Postoperative Care Flashcards Preview

Nursing The Hospitalized Adult > Postoperative Care > Flashcards

Flashcards in Postoperative Care Deck (22):
1

Factors Affecting Wound Healing?

age (geriatric)
wound infection
obesity
hydration
non-compliant with Dr. orders
*diabetic
*PVD

2

Types of wound healing?

Primary
secondary

3

Primary intention wound healing?

Tissue surfaces approximated
Minimal or no tissue loss
Example: surgical wound

4

Secondary intention wound healing?

Edges can not be approximated
Involves considerable tissue loss
Example: decubitus ulcer, cut from piece of glass

5

Tertiary intention?

wound has dehisced (opened up)

6

Phases of Wound Healing?


1. Inflammatory: initial occurrence; 4-6 days after hemostasis; phagocytosis is happening

2. Proliferation: 4-21 days, fibroblasts make collagen which gives wound tensile strength; max 80%

3. Maturation/Remodeling: 21 days spent in recovery

7

Complications of Wound Healing?

Hemorrhage → bleeding of large volume >500 mL

Dehiscence → wound opens up; caused by infection, obesity

Evisceration → abdominal organs come out of incision; caused by lifting, movement, smoking, dehydration

Infection → show up between 4-7 days of Sx

8

Main nutrients of wound healing?

protein
vitamin c

9

How PROTEIN is primarily lost in a surgical patient?

with loss of blood or edema

10

Keloid?

buildup of scar tissue

11

Hematoma?

buildup of blood under skin (associated with low HGB count)

12

COMFORT MEASURES for NAUSEA & VOMITING?

antiemetic
head of bed upright
ice chips
dim lights
cool compress
breathing techniques
Dimenhydrinate (gravol)
Metoclopramide (maxeran)

13

Nursing Assessment & Care of Patient on Admission to Clinical Unit?

Record time of patient’s return to unit and indentify patient
ABCs (compare with baseline)
Vital signs and O2 sat
Assess neurologic status → including LOC & movement of extremities (to verbal command and spontaneously)
Assess color and temperature of skin
Assess wound, dressing, drainage tubes
Note type & amount of drainage
Connect tubing to gravity or suction
Assess urinary status
Note time of voiding
Note presence of catheter and total output
Check bladder for distention or urge to void
Note catheter patency
Assess pain and discomfort
Note last dose and type of pain control
Note current pain intensity
Position for airway maintenance, comfort & safety
(bed in low position, side rails up)
Check IV infusion
Verify type of solution
Note amount of fluid remaining
Verify flow rate
Check integrity of insertion site(s)
Attach call light within reach & reorient patient to use of call bell
Ensure that emesis basin and tissues are available
Assess emotional condition and support
Check for presence of family member or significant other

14

S&S of hip fracture?

External rotation
Muscle spasm
Shortening of the affected extremity
Pain, usually severe
Tenderness in the region of the fractured site

15

Hip Pinning - ORIF?

line bone up properly + stabilize

Internal fixation  involves stabilizing broken bones with surgical screws, nails, rods, or plates. This type of surgery is usually for people who have fractures in which the bones can be properly aligned. This may also be called "hip pinning."

Hip pinning surgery to repair a hip fracture involves two main steps:
1. Reduction (getting the bone lined up correctly)
2. Internal Fixation (stabilizing broken bones)

16

Hemiarthroplasty?

replaces the ball portion of the hip joint (femoral head)

17

Total hip replacement (THR)?

ball & socket are replaced.
Cemented- older adults
Uncemented- younger adults (allows tissue to grow around)

18

Preop Teaching - #hip?

Moving unaffected leg and both arms – method & frequency
Trapeze bar & Using opposite side rail
Discuss mobility/physio involvement
Getting out of bed & transferring to chair
Weight bearing status
Plans for discharge
Rehab
Home

19

Post operative Care?

Care as for any surgery
Neurovascular assessment – 7Ps
Alignment of extremity
Abductor splint, pillow
Preventing movements that may cause dislocation
crossing legs, scissoring of legs
Slipper Bedpan
Ambulation on day 1 or 2 or as per doctor’s orders
no internal rotation + no hip abduction
Avoid daily activities that may produce these positions:
Putting on shoes or socks
Crossing legs or feet while seated/lying
Assuming side lying positions incorrectly
Standing up or sitting down while body is flexed relative to the chair
Sitting on low seats – especially low toilet seat

20

Neuro Assessment?

sensation
motor function

21

Vascular assessment?

colour
temperature
cap. refill
peripheral pulses

22

7 p's?

pain
pallor
pulses
polythermia (temp.)
puffiness (edema)
paresthesia (nerve sensation)
paralysis (movement)