About
Surgical procedure involving making a small incision in the abdomen and placing a scope inside the incision to visualize the inside of the peritoneum and gastrointestinal structures. Less invasive technique than open surgery, and allows for retrieval of tissue specimens for analysis. Also may be used to remove scar tissue and/or inflamed organs ( appendix, gall bladder).
Assess
Understanding of procedure, Incision, bleeding, bowel sounds, lung sounds, bruising, circulation; Vital signs, pulse oximetry, pain level
Complications
Infection; post-operative complications ( pneumonia, DVT, constipation, paralytic ileus, pain, PE)
Diagnosis
- Acute pain related to surgical procedure
- Risk for infection related to surgical procedure
- Deficient knowledge related to post surgical treatment regimen
Goals
The client will understand pre-, intra-, and post-operative instructions.
The client will remain free from post-operative complications.
Interventions
- Monitor vital signs every 15 minutes X 2, 30 minutes X2, one hour X2, than every 4 hours ( may have different guidelines for each clinical agency).
- Monitor for signs and symptoms of infection.
- Assess lung sounds, pulse oximetry, bowel sounds, circulation frequently.
- Implement incentive spirometry pre-operatively.
- Encourage to do IS post-operatively at least ten times an hour.
- Teach abdominal splinting.
- Apply elastic compression stockings and/or sequential compression device as ordered.
- Maintain NPO prior to surgery and start with clear liquids after surgery.
- Encourage early ambulation to avoid complications.
- Teach client signs and symptoms requiring immediate follow-up by a health care provider.
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