Discharge And Home Healthcare Guidelines

After a laparoscopic cholecystectomy, provide discharge instructions to a family member or another responsible adult, as well as to the patient, because the patient goes home within 24 hours after surgery. Explain the possibility of abdominal and shoulder pain because of the instillation of carbon dioxide to prevent anxiety about a heart attack if the pain occurs. Teach the patient to avoid submerging the abdomen in the bathtub for the first 48 hours, to take the prescribed antibiotics to provide further assurance against infection, and to watch the incisions for signs of infection. Following a 3- to 5-day hospital stay for an open cholecystectomy, instruct the patient on the care of the abdomen wound, including changing the dressing and protection of any drains.

Reinforce pain control and deep-breathing exercises until the incision is completely healed. The patient may need instruction on control of elimination after this surgery. The continued use of opiate-type analgesics for 7 to 10 days may necessitate the use of laxatives or suppositories, which are generally prescribed by the physician before discharge. Explain that gradual resumption of both a normal diet and activity aid normal elimination. Instruct the patient to report to the physician if any new symptoms occur, such as the appearance of jaundice accompanied by pain, chills and fever, dark urine, or light-colored stools. Usually, the patient has no complications and is able to resume normal activity within a few weeks. Instruct the patient who has been treated nonsurgically with bile salts or extracorporeal shock wave lithotripsy about a low-fat diet to avoid recurrence of gallstones.

Chorioamnionitis

DRG Category: 373

Mean LOS: 1.9 days

Description: MEDICAL: Vaginal Delivery without

Complicating Diseases DRG Category: 370 Mean LOS: 4.9 days Description: SURGICAL: Cesarean Section with CC

Chorioamnionitis is an infection of the chorion, amnion, and amniotic fluids that surround the fetus and is characterized by mono- and polymorphonuclear leukocytes invading the membranes. Leukocytes in the membranes are maternal in origin; leukocytes in the amniotic fluid (amnioni-tis) or in the umbilical cord (funisitis) are fetal in origin. Subsequently, the fetus also becomes infected. Chorioamnionitis, which can occur with subtle or acute signs and symptoms, can happen at any time during the prenatal or intrapartal period. It occurs in 1% of all pregnancies, most commonly after premature rupture of the membranes. Chorioamnionitis can also cause premature rupture of the membranes and preterm labor. If left untreated, it can lead to maternal sepsis or fetal demise.

The prognosis for the mother with chorioamnionitis is good. Once the baby is delivered, the source of infection is removed. Rarely does chorioamnionitis lead to septic shock. Occasionally, pelvic inflammatory disease can develop if the infection is not totally resolved. The prognosis for the infant varies, depending on the degree of infection that is transmitted to the fetus. Occasionally, no signs of infection develop for the infant, but this is not typical. Another factor involved in the infant's prognosis is prematurity; for the very premature infant, the risk of respiratory distress syndrome may be even greater than the risk of infection.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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