M37 perforated viscus. POD3 for exploratory laparoscopy, repair of perforated rectum, incidental appendectomy
Nutrition: DAT (as of Nov 23)
Intake presentation: Abdominal pain in RLQ, blood in stools, dysuria, no nausea or vomiting
Concepts
Allergies: None known
Psychosocial
Treatments
Potential complications
Comorbidities: none known
Lab trends: HIGH WBC HIGH neut LOW lymph
Anxiety and depression related to hospitalization and surgery recovery
Impaired sexual function
Infection
Acute pain
Wound dehiscence
Bleeding
Impaired bowel function
Nausea/vomiting
Elimination: reduced elimination common following abdominal surgery; repair of perforated rectum may be impacted by straining. Monitor for return and ease of bowel function
Infection: high risk of infection following abdominal surgery due to bowel microbiota, reduced nutrition, reduced elimination, impaired immunity.
Wound care/inflammation: Honeycomb dressing remains in place for up to 3 weeks - monitor for leakage, loose dressing, inflammation, signs of infection
Infection prophylaxis
Foley out Nov 22
Midline honeycomb dressing
AAT
IV saline locked
Nothing per rectum
ERAS
DVT prophylaxis
Pain management
Multimodal analgesia
Fluid balance
Diet transition
Mobility