T.B. undergoes the ERCP and stones and bile are released, but imaging reveals that a stone is still retainedwithin the cystic duct, and multiple stones remain within the gallbladder itself
A surgical consultation is obtained, and a laparoscopic cholecystectomy ("lap choley") is planned.
Identify at least four preoperative orders that will likely need to be completed before T.B. goes to surgery.
• Obtain any additional preoperative laboratory specimens that have been ordered. A 12-lead ECG is
often obtained for patients of T.B.'s age
• Maintain patient on NPO status.
• Ensure that his allergies, if any, are noted on the chart.
• Patient requires preoperative teaching (include teaching for an open cholecystectomy) and
pulmonary toilet teaching (cough and deep breathe, instructions on incentive spirometer [IS]
usage), discussion of postoperative pain expectations and pain management, and a review of what
a cholecystectomy entails. Answer any questions he might have.
• Complete the preoperative checklist, including a recent set of vital signs and his height and weight
• Ensure that T.B.'s daughter has his valuables.
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