care for a patient following gastric surgery

Expert Solution

Gastric surgeries refer to the surgical processes in the stomach and the most common gastric surgery is the Gastric bypass surgery( stomach is divided into a small upper pouch and a much larger lower "remnant" pouch and then the small intestine is rearranged to connect to both).

Care for a patient following gastric surgery

1) Wound Care

change the dressing every day if your provider tells you to do so.
Be sure to change dressing if it gets dirty or wet.
DO NOT allow to wear tight clothing that rubs against incisions while they heal.
Keep dressing (bandage) on wound clean and dry.
If there are sutures (stitches) or staples, they will be removed about 7 to 10 days after surgery.
Some stitches can dissolve on their own.
Unless told otherwise, DO NOT shower until after follow-up appointment with provider.
Advise to press a pillow over incisions when the patient need to cough or sneeze.

2)Post-operative lab work

Lab work is done at 4, 12, 18, and 24 month visits after surgery, and then yearly:

CBC
Ferritin, iron, iron saturation
Comprehensive metabolic profile
Intact parathyroid hormone
RBC folate
Vitamins A, B1 (thiamine), B12, and 25 hydroxy Vitamin D

3) Follow-up with your patient

After gastric surgery, it is helpful to see your patients within one to two weeks after surgery to review medications, and to check the status of the abdominal wound.

Patients who have diabetes may need decreased amounts of diabetic medication within a few days of surgery. Patients are instructed to monitor their glucose levels four times daily.
The need for antihypertensive medication may change early after surgery, as well. Patients who take antidepressant medications should be encouraged to remain on these medications for the first few months following surgery.
Patients are encouraged to drink at least 48-64 ounces of non-caloric fluids daily.

4) Post-operative

After surgery patients will progressively advance their diet from liquids to solids, over a seven-week period.

Nightingale answered 2 years ago

You are caring for a patient who just had gastric bypass surgery. She is 35 years...

You are caring for a patient who just had gastric bypass surgery. She is 35 years old. Past medical history includes obesity and hypertension. Pain is being controlled with Demerol via Patient controlled analgesia (PCA) pump. The PCA pump is delivering Demerol continuously and on demand. 1. What data should the nurse obtain? What s/s should you be monitoring for while the patient is using a PCA pump? 2. Describe signs and symptoms of pain and what pain scale would...

Discussion - Bariatric Surgery Patient EJ is a 28-year-old female. She is being admitted for Gastric...

Discussion - Bariatric Surgery Patient EJ is a 28-year-old female. She is being admitted for Gastric Bypass Surgery. She is 5'6'' and 265 pounds. She has a history of Diabetes and hypertension, she is not on medications at the time. What client education topics are important to reinforce for this client? How will this client's diet be advanced? What complications can occur after this surgery? What is Dumping Syndrome and what are some interventions to help prevent its development?

Your patient is a 56 year old male recovering from gastric bypass sleeve surgery. 1. Write...

Your patient is a 56 year old male recovering from gastric bypass sleeve surgery. 1. Write 1 one day protocol to get him on the road to weight loss. 2. Suggest any follow up labs or screenings necessary and at what point in time? 3. Suggest any supplements your patient should be taking post surgery. 4. Suggest 3 lifestyle and 3 dietary recommendations for your patient.

A home care patient is experiencing pain secondary to surgery for head and neck cancer. She...

A home care patient is experiencing pain secondary to surgery for head and neck cancer. She takes a liquid narcotic in suspension form. Her doctor ordered 2 teaspoons q. 4 hours, PRN for pain and gave orders to the home health nurse to titrate the dose to the patient’s pain level. The nurse is to report on the patient’s pain level and response to the analgesics every week. Given the patient’s condition and level of pain and previous response to...

Bariatric Surgery Case Study Mr. McKinley is admitted for a Roux-en-Y gastric bypass surgery. He has...

Bariatric Surgery Case Study Mr. McKinley is admitted for a Roux-en-Y gastric bypass surgery. He has suffered from type 2 diabetes mellitus, hyperlipidemia, hypertension, and osteoarthritis. Mr. McKinley has weighed over 250 lbs since age 15 with steady weight gain since that time. He has attempted to lose weight numerous times but the most weight he ever lost was 75 lbs, which he regained over a two-year period. He had recently reached his highest weight of 434 lbs, but since...

The client with a perforated gastric ulcer who is scheduled for emergency surgery cannot sign the...

The client with a perforated gastric ulcer who is scheduled for emergency surgery cannot sign the operative consent form because of sedation with opioid analgesics. The nurse should take which priority action? 1. Send the client to surgery without the consent form being signed. 2. Have the hospital chaplain sign the informed consent immediately. 3. Notify the primary health care provider (PHCP) to obtain a court order for the surgery. 4. Obtain telephone consent from the family member witnessed by...

In the roux-en-Y gastric bypass surgery, food travels directly from the esophagus into the jejunum, and...

In the roux-en-Y gastric bypass surgery, food travels directly from the esophagus into the jejunum, and the duodenum is excluded from the flow of nutrients. Which of the following is an expected consequence of this change in the anatomy of the digestive tract? Group of answer choices increased secretion of amylase after a meal an increase in the amount of secretin that can be found in the blood after a meal an increase in the amount of gastrin that can...

A young woman presents at the clinic six weeks after a gastric bypass surgery. She had...

A young woman presents at the clinic six weeks after a gastric bypass surgery. She had more than 100 lbs. to lose and so far, has lost 40 lbs. She expected to gain some strength and begin exercising, but she is very weak. She states that at times she is too weak to even comb her hair. She eats small meals several times a day, but has watery diarrhea and is nauseated much of the time. She is losing her...

Case Scenario: A young woman presents at the clinic six weeks after a gastric bypass surgery....

Case Scenario: A young woman presents at the clinic six weeks after a gastric bypass surgery. She had more than 100 pounds to lose and so far, she has lost 40 pounds. She expected to gain some strength and begin exercising, but she is very weak. She states that at times she is too weak to even comb her hair. she eats small meals several times a day, but has water diarrhea and is nauseated much of the time. She...

Ms. Warren is having gastric bypass surgery tomorrow She is a diabetic and injects 30 units...

Ms. Warren is having gastric bypass surgery tomorrow She is a diabetic and injects 30 units of 70/30 insulin SQ in the evening before dinner and in the morning before her breakfast. What pre op instructions ( 24 hours before surgery ) should the Nurse Practitioner give her regarding her insulin dose and why?

Question