Post-Op Flashcards
What do you do when the patient arrives in Post-Op?
- GET VITAL SIGNS
- EVALUATE LOC
- Hook up any equipment or monitoring device
- Observe dressings, incision, ect.
- Get report (How did the surgery go)
- RN from PACU shouldn’t leave until the receiving RN are satisfied patient is stable
What should the Anesthesiologist/RN from PACU report?
- Name of patient and surgical procedure
- Anesthetic agents and reversal agents used
- Estimated blood/fluid loss and replacement
- Vital signs and any problems encountered
- Complications (anesthetic or surgical)
- Preoperative condition and co-morbidities
- Parameters for immediate post-op management
What are some expected outcomes for a post operative patient?
-Airway maintained = gag reflex
- normal spontaneous
respiration
- ABGs within preoperative normal values (coming back up)
- No evidence of aspirations (listen to crackles [rails] at the bottom of the lungs)
- Heart rate and BP return to pre-op values 1-2 hours post anesthesia and remain stable
- Body temperature continues to rise until wdl (cold after surgery)
- No evidence of hyper/hypo-volemia (high bp = hypervolemia, tenting skin turgor = hypovolemia)
- Arousas easily and responds appropriately to commands
- Moves all extremities purposefully and with normal strength
- Skin integrity intact (redness and swelling at incision site is normal)
-Nutritional intake re-established
-Pain less than 4 on pain/visual scale
-Has personal support system used to reduce anxiety
What is an extremely important expected outcome post-op and post-pacu?
Urine Output > 0.5 mL/kg/hr.
What route can a nurse re-establish nutritional intake and when can they do so?
- Oral (Involves Swallowing) when protective airway reflexes return
- Enteral (Sticks Tube Down Throat) when bowel sounds return
- Parenteral Route when hemodynamically stable (heart and circulation is stable)
What is a sign of a hemorrhage complication?
-Pulse increase even if they are laying with no activity
What are some potential complications in post-op care?
- Hemorrhage
- Thromboembolism
- Urinary Retention
- Paralytic Ileus (Dead Bowel)
How do you treat URINARY RETENTION in post-op?
How do you treat PARALYTIC ILEUS, dead bowel, in post-op?
- Give patient water, get them moving, catheterization is a last resort
- Get them moving
What happens to the lungs during surgery?
What can you do to treat this afterwards?
- Aclectasis (alveli collapse during surgery and some stay collapse)
- Incentive Spirometer
What does the coughing and deep breathing do?
- Moves up secretions up respiratory tract and helps cough it up
- Splint abdomen with pillow or blanket by clutching it to the patient’s abdomen on top of the wound, deep breath in, and cough while deep breathing out
What are some ways to prevent venous stasis of the legs?
- Put something at their feet so they have something to push against to EXERCISE CALF MUSCLES because he majority of blood clots occur there
- Quadriceps exercise, knee flexion and extension
- Food circles
- PUSH KNEE TOWARDS BED
Who is more likely to have a THROMBOEMBOLISM complication?
What might they need to be put on?
- The Elderly and those with Hip Surgery
- Anticoagulants
What are some of the effects that pain causes?
- Increased sympathetic activity
- –> Increases metabolism
- –>Increases O2 demand
- Increases Stress
- –>Decrease ability to fight infection
- –>Decreases healing
- Interferes with sleep, eating, activity, and healing
- Interferes with cough and deep breathing
What is dependence?
What is addiction?
Dependence- a PHYSIOLOGICAL need for the drug based on long term use
Addiction- PSYCHOLOGICAL need for drug
You’re more likely to develop dependence on drugs through chronic use than acute use
What are the advantages of PCAs?
- Sense of control over pain
- Better pain control
- Less pain medication used over time
- Less chance of overdose
