HELP!! Post Op Bariatric Nursing

suzanne4, RN · Oct 2, 2005

Is it the open belly procedure or done via laparoscopy? There will be some differences in what to look for as well as expect. With any surgery of this type, you are going to need to watch the electrolytes quite carefully, as by removing or resectioning a part of the bowel, you are going to be changing the absorption to food, and can easily lower the sodium and potassium. Also look for signs of bleeding, especially with the laparoscopy cases.

Trauma Columnist · Oct 2, 2005

As Suzanne stated, it depends on the surgery. There are two types of bariatric surgery now being done: the rerouting (Roux N Y) either open or laparascopic and the restrictive (Lap Band). With the Roux N Y, you are essentially being malnourished intentionally. Electrolyte monitoring is vitally important but so is watching for dehydration. There should be extensive preop teaching done with these patients. All patients should be out of bed the day of surgery or the morning after (if done late in the day). Most patients go home within 24 hours. Ambulating, cough, turn, deep breathing are all very important.

I have been doing extensive clinical hours with a surgical APN and she has taught me a lot - its an exciting field.

scampi710 · Oct 6, 2005

Dear Suzanne...thank you so much for your guidance. I retreived as much info as I could on the surgical procedure etc. I am with a friend who had the Roux-en Y surgery (Oct. 3) and am now at home with her. Thanks for the heads up on the K+. The surgeon told me that "...we don't do post-op chemistries or worry about Hct/Hcg...." I really appreciate your input. Scampi710

Is it the open belly procedure or done via laparoscopy? There will be some differences in what to look for as well as expect. With any surgery of this type, you are going to need to watch the electrolytes quite carefully, as by removing or resectioning a part of the bowel, you are going to be changing the absorption to food, and can easily lower the sodium and potassium. Also look for signs of bleeding, especially with the laparoscopy cases.

scampi710 · Oct 6, 2005

:blushkiss Dear Trauma RUs....thank you for your input. I too have been in ED since 1979, so I do not consider myself a specialist in Post Op surgery. My friend had the Roux-en Y, and is now at home I am taking care of her here. I saw the procedure on the internet, gathered info/data, but then the surgeon told me that ."....we don't do Chemistries or Hct/Hcg on our post-ops. Thank you for guiding me in the right direction. Scampi710

As Suzanne stated, it depends on the surgery. There are two types of bariatric surgery now being done: the rerouting (Roux N Y) either open or laparascopic and the restrictive (Lap Band). With the Roux N Y, you are essentially being malnourished intentionally. Electrolyte monitoring is vitally important but so is watching for dehydration. There should be extensive preop teaching done with these patients. All patients should be out of bed the day of surgery or the morning after (if done late in the day). Most patients go home within 24 hours. Ambulating, cough, turn, deep breathing are all very important.
I have been doing extensive clinical hours with a surgical APN and she has taught me a lot - its an exciting field.

scampi710 · Oct 6, 2005

Dear Suzanne4 and TraumaRUs......thank you for your guidance....I am definitely feeling more confident now that I have your input. I thought I was on the right track, and you have confirmed it for me with your expertise. Scampi710

kellieskorner · Jun 27, 2010

I am wanting to find you some information.I am in my last year of BSN in Australia.As a project i want to do a professional poster teaching nurses how to taske care of postop gastric bypass patients and what to watch for.electrolyte imbalances, pain management as i have heard there are meds like ibuprofen you cant take as more risk for stomach ulcers. can anyone let me know of any good web sites that could assist me with info as we are about 10 years behind the US and most people have lap bands here.

excited about what i can learn and teach others.

thanks for any imput

[email protected]

positivevive · Oct 14, 2011

Other things to look for on bariatric patients.

1) Pain management. Lortab 10-15ml liquid.

2) ambulate as soon as they are able to, I'd say within 2 hrs after they arrive to surgical floor. Gas pain will be worst of all.

3) depending on MDs, some let them have clear liquid diet on the day of surgery. Make sure no straw. Give them medication cup to drink liquid.

4) n/v

5) 5 lap sites. Some may bleed, use 2X2

6) vital signs, make sure they are on continue pulse ox on the first day of surg.