Question

Case Study, Chapter 50, Assessment and Management of Patients With Biliary Disorders 1. Evelyn Bean, 52 years of age, is admitted to the same-day surgery unit for an elective laparoscopic cholecystectomy. The patient presents with jaundice of the skin and sclera. The patient's urine is dark and the patient stated that she has clay-colored stools. She stated she has occasional colicky pain in her right upper quadrant of her abdomen radiating to her back. The patient had preadmission testing 1 week ago and the results are on the patient's chart. The record of patient education and an informed written consent are also on the chart. (Learning Objectives 2 and 3) What additional procedure will be performed if the common bile duct is obstructed by a gallstone? a. The nurse in the same day surgery unit provides the discharge instructions to the patient and family before the patient goes for surgery so the patient is fully awake to receive the instructions and ask questions. What written and verbal instructions should the nurse provide? b.

Answer 1

ANSWER

a. ERCP (Endoscopic retrograde cholangiopancreatography.) is a surgical

   procedure useful to remove stones in the gall bladder can used as a additional

   procedure if common bile duct i8s obstructed by gall stones.

b. Discharge Instruction for patient undergo surgery.

        * Inform the physician if any complications like severe and continous

          abdominal pain,fever,vomiting,chest pain etc occur after discharge.

        * Problems like nausea,sore throat are common few days following

          surgery so use lozenges or salt water to clean mouth.

        * Avoid use of alcohol few days after the procedure.

        * After surgery begin to start eating with a liquid diet then changed to normal

          diet to avoid abdominal discomfort.

       * Take antibiotics as per physician prescribed in the discharge summary.

       * Avoid straining exercises few days following surgery.