A patient scheduled for a laparoscopic cholecystectomy in 4 days ...

[rosent76]

A patient scheduled for a laparoscopic cholecystectomy in 4 days asks how pain can be controlled until the surgery. How should the nurse respond?
 
  1. You will feel better if you sit in a recliner and drink water and try not to eat anything. Do not eat any fat.
  2. You will feel better if you rest in bed and do not eat anything until the procedure. Drink only water and milk.
  3. You will feel better if you alternate lying on your back and lying on your abdomen. You may eat anything except fatty food.
  4. You will feel better if you walk as frequently as possible. You may drink coffee, but not soda.

Question 2

The nurse is teaching a patient with an acute attack of cholecystitis about nutritional interventions. Which patient statement indicates additional teaching is required?
 
  1. I need to stop eating and drinking everything for a while.
  2. I may need a tube inserted into my nose that goes all the way into my stomach.
  3. I may be prescribed vitamins B and C.
  4. I may need extra bile salts to promote health.

[14vl19]

Answer to Question 1

Correct Answer: 1
For greatest comfort the patient should sit in the Fowler's position, which reduces pressure on the inflamed gallbladder. A person in the Fowler's position is sitting straight up or leaning slightly back. The legs may be either straight or bent. Fat intake should be reduced to minimize gallbladder contractions and pain. Resting in bed, lying on the back and abdomen, and walking will not help with pain control before the surgery. The patient should not eat anything during an acute episode of pain.

Answer to Question 2

Correct Answer: 3
Food intake may be eliminated during an acute attack of cholecystitis, and a nasogastric tube may be inserted to relieve nausea and vomiting. If bile flow is obstructed, fat-soluble vitamins (A, D, E, and K) and bile salts may need to be administered.