Inpatient/Outpatient surgery

suzanne4, RN · Feb 14, 2006

Post-op teaching is usually stressed more for the outpatient that will be going home an hour or so after their surgery.

Post-op teaching for the inpatient is usually done by the nurse that does the discharge from the hospital.

Lets take a lap chole for example. What do you think the requirements are going to be? Up walking or even sitting in a chair to let the gas move its way up. They may have shoulder pain from the gas. Showering is usually okay 24 to 48 hours later, depends on the surgeon. Oral pain meds given.

For the chole patient that needed a duct exploration and required a JP drain, they may end up staying, or the patient that became an open chole, they are going to be getting IV pain meds the first day normally, then will convert to po. For the open chole, they will probably get a PCA for pain.

If they require the open procedure, they will not be in any shape to hear any discharge instructions that day.................

These are just some simple things that come to my mind, I am sure that there are many others that will post following me.

Charity, RN, APRN · Feb 17, 2006

While pain control is always on the top of everyones list, outpatients will need information on activity, wound care (when can they shower? Will there be drainage or bleeding?), diets and follow-up appointments. They will need instruction on any drains still in place. Post-anesthesia teaching:nausea and how to deal with it. Will the patient have a local or regional block that will affect movement/sensation? Are they going home with an On-Q pump?

Naturally all this is usually conveyed to the patient and another person in case the patient has trouble remembering when they go home. (I am writing this after having a procedure myself this morning, so I know what I am talking about!) They will be told to expect a follow-up call from a nurse to check on them.

Inpatients are usually told what to expect immediately post-op. Pain control. Coughing, deep breathing exercises. What to expect while in the hospital. When to call the nurse (increasing pain, bleeding, signs of infection, etc). A timeline of their stay (additional tests, PT or OT, etc). Most of the teaching involving wound care and activity occurs post-op with an inpatient, during each interaction.

Hope this helps.