s/p lap appy...died in 24 hrs

  1. i work in a med-surg floor, had a pt s/p lap appy, pt was stable, alert and oriented, ambulatory to the bathroom post op. main issue was pain. pt died after a day. whats the probable cause?
    •  
  2. 17 Comments

  3. by   chenoaspirit
    Do you have any details of what was going on when the patient died? Such as SOB, tremors, temp., bp, HR, o2 sat., etc.
  4. by   suzy253
    perhaps pulmonary embolism?.....need more info though
  5. by   augigi
    Could be anything - internal hemorrhage from a nicked organ, massive sepsis (although it's pretty early, would have probably been septic preop), anesthetic-related complications, stroke, MI, PE, respiratory failure, electrolyte imbalance postoperatively (unlikely) etc etc
  6. by   hunny_pye
    No Idea What Was The Pts Status When Pt Died. They Ttansfered The Pt To Ccu And Coded There. But During My Shift Pt Was Alert And Oriented, Ambulatory.only Prob Was Unable To Urinate And Pain. Straight Cath Was About 350ml And Able To Void About 150ml. Sleeps Most Of The Shift And Will Wake For Pain Issues. The Next Day, Failure To Urinate Again, Straight Cath Was None.
  7. by   hunny_pye
    Are You Able To Detect Pulmonary Embolism Ryt After Surgery?IS BOWEL PEORATION A FACTOR? CAN YOU DETECT THESE RYT AFTER SUGERY?
  8. by   augigi
    Why did he get sent to CCU? Sounds like they were worried about cardiac function, which may have led to acute renal failure?
  9. by   leslie :-D
    i was thinking peritonitis?

    leslie
  10. by   AnnieOaklyRN
    Maybe had a nick to his/her colon and ended up with peritonitis (sp) which would explain the pain.

    swtooth
  11. by   GardenDove
    We need more information such as medical hx, age, VS. It seems that Med-Surg nurses deserve some feedback on something like this as well, in order to get a clearer picture as to possible complications. Have you talked to your manager about this?
  12. by   coffeeaddict
    If he died within 24 hrs after appy, then it would not be sepsis, ARF. Hemmorage could cause pain and low urine output. Have also seen PE cause sudden death, but most of the time they code on the floor, no time to get to the unit. My bet would be bleeding if younger, if older add MI, Stroke to the mix.
  13. by   gr8rnpjt
    I had a patient's op wound open wide with popped stitches several hours after a lap appe. The surgeon was well known for bad outcomes. pt CTB within 24 hours.
  14. by   hunny_pye
    pt is young early 30's, hx of drug abuse, obese...
    i just heard that they gave the pt bolus of 1liter and still no UO. VS on my shift 99 degrees something, sbp around 130's, 93-96 % rooma 2liters, checked again, wthin dat range also. but the next morning he's febrile, tachy and diaphoretic, dont knw the bp, able to sleep after pain shot. md came to visit and didnt detect anythin wrong. then he coded the next day.

close