Reference no: EM133445765

A 67-year-old male has been complaining of intermittent abdominal pain and nausea for the last several weeks. In the last two days, he suffered several bouts of vomiting that relieved the abdominal pain. He does not show signs of jaundice. An abdominal sonogram revealed multiple stones in the gallbladder and partial obstruction of the cystic duct by a stone and the gastroenterologist diagnosed symptomatic cholelithiasis and cholecystitis. He tells the patient that it is necessary for him to be admitted to the hospital today so that his condition can be monitored.

Upon admission to the hospital the patient exhibits abdominal pain radiating to his right shoulder, fever, and episodes of nausea and vomiting. His medical and surgical history includes Type II Diabetes, Coronary Artery Bypass Graft x4 two years ago, hypertension, chronic insomnia, penicillin allergy. His cardiologist has cleared him for surgery. He is a retired post office carrier. He and his wife have three children, none of whom live in proximity.

Questions

1. Describe standard preoperative teaching and rationale for a cholecystectomy abdominal surgery.

2. Discuss the legal ramifications in obtaining operative consent forms.

3. Describe the nursing management of a preoperative open cholecystectomy patient. Please include the rationale for each intervention.

4. Discuss pain management (nonpharmacological and pharmacological) of the acute cholelithiasis patient.

5. Outline the following for each medication: brand and generic name, drug action, usual dosage, onset/peak/duration if applicable, common side effects and nursing considerations.

0.9% Sodium Chloride

Hydromorphone

Insulin Glargine

Insulin Lispro

Ondansetron

Ticarcillin/Clavulanate

Cefepime