A client reports severe right shoulder pain 24 hours after laparoscopic cholecystectomy. Which statement provides correct information for the nurse to convey?

A client reports severe right shoulder pain 24 hours after laparoscopic cholecystectomy. Which statement provides correct information for the nurse to convey?

• A. This pain may be caused by a bile duct injury. You will need to go to the hospital immediately to have this evaluated.
• B. This pain is caused from the gas used to inflate your abdomen during surgery. Sitting upright in a chair, walking, or using a heating pad may ease the discomfort.
• C. This pain is caused from your incision. Take analgesics as needed and as prescribed and report to the surgeon if pain is unrelieved even with analgesic use.
• D. This pain may be an infection; you should contact the surgeon today for evaluation.

Answer: (B)

Pain in the right shoulder after this surgery is most often from the gas used to inflate the abdomen during the procedure irritating the diaphragmatic peritoneum, which refers pain to the shoulder via the phrenic nerve. This is a common, expected finding in the first day after lap chole. The best nurse message is that sitting upright, walking, or using a heating pad can help ease this discomfort by promoting movement of the gas and reducing diaphragmatic irritation. This explanation fits the timing and nature of the pain better than attributing it to a bile duct injury or to incision pain alone. Bile duct injury would usually come with additional signs such as unusual RUQ tenderness, jaundice, fever, or drainage issues requiring urgent evaluation, while incision pain would be more localized to the wound and managed with prescribed analgesics. If infection signs develop—fever, redness, foul drainage, or systemic symptoms—then medical evaluation is warranted.

Pain in the right shoulder after this surgery is most often from the gas used to inflate the abdomen during the procedure irritating the diaphragmatic peritoneum, which refers pain to the shoulder via the phrenic nerve. This is a common, expected finding in the first day after lap chole. The best nurse message is that sitting upright, walking, or using a heating pad can help ease this discomfort by promoting movement of the gas and reducing diaphragmatic irritation. This explanation fits the timing and nature of the pain better than attributing it to a bile duct injury or to incision pain alone. Bile duct injury would usually come with additional signs such as unusual RUQ tenderness, jaundice, fever, or drainage issues requiring urgent evaluation, while incision pain would be more localized to the wound and managed with prescribed analgesics. If infection signs develop—fever, redness, foul drainage, or systemic symptoms—then medical evaluation is warranted.