pressure decreases by 10 mm Hg or higher, and there could be no change in heart rate or there could be an increase in the heart rate of 20 beats/minute or higher while reposition from the supine position to the

Get Access
Related
Get Access