Gallbladder removal

[pioneerchick007]

I had a patient who had a cholecystectomy and a history of COPD. I'm supposed to do a teaching plan on him and I was wondering if you all had any ideas on what to do. The wound was well approximated by the time I had clinical so I don't think I can do wound care as my teaching plan. I was thinking maybe some type of diet plan, but I'm not really sure if that would work. I'd really appreciate some assistance. Thank you!

[Esme12, ASN, BSN, RN]

Why do they have COPD? Are they still smoking?

[EDRN1091]

A diet plan might be a good idea. What kind of diet do post-chole patients have to follow? How will you as the nurse educate and effectively teach that to this patient? What is his nursing dx, what is the teaching and discharge plan, how will the interventions you've done be evaluated (how will you know what you taught him worked)?

[Double-Helix, BSN, RN]

I agree with the diet plan. There are some important diet changes that need to be made initially after a cholecystectomy as the liver learns how to regulate bile production without the gallbladder.

[KelRN215, BSN, RN]

I had a patient who had a cholecystectomy and a history of COPD. I'm supposed to do a teaching plan on him and I was wondering if you all had any ideas on what to do. The wound was well approximated by the time I had clinical so I don't think I can do wound care as my teaching plan. I was thinking maybe some type of diet plan, but I'm not really sure if that would work. I'd really appreciate some assistance. Thank you!

I disagree that you cannot do something about wound care just because it appears to be healing well... there are still things you much teach a post-operative patient about caring for his/her wound after discharge. At my former hospital these things included: the dressing stays on for 7 days and must remain dry; after seven days the dressing can be removed and the wound can get wet but it cannot be soaked or immersed in water for an additional week; call the MD on-call for any signs of infection at the surgical site including redness, swelling, odor or drainage or for fever of greater than 101 degrees Fahrenheit; sutures are either absorbable or they need to be removed in so many days. Even post-op patients who have no complications need this teaching.

I agree that diet teaching would also be appropriate.

[NicuGal, MSN, RN]

It depends on the type of incision, was it a full incision or was it a laparoscopy? Our surgeons superglue it shut and you are able to shower the next day. No dressings. But you still have to teach about s/s infection.

Diet changes are good.

Pain management is also good.