4 hours postoperative after laparoscopic cholecystectomy, which finding should the nurse expect?

4 hours postoperative after laparoscopic cholecystectomy, which finding should the nurse expect?

• A. Urine output 20 mL/hr
• B. Temp 101 F
• C. Oxygen saturation 92%
• D. Right shoulder pain

Answer: (D)

Right shoulder pain is commonly expected after laparoscopic cholecystectomy. The procedure uses CO2 to inflate the abdomen, and some gas can irritate the diaphragmatic peritoneum. The phrenic nerve (C3–5) carries that irritation to the shoulder, so patients often experience referred pain in the right shoulder several hours after surgery. This is a self-limited, common post-op symptom and typically improves with time, analgesia, and activities that help vent the gas (deep breathing, ambulation). Other findings aren’t as typical at four hours post-op. Urine output of 20 mL/hr would be lower than expected and could indicate hypoperfusion or renal issues, not a normal post-op finding. A temperature of 101°F can occur but is not the most expected sign this early after surgery. Oxygen saturation of 92% on room air suggests hypoxemia, which would warrant intervention rather than being an expected post-op finding.

Right shoulder pain is commonly expected after laparoscopic cholecystectomy. The procedure uses CO2 to inflate the abdomen, and some gas can irritate the diaphragmatic peritoneum. The phrenic nerve (C3–5) carries that irritation to the shoulder, so patients often experience referred pain in the right shoulder several hours after surgery. This is a self-limited, common post-op symptom and typically improves with time, analgesia, and activities that help vent the gas (deep breathing, ambulation).

Other findings aren’t as typical at four hours post-op. Urine output of 20 mL/hr would be lower than expected and could indicate hypoperfusion or renal issues, not a normal post-op finding. A temperature of 101°F can occur but is not the most expected sign this early after surgery. Oxygen saturation of 92% on room air suggests hypoxemia, which would warrant intervention rather than being an expected post-op finding.