Lap chole

[cndrn]

What criteria / orders do you have for discharging a lap chole patient? We are discharging these patients from an outpatient surgery unit when they meet PRS critieria, but sometimes that doesn't seem like a long enough recovery time. They could meet PRS score in 1 or 2 hours, and we have no specific postop order telling us to keep them any longer than that. Any help out there?

[MT RN]

It's usually an overnight stay at my facility, then as long as they are taking PO well, peeing, and ambulating OK they can be discharged.

[VivaLasViejas, ASN, RN]

Most lap chole's where I worked could be discharged when their pain was well controlled, they could eat, drink, pee, and ambulate without problems, and their vital signs were stable. This usually meant a 2-4 hour stay on the med/surg floor, although when I had mine last summer, I stayed overnight........guess I'm a wuss:wink2:

Actually, I stayed because a) I didn't want to deal with my kitties romping all over my sore belly in the middle of the night, and b) it was covered by the insurance I had at the time. It was nice to have the option.

[nursenatalie, ADN, RN]

We rarely have any stay overnight. Usually when pain and nausea are controlled and they can pee they go home. Average 2 hours. I had a lap chole last summer and left after 45 minutes, I met criteria and didnt want to stay a minute longer.

[MU/WVUGRADRN]

:yeahthat:

[gitterbug]

Agree with above guidelines. Post discharge they should avoid driving x week, no heavy lifting, no greasy food, report any fever, change in wound status, increase in pain, or n/v.

[emllpn2006]

I dont know about the official guidelines but when I had mine done I went into the hospital at 8:00 had the surgery around 9:30 and was sitting at home on the couch by noon. This was a little scary to my mother who was staying with me at the time since the er visit to have gall stones diagnosed was 6 hours and surgery and recovery was less than 4.

[cndrn]

THanks for the feedback:nurse:

[nursenatalie, ADN, RN]

Funny how things are different, we allow pts to drive after 24 hours. I was back at work in three...would be funny to be able to work but not able to drive yourself there.