Undergoing an Open cholecystectomy

M.N., age 40, was admitted with acute cholecystitis. After undergoing an open cholecystectomy, she is being admitted to your surgical floor. She has a nasogastric tube to continuous low wall suction, one peripheral IV, and a large abdominal dressing. Her orders are as follows:

Physician’s Orders
Progress diet to low-fat diet as tolerated
D5 ½ NS with 40 mEq KCl at 125 mL/hr
Turn, cough, and deep breathe q2h
Incentive spirometer q2h while awake
Dangle in AM, ambulate in PM
Morphine sulfate 10 mg IM q4h prn for pain
Ampicillin (Omnipen) 2 g IVPB q6h
Chest x-ray in AM

Four hours after admission, the nursing assistive personnel (NAP) reports to you the following:
Blood pressure 148/82 mm Hg
Heart rate 118 beats/min
Respiratory rate 24 breaths/min
Temperature 101° F (38.3°C)
Sa O2 88%

4. You know M.N. is at risk for postoperative pneumonia and atelectasis. What is atelectasis, and why is M.N. at risk?