UNIVERSITY OF CEBU – BANILAD

COLLEGE OF NURSING

STUDENT’S GUIDE FOR THE PRE-OPERATIVE REPORT

I. GENERAL INFORMATION
Name of Patient: L.S.C. Ward: SP-3 Bed No.: 313D
Address: Danao City Cebu Sex: Male Civil Status: Married
Occupation: Farmer Nationality: Filipino Religion: Catholic
Date and Time of Admission: January 19 2019 8:22 AM
Admitting Diagnosis: Cystolithiasis
Operation to be Performed: Cystolithotripsy

II. NURSING HISTORY (History of Present Illness)

A2 months PTA, persistence of symptoms and onset of growing sudden right flank pain PS 10/10
prompted consult at Danao District Hospital. Ultrasound done which reveled stones at the urinary
bladder and both the kidneys.

1 month PTA, noted passage of stones while urinating (-) hematoma

5 weeks PTA, noted minimal urine output and difficulty in urinating

III. DIAGNOSIS / IMPRESSION

Cystolithiasis – the presence of stones/calculi in the urinary bladder

IV. ANATOMICAL ORGANS INVOLVED AND ITS PHYSIOLOGY

Organ: Urinary Bladder
Function: Stores urine

V. PATHOPHYSIOLOGY
Organ and its Function: Urinary Bladder – stores urine
How did it become a disease? Vesical calculi formed de novo within the bladder, but some initially
may have formed within the kidneys as a dissociated Randall plaque or on a sloughed papilla and
subsequently passed into the bladder, where additional deposition of crystals causes the stone to
grow.
Signs and Symptoms: frequent urination, lower abdominal pain, burning sensation or pain felt during
urination, bloody or cloudy urine, incontinence
 Prognosis: Patient will be able to void freely without the experience of pain after recovery from surgery

VI. OPERATION PERFORMED

Why this procedure? Cystolithotripsy is an effective and safe technique for treating large bladder
calculi.
Advantages: Minimally invasive, avoids urethral injury and can be used to fragment and remove
large and hard ladder calculi.
Disadvantages: Suprapubic incision; more analgesic medications, more morbidity, and a longer
postoperative hospital stay.
Why is this indicated? This operation is indicated for stone sizes of more than 3 cm, multiple
stones of more than 1 cm, and inability to perform transurethral cystolithotripsy.

VII. SKIN PREPARATION

Type of Skin Preparation: Most common solution is the betadine
Location of the skin preparation: Groin area to the lower abdomen and to the rectum

VIII. POSITION
Patient will be placed in a lithotomy position where the genitalia is more accessible for the procedure

IX. ANTISEPTIC USED

Type of Antiseptic Used: Iodine

X. DRAPES
Urology drapes

XI. INSTRUMENTS TO BE USED

Instrument Set: Endourology set
Content of the Instrument Set: Mayo Forceps, Tissue Forceps, Van Bauren, Dressing Forceps, Metz,
Blassucci Spiral Urethral Catheter, Braasch Bulb Urethral Catheter, Open Cone Tip Urethral Catheter,
Olive Tip Urethral Catheter, Round Tip Urethral Catheter, Whistle Tip Urethral Catheter, Ureteral
Connector, Simplastic Suprapubic Catheter
XII. TISSUES – SUTURES – NEEDLES
Type of Suture: Vicryl Type of Suture: Novosyn
Needle: 2.0 Needle: 5.0

XIII. PRE-OPERATIVE MEDICATION

Generic Name: Bisacodyl
Classification: Laxative
Action: Stimulates peristalsis by directly irritating the smooth muscle of the intestine, possibly
the colonic intramural plexus.
Adverse Effects: abdominal cramps, nausea, diarrhea, rectal burning, hypokalemia, muscle weakness
Why? To empty bowels before a surgery
Normal Symptoms: stimulation of the bowel movements

Generic Name: Fleet Enema

Classification: Laxative
Action: Phosphate ions that are not well absorbed within the small intestines, causing a retention of
water and indirectly increasing bowel movements.
Adverse Effects: rectal bleeding, symptoms of dehydration
Why? To empty bowels before a surgery
Normal Symptoms: stimulation of the bowel movements

Generic Name: Ciprofloxacin

Classification: Antibiotic
Action: active against both gram-positive and gram-negative bacteria. Inhibits DNA gyrase, and a
type 2 topoismerase, necessary to separate bacterial DNA
Adverse Effects: severe dizziness, fainting, fast or pounding heartbeats, sudden pain, swelling,
stiffness
Why? To reduce the incidence of surgical wound infection

IX. ANESTHESIA
Type of Anesthesia: General Anesthesia
Technique: GETA/GAOT/Lumbar
 X. NURSING MANAGEMENT
A. Pre-operative Nursing Care
Health Education taught to the patient day/night prior to operation
Follow directions, such as, withholding food and fluids prior to surgery
B. Post-operative Nursing Care
Immediate post-operative care, follow-up care
Monitor vital signs frequently, monitor amount, color, and clarity of urine output, maintain
placement and patency of urinary catheter

Name of Student: Laurence C. Pelino Section: A

Inclusive Date of Assignment: January 22-23, 2019
Date of Submission: January 23, 2019

Name of Clinical Instructor: Mr. BJ R. Toledo