postoperative care

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created 7 months ago by Akosua_Ruby
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updated 7 months ago by Akosua_Ruby
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1

initial assessment

  • Airway: make sure it's not blocked
  • Breathing: check respiration and chest for movement
  • Circulation: capillary refill, color
2

care in PACU (initial assessment)

  • O2 therapy: check O2 levels if patient is confused
  • neurologic assessment: LOC, orientation, sensory and motor status, pupil reaction
  • urinary system (I&O, F&E balance)
  • surgical site and dressing ( keep dressing to prevent bleed out, infection, etc)
  • drains/tubes (check incision site for bright red blood)
  • pain
3

gerontological considerations

  • older adults more prone to complications
  • higher risk for drug toxicity
  • potential changes in mental status
4

pulmonary edema

crackles, trouble breathing, giving too much fluids

5

aspiration

keep patiens NPO before surgery to prevent this

6

bronchospasm/ atelectasis

  • wheezing, airway narrowing
  • collapse of lower area lungs
7

hypoventilation

respiratory rate is low, oxygen is low, CO2 goes out

8

hypotension, hypertension

  • hypo due fluid or blood loss
  • hyper due to fluid overload, or pain
9

hemorrhage

low BP, high heart rate

10

dysrhythmias and syncope

low potassium (hypokalemia), low BP

11

fluid overload/deficit

slow down fluid if too much. if low output give fluids

12

pain and discomfort

  • pain is subjective
  • if not fully awake: restless, moaning, diaphoresis, VS changes
  • opioid analgesics, NSAIDs, PCAs
13

post op problems

  • postoperative delirium (older adults)
  • hypothermia
  • N/V
  • delayed gastric empyting/peristalsis
  • urinary retention (minimum 30ml/hr)
  • wound infection, dehiscence
14

nursing interventions to prevent complications

  • cough and deep breathe
  • oxygen therapy
  • pain control, turning and position
  • ambulation
  • adequate hydration
15

role of RN caring for postop patient

  • assess ABCs, evaluate mental status, ongoing assessments, teaching
16

role of LPN caring for postop patient

administer oxygen, give analgesics, catheter insertion, wound care

17

role of UAP

positioning, VS, elimination needs, record I/O, provide hygiene

18

role of respiratory during post op care

help with extubating, oxygen therapy

19

role of PT during post op care

support patient return to baseline functional mobility

20

discharge teaching

  • symptoms to report
  • when and how to take prescribed medications
  • care of incisions or dressings
  • prohibited activities
  • dietary restrictions
  • follow up appt
  • answer questions