Question

The client is admitted to the unit after a cholescystectomy. Montgomery straps are utilized with this client. The nurse is aware that Montgomery straps are utilized on this client because: A. The client is at risk for evisceration. B. The client will require frequent dressing changes. C. The straps provide support for drains that are inserted in the incision. D. No sutures or clips are used to secure the incision.

Short answer

Answer: Montgomery straps are utilized for a post-cholecystectomy client to facilitate frequent dressing changes without causing further pain or injury to the client.

Step-by-step solution

1. Understand the concept of Cholecystectomy and Montgomery Straps

Cholecystectomy is the surgical removal of the gallbladder. Montgomery straps are adhesive strips that are used to support a wound dressing or bandage, making it easier to change the dressing without causing irritation or damage to the skin.

2. Analyze Option A

Option A suggests that the client is at risk for evisceration. Evisceration is a severe complication that occurs when the organs protrude through an open wound. Although evisceration is a potential risk following any abdominal surgery, Montgomery straps do not serve the primary purpose of preventing evisceration but rather to help with dressing changes.

3. Analyze Option B

Option B states that the client will require frequent dressing changes. This is the main purpose of Montgomery straps - they make dressing changes easier and less painful for the patient by keeping the wound secure without disturbing the sutures or staples.

4. Analyze Option C

Option C suggests that the straps provide support for drains inserted in the incision. While it is possible that drains may be inserted in the incision after a cholecystectomy, it is not the primary purpose of Montgomery straps, which are focused on supporting dressing changes.

5. Analyze Option D

Option D states that no sutures or clips are used to secure the incision. This is not the reason for using Montgomery straps, as they are not an alternative to sutures or clips. Rather, they work alongside them to provide additional support and facilitate dressing changes.

6. Choose the correct option

Based on the analysis of each option, the most accurate explanation for using Montgomery straps in this client's case is Option B, as they facilitate frequent dressing changes without causing further pain or injury to the client.

Key concepts

Postoperative care

Postoperative care is an important part of a patient's recovery following surgery, including a cholecystectomy, which is the removal of the gallbladder. The objective of postoperative care is to enhance recovery, prevent complications and support the patient's overall wellbeing. Effective postoperative care involves monitoring the patient's vital signs, managing pain, and providing nutrition.
After a cholecystectomy, patients may experience discomfort or pain, particularly around the surgical site. It is vital to manage pain effectively to allow mobility and prevent complications such as blood clots. Nurses play a key role in administering prescribed medications and providing comfort measures.
Additionally, postoperative care includes ensuring adequate hydration and nutrition to promote healing. This might involve intravenous fluids initially, gradually progressing to a normal diet as the patient can tolerate it. Monitoring for complications like infections or surgical wound issues is also crucial. Effective communication, reassurance, and support from the healthcare team can significantly aid in the patient's recovery.

Wound management

Wound management post-cholecystectomy is crucial for preventing infection and promoting healing. The surgical wound requires careful attention, and Montgomery straps may be used to facilitate this care. These straps are specially designed adhesive strips that stabilize the dressing while allowing for frequent changes without hurting the skin.
Key considerations in wound management include:

• Keeping the wound clean and dry to prevent infection.
• Ensuring dressing changes are performed under sterile conditions.
• Monitoring for signs of infection, such as redness, swelling, or unusual discharge.
• Checking for proper wound healing and suture integrity.

Using Montgomery straps can greatly ease the process of changing dressings. By reducing the strain on the skin and underlying tissues, they help in minimizing discomfort and promoting better healing of the surgical site. This approach also facilitates easier access for wound assessments without disrupting the healing process.

Nursing interventions

Nursing interventions are fundamental for patients recovering from a cholecystectomy, as they directly influence patient outcomes. These interventions are designed to address physical care needs, emotional support, and education.
Some essential nursing interventions post-surgery include:

• Monitoring vital signs to detect any signs of complications early.
• Administering medications as prescribed, including pain management protocols.
• Encouraging mobility to enhance circulation and prevent blood clots.
• Educating the patient about signs of complications to watch for and how to care for their wound at home.

Nurses also provide emotional support by offering reassurance and answering questions regarding the patient's recovery process. This support helps reduce anxiety and empowers patients, ensuring they actively participate in their recovery. Additionally, nurses play a vital role in coordinating multidisciplinary care, ensuring the patient receives comprehensive treatment and support.