Question

Describe the initial postoperative management of the nephrectomy patient and discuss collaborative management designed to prevent complications?2. What is the purpose of a bulb-type surgical drain? How does it work? Discuss the expected drainage amount and characteristics in a surgical drain immediately postoperatively.3.What are the nurse’s responsibilities to the family?

Answer 1

ANSWER:-

1.INITIAL POST-OPERATIVE MANAGEMENT OF NEPHRECTOMY TO PREVENT COMPLICATIONS :-

Immediately after the surgery, the patient will be taken to a recovery room and then transferred to the room once the patient is fully awake and the vital signs are stable.

-post-operative pain:- pain mdications can be given to control pain and can be administered through an epidural or intravenous catheter or through injection by a staff nurse.

-Nausea:- The patient can feel nausea due to the anaesthesia given. Medications are available to treeat persistent nausea.

-urinary catheter:- it is common to have a catheter inserted to drain your bladder. it is inserted before the durgery in the operating room. Blood-tinged urine is quit common for few days after surgery.

-Diet:- An intravenous catheter is inerted and kept for one or two days. Necessary IVflids are administered to keep the patient hydrated and medications are also give via it. Most patients are able to tolerate ice chips and small sips of liquids the day of the surgeryand regular food on the second day. once the patient takes regular diet medications are givn orally in tablet form .

- fatigue:- fatigue is common and should have to subside ina few weeks following surgery.

-Incentive Spiromtry:- very simple exercises help to prevent respiratory infections by using an incentive spirometry device. coughing and deep breathing exercises are an important art and help to prevent pneumonia and other pulmonary complications.

-Ambulation:- on the day of surgery,it is very important to start walking with the supervision of the nurse or family member. to prevent blood clots from forming in the legs. Sequential compressive devics and stocking cn be used to prevent blood clots.

-Constipation/ Gas cramps:- sluggish bowels can be seen for few days following surgery as a result of anasthesia. Suppositories and stool softners are usually givn to help this problem.Taking a spool of mineral oil daily can help prevennt constipation. Narcotic pain medications can also cause constipation.Therefore narcotic medications are stopped soon after the surgery as tolerated.

- To prevent complications Maintain gravity drainage, irrigate only as ordered. Maintaining drainage tube patency is crucial to prevent potential hydronephrosis Bright bleeding oor unexpected drainage may indicate a surgical complication. Frequently assess urine colour, amount,and character,note any hematuria, pyuria,or sediment. report oliguria or anuria. Preserving function of the other kidney is critical.Frequent assssment is needeed to for early intervensionfor potential problems

2. A Bulb-type surgical drain ( A Jackson-Pratt drain (JP)) is used to remove fluids that accumulate in certain parts of the body after surgery.It removes fluid by creating suction by the bulb to pull the fluid into the bulb from the body.. The bulb is squeezed flat and connected to the tube that sticks out of the body. The bulb expands asit fills with fluid. The rubber tube is held in place by one or two stitches in the skin.

3. The amount of serosangineous fluid ( serous fuid and blood mixed fluid) should decrease each day and the colour of the fluid will turn light pinkor light yellow. The surgeon will usually remove the drain when drainage is below 25ml per day for two days in a row. On average, JP drains can continue to drain for 1-5weeks.

4. NURSES RESPONSIBILITIES TO THE FAMILY:-

- Teach and explain everything about the surgery, its complications and prevention.

- Teach the importance of protecting the other kidney by preventing UTI, renal calculi, and trauma. Any daamage to the remaining kidney can cause renal failure.

-maintain fluid intake of 2000 to 2500ml per day. it heplps to prevent dehydration and maintain good urine flow.

-gradually increase exercise , avoid heavy lifting for a year after surgery to allow full tissue healing. avoid participating in sports to reduce damage to the other kidney.

- Teach care of the incision and any remaining drainage tubes, catherters, or stents. it is important to prepare client for self-care. and prevent complications.

-Instruct the family members or patient to report signs and symptoms to he physician, including UTI,or systemic infections( fever, general malaise, fatigue) , redness, swelling, pain, or drainage from the incision site.

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