nursing diagnoses for laproscopic cholecystectomy

[stornoway]

hi students

i'm new a new student to this site so i hope my question is appropriate. i'm working on an assignment on developing a care plan for someone who has just had a laproscropic cholecystectomy and i've got to come up with a list of nursing diagnoses and then prioritise the 5 key ones and present them on a care plan. i can't decide on the five and would love some feedback

1. pain related to gallbladder removal

2. ineffective airway clearance related to incisional pain

3, nausea and vomiting related to surgery

4. risk of infection to site of incision related to surgery

5. risk of fluid volume inbalance related to surgery

6. consipation

7. bleeding

8. mobility

9. dvt

10. skin integrity

i'd greatly appreciate any feedback.

[nlion87]

You need to base your nrsg dx on abnormal findings from your head to toe assessment. You are doing the prosess backwards. You first assess than diagnose based on your assessment findings

[stornoway]

hi

i should have mentioned i've just done my clinicals in a surgical ward and my assignment is on a patient who i observed have the operation and need to do postoperative care plan. the patient N&V, pain etc

[brewskiii]

My clinical instructor grills the hell out of us for Dx's that are the most critical: ABC's (Airway, breathing, circulation) no matter what the medical dx may be. I know this may be different for some of you.

My opinion:

1. ineffective airway clearance (think about post op breathing complications like atelectasis- the patient may not feel like coughing and deep breathing after this procedure)

2. DVT

3. Pain rel. to gb removal

4. Risk for infection

5. Risk for fluid volume inmbalance

[aerorunner80, ADN, BSN, MSN, APRN]

So your instructor is wanting you to come up with POSSIBLE NDx then?

Without an assessment of abnormal data, you can't formally state a nursing diagnosis.

Are you sure your instructor isn't asking for potential complications? Those you can do before you see your patient because these are the things you need to learn to look for and they also help direct your nursing interventions.

[Bobbkat]

When I had a lap chole my #1 def would have been acute pain r/t surgical removal of gall bladder AEB facial grimmacing, patient states pain of 8/10, etc, etc. That recovery was way worse than the recovery for my open appy, or c-section. OUCH!

I say that because the pain affected every other aspect of healing for me, so if I had been my nurse it would have been my primary. Ineffective airway clearance, risk for infection, limited mobility are all very important, but if my pain wasn't in control nothing else mattered. There was no way I was going to deep breathe, move, or do anything else. Once my pain was controlled, the other nursing problems could be taken care of.

What was the number one problem that you found with your patient after assessment? Generally, a primary nursing diagnosis will have a trickle down effect to the others.

[stornoway]

thanks everyone. i've just finished my assigment. i'm really enjoying this site.