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Discussion

Lap chole

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?

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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.

  • Guides

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.

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.

:yeahthat:

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.

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.

  • Author

THanks for the feedback:nurse:

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.

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