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Crtical thinking question ned help!!!!!!!!!!!

If you had a patient that just had gallbladder removed and smokes three packsof cigarettes a day. And the doctor asks what kind of treatment you recommend, what would best. And why would they be most at risk for atelectasis?

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Permalink Reply by J. D'Urbano on January 22, 2010 at 8:09am
The risk for atelectasis is increased with any abdominal surgery because surgical pain prevents patients from taking deep breaths, coughing, and getting up and walking around. For your patient I would say a nicotine patch, ativan prn, and SVNs prn at the very least. Any more than that and I'd probably have to know more about the patient. I hope this helps...

J.D.
Permalink Reply by Amber Morton on January 22, 2010 at 5:12pm
Thanks so much.
Permalink Reply by Shahid Khan on September 13, 2010 at 1:16am
Why are RT's asked to do CPT on Post OP patients.
Permalink Reply by Ahmad Alhoshki.BHSRT.RCP.RRT on January 22, 2010 at 8:30am
Given the fact that the patient in question had smoke 3 ppd (pack per day) that would put in the COPD club for men and women, that being said, this would increase his chances developing atelectasis since his abdomen being compromised with gallbladder surgery so his chances of developing atelectasis has increase I would agree with SVN with front and back door bronchodialtor and also I would add IS/ WA, hope this would help. Unless the Pt has other medical issues that would compromise care plan.
Permalink Reply by Amber Morton on January 22, 2010 at 5:13pm
I also appreciate your response, thanks.
Permalink Reply by Eric Cheng on January 23, 2010 at 12:49am
I think someone mentioned this but incentive spirometer. What is WA?

Patient positioning: If toleratable, get the pt to sit up more to allow gravity to help pull abdominal contents down. Hopefully this surgical site is fine. Prone (?) I have no experience with this.
Permalink Reply by Ahmad Alhoshki.BHSRT.RCP.RRT on January 23, 2010 at 5:00am
Alejandro:)
how would prone this Pt."(surgical site remain fresh proning :")
Permalink Reply by Ahmad Alhoshki.BHSRT.RCP.RRT on January 23, 2010 at 5:00am
yes indeed WA is ( while a wake)
Permalink Reply by Ronald Taylor on January 23, 2010 at 10:33pm
I agree with Mr D'Urbano but I would have done a Lung Function Assessment prior to surgery. Was the Cholecystectomy open or Lap/Chole . As for pain control PCA would be a good start
Permalink Reply by Paul Myers on November 28, 2010 at 3:00pm
good question. i was about to ask that one myself :)

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