DISCHARGE HOME HEALTHCARE
PATIENT TEACHING. After a laparoscopic cholecystectomy, provide discharge instructions to a family member or another responsible adult as well as to the patient, because the patient goes home within 24 hours after surgery. Explain the possibility of abdominal and shoulder pain caused by the instillation of carbon dioxide so that if the pain occurs, the patient will not experience unnecessary anxiety about a heart attack. Teach the patient to avoid submerging the abdomen in the bathtub for the first 48 hours, to take the prescribed antibiotics to provide further assurance against infection, and to watch the incisions for signs of infection. Following a 3- to 5-day hospital stay for an open cholecystectomy, instruct the patient on the care of the abdomen wound, including changing the dressing and protection of any drains.
POSTOPERATIVE INSTRUCTIONS. Reinforce pain control and deep-breathing exercises until the incision is completely healed. The patient may need instruction on control of elimination after this surgery. The continued use of opiate-type analgesics for 7 to 10 days may necessitate the use of laxatives or suppositories, which are generally prescribed by the physician before discharge. Explain that gradual resumption of both a normal diet and activity aid normal elimination. Instruct the patient to report to the physician if any new symptoms occur, such as the appearance of jaundice accompanied by pain, chills and fever, dark urine, or light-colored stools. Usually, the patient has no complications and is able to resume normal activity within a few weeks. Instruct the patient who has been treated nonsurgically with bile salts or extracorporeal shock wave lithotripsy about a low-fat diet to avoid recurrence of gallstones.
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