Please help!!!

[lnxyourxeyez]

Hello. I am having some trouble with my careplan.

So I have a patient that came in for laparoscopic cholecystectomy, a week later the patient was readmitted for peritonitis - they did a CT scan and found a small-bowel injury that mustve occurred during the laparoscopic cholecystectomy. They did a small bowel resection and an anastomosis. The patients leukocytes were high so they did a second CT scan and it showed residual fluid collection and air bubbles under the diaphragm and pelvic cavity.

She has 3 drains right now, still having drainage.

I thought Fluid Volume Deficit, but are there any other diagnosis ?

Also, what are the most IMPORTANT things to assess / intervene for this patient?

Sorry I'm kind of new to this and I want to expand my brain and think as much as possible but I'm having a brain cramp

[Fiona59]

Homework question????

Honestly, as a working floor nurse I've never had to write a careplan for this type of patient.

It's a case of follow orders, do the drain care, medicate, watch for signs that they might be in difficulties, and deal with the other six patients on my assignment.

How about you tell us what you want to look for in this patient?

[lnxyourxeyez]

Yes Fiona, this is for a careplan I am working on. My nurse told me something similar - take care of the patient until the patient isn't having anymore drainage and make sure theres no complications - then discharge!

But I know there HAS to be problems that could occur with this patient, such as Fluid Volume Deficit, from all the drainage my patient was loosing. But I kind of wanted to find a different dx considering that is a very liked/common dx (like risk for infection!)

[Fiona59]

Drains can be a huge source of infection. Site cleansing, and when you open them to empty.

These patients often become, shall we say, physically needy because of the drains. So you have to get them out of bed and moving. Novel concept but they can walk with drains.

Oh, and admit you are a student looking for help on homework. We are usually kinder when the poster is honest

'cause we ain't the homework hotline

[lnxyourxeyez]

I did admit this was for homework from the initial post. I said its a careplan l I'm working on :)

yes, I agree that Risk for Infection and Fluid Volume Deficit are good dx. I was just hoping to find something else that wasn't such a common dx.

[KelRN215, BSN, RN]

How much is draining from these drains? Presumably she's getting some sort of IV fluid if she's not well enough to drink. I'm not convinced that the presence of a drain alone is enough to say that the patient has a fluid volume deficit. With appropriate nursing care she should not develop one.