"Case Study: Postoperative Care and Management of a Type 2 Diabetes Patient Undergoing Laparoscopic Cholecystectomy"

AT3 - Case Study 2025

Mrs. Fang Li, preferred name Lois, (DOB: 05/01/1980) is a Chinese woman who has lived in Australia since she was 12. She co-owns an accountancy firm with her husband, working long hours and commuting up to an hour daily. Often, she skips meals or gets takeaway on her way home. Lois and her husband and two cats live in a lovely townhouse, while her two children, aged 20 and 18, are away at university.

INITIAL PRESENTATION - Admission Day 1:

Mrs Li presents to the Emergency Department at 2230 hours with right upper quadrant pain, radiating into her back. She has been vomiting for the previous 2 hours after eating spaghetti carbonara for dinner. Diagnosed with Type 2 Diabetes Mellitus (T2DM) 5 years ago, her Blood Glucose Level (BGL) has well controlled with lifestyle changes and Metformin 500mg BD. She has mild hypertension, treated with Lisinopril 20mg mane. Mrs. Li is a non-smoker and drinks a glass of wine only on weekends. She has been struggling to lose weight, weight is currently 88kg and height 165cm.

On arrival at the ED, the triage nurse assessed her and assigned her to a bed. She is seen by the medical officer and an Intravenous cannula (18G) is inserted into her left forearm and bloods are collected.

Vital signs are completed by the triage nurse and placed on the ADDS chart.

She was admitted to the surgical unit overnight for further investigation with a provisional diagnosis of cholelithiasis.

Please review the following documentation related to Mrs Li:

• Vital signs chart ADDS


• IV fluid orders chart


• Fluid Balance Chart (FBC)


• Pathology results


• ECG


• PIVC chart


• Medication Chart


• Adult subcutaneous insulin prescribing chart


• Urinalysis


• Progress Notes

Admission Day 2:

Mrs Lis abdominal ultrasound results identified gallstones as shown in the below

Mrs. Li was reviewed by the general surgeon and consented to a laparoscopic cholecystectomy. Her preparation for surgery the next day was commenced.

Admission Day 3:

At 09:00 the following morning, Mrs. Li underwent the procedure. After an hour in the post anaesthetic recovery unit (PACU), she returned to the ward at 11:30hrs. The PACU nurse reported that the operation was successful with no postoperative complications.

On return to the surgical unit, the following documentation needs to be reviewed and actioned:

• Vital signs chart ADDS


• IV fluid orders chart


• Fluid Balance Chart (FBC)


• PIVC chart


• Medication Chart


• Adult subcutaneous insulin prescribing chart


• Progress Notes


• Operation record and post operative orders