Question

1.Identify the top priorities for the nursing management of a postoperative abdominal surgery patient.

2.Discuss the following types of IV solutions utilized in the care of postoperative patients and identify at least two specific solutions for each.

3.What is the function of the peritoneum?

Answer 1

1) Priorities of nursing management in postoperative abdominal surgery :

1) Balanced nutrition - client’s metabolic needs are high, but there is a decreaseddesire/ability to ingest and digest food.Assure that electrolyte levels are balanced

2) Watch for infection - any procedure done on the abdomen is just asking for aninfection!Watch for distention, redness, swelling, and pain.

3) Maintaining Normal Elimination Patterns

4) Controlling pain - a client who is comfortable will be able to participatein the post-opregimen

2) IV solutions used are :

Crystalloids

▪︎Normal Saline

▪︎ 5% Dextrose

▪︎ Isotonic Glucose with blood ( 50g of glucose in each liter of water)

Colloids like

▪︎Human Albumin

▪︎ Fresh frozen plasma

▪︎ Gelatins

▪︎ Dextrans

▪︎Hydroxyethyl starches

■ 0.9% NaCl with 5% dextrose
■ 0.45% NaCl with 5% dextrose

■ 0.9% NaCl (mainly used for fluid boluses to replace ongoing losses or correct
hypovolaemia), but also an appropriate maintenance fluid
■Hartmann’s solution = Compound Sodium Lactate
■Potassium should be added after >24hours of fasting, usually KCl 20mmol/L.

3) Functions of Peritoneum  :

1- Secretion of peritoneal fluid to lubricate and glide mobile viscera easily on one another.

2- Peritoneal coverings of intestine tend to stick together in the presence of infection. Greater omentum, which is kept constantly on the move by peristalsis of neighboring intestinal tract, may adhere to other peritoneal surfaces around a focus of infection. therefore, many of intraperitoneal infections are sealed off and remain localized by greater omentum which is called Watch dog or policeman of the abdomen.

3- Peritoneal folds play an important part in suspending various organs within peritoneal cavity and serve as a means of conveying blood vessels, lymphatics, and nerves to these organs

4- Large amounts of fat are stored in the peritoneal ligaments and mesenteries, and especially large amounts can be found in the greateromentum.