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nrsg 302 > Week 3 - PostOp Complications > Flashcards

Week 3 - PostOp Complications Flashcards

1
Q

what are common and potential post-operative complications for neuro-psychological?

A
  • delirium
  • fever
  • hypothermia
  • pain
  • postoperative cognitive dysfunction
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2
Q

what are common and potential post-operative complications for respiratory?

A
  • airway obstruction
  • aspiration
  • atelectasis
  • bronchospasm
  • hypoventilation
  • hypoxemia
  • pneumonia
  • pulmonary edema
  • pulmonary embolus
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3
Q

what are common and potential post-operative complications for cardiovascular?

A
  • dysrhythmias
  • hemorrhage
  • hypertension
  • hypotension
  • superficial thrombosis-phlebitis
  • venous thrombo-embolism
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4
Q

what are common and potential post-operative complications for gastro-intestinal?

A
  • delayed gastric emptying
  • distension/ flatulence
  • hiccups
  • nausea/ vomiting
  • postoperative ileus
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5
Q

what are common and potential post-operative complications for urinary?

A
  • infection
  • retention
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6
Q

what are common and potential post-operative complications for integumentary (incision site)?

A
  • dehiscence
  • hematoma
  • infection
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7
Q

what are common and potential post-operative complications for fluid and electrolytes?

A
  • acid/ base disorders
  • electrolyte imbalances
  • fluid deficit
  • fluid overload
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8
Q

when looking at vital signs you just took which of them are indicators that the pt could be in pain?

A
  • increased HR
  • increased BP
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9
Q

what are the main things to be aware of in regards to pain crisis?

A
  • 10 or > out of 10
  • occur gradually or slowly over time
  • often pt will be extremely still
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10
Q

what are some risk factors for hypothermia?

A
  • effects of anesthesia
  • stress response
  • body temp loss in OR
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11
Q

what might you find in your assessment of a pt experiencing hypothermia?

A
  • shaking
  • appeal pale or cyanotic
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12
Q

what are some interventions the nurse can do to help a hypothermic patient?

A
  • warmed blankets
  • warm fluids
  • forced-air warmers
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13
Q

for a pt with thermoregulation issues what are common findings that would happen with a mild fever (<38) during days 0-2?

A
  • inflammatory response to surgical truama
  • hematoma
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14
Q

for a pt with thermoregulation issues what are common findings that would happen with a persistent fever (>38) during days 0-2?

A
  • atelectasis
  • specific infections related to surgery
  • dehydration
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15
Q

for a pt with thermoregulation issues what are common findings that would happen during days 3-5?

A
  • pneumonia
  • UTI
  • sepsis
  • wound infection
  • phlebitis
  • abscess formation
  • DVT
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16
Q

what are signs and symptoms of sepsis?

A
  • fever
  • increased HR
  • decreased BP
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17
Q

pt are at an increased risk of dizziness and fainting in the first what?

A

24-48hrs post surgery

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18
Q

which pts are at the highest risk of dizziness and fainting?

A
  • spinal epidural
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19
Q

why are pts who had a spinal epidural at the highest risk of dizziness and fainting?

A
  • freezes motor, sensory and autonomic nerves
  • pt stands vessels don’t contract so blood pools in feet and BP drops > pt faints
  • vaso-vagal response can occur
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20
Q

for pt’s experiencing post op delirium what do you use to assess them?

A

CAM scale

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21
Q

is post-op delirium an emergency?

A

yes

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22
Q

delirium is different than dementia and has rapid onset and cluster symptoms. What are they?

A
  • acute onset
  • fluctuation throughout day
  • difficulty focusing attention
  • disorganized thinking
  • altered LOC
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23
Q

post-op delirium can be ____ or _____

A

hypoactive or hyperactive

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24
Q

what do you use to treat post-op delirium?

A
  • PRISME
  • may need a 1:1 CCP
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25
Q

respiratory complications can occur after what?

A

major surgery

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26
Q

what are some risks for an airway obstruction?

A
  • spasm of bronchus and larynx
  • tongue falling back
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27
Q

what assessment data do you expect to gather for an airway obstruction?

A
  • stridor
  • tachypnea
  • shallow/ wheezing breaths
  • dyspnea
  • gasping
  • increase pulse
  • irritability
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28
Q

what interventions should then nurse implement if the pt has an airway obstruction?

A
  • stimulation
  • positioning
  • artificial airway
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29
Q

what are some risk factors for aspiration?

A
  • GERD
  • pregnancy
  • H hernia
  • ulcers
  • trauma
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30
Q

what assessment data do you expect to gather for a pt experiencing aspiration?

A
  • coughing
  • crackles
  • rattling chest
  • decreased SpO2
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31
Q

what are some interventions the nurse can do for a pt experiencing aspiration?

A
  • sit up for feeding and drinking
  • protection of airway
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32
Q

what are some risk factors for atelectasis?

A
  • airway obstructed by bronchial secretions
  • trapped air absorbed and alveolar collapse
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33
Q

what assessment data do you expect to gather for a pt experiencing atelectasis?

A
  • slow recovery
  • poor color
  • mild tachypnea
  • tachycardia
  • sometimes increased temp
  • decreased air entry heard to lung fields
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34
Q

what are some interventions the nurse can do for a pt with atelectasis?

A

pre and postoperative physiotherapy

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35
Q

what are some risk factors for bronchospasm?

A
  • asthma
  • COPD
  • intubation
  • aspiration
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36
Q

what assessment data do you expect to find with a pt who has bronchospasm?

A
  • wheezing
  • dyspnea
  • tachypnea
  • decreased SpO2
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37
Q

what are some interventions a nurse can do for a pt who has bronchospasm?

A
  • administer O2
  • bronchodilators
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38
Q

what are some risk factors for hypoventilation?

A
  • respiratory depression from narcotics/ opioids
  • poor muscle tone
  • pain
  • mechanical restriction
39
Q

if a pt is experiencing hypoventilation what assessment data does the nurse expect to find?

A
  • Decreased RR
  • shallow resps
  • decreased SpO2
  • increased PaCO2
40
Q

what interventions can a nurse do for a pt experiencing hypoventilation?

A
  • administer O2
  • ventilator assistance
  • stimulation
  • positioning
41
Q

what are some risk factors for pneumonia?

A
  • hypoventilation
  • immobility
  • aspiration
  • resp issues
42
Q

If a pt has pneumonia what assessment data does the nurse expect to find?

A
  • infection from stasis or secretions
  • dull/ productive cough
  • fever
  • chills
  • pleuritic pain
  • WBC
43
Q

what are some interventions the nurse can implement for a pt with pneumonia?

A
  • antibiotics
  • physiotherapy
44
Q

how can you prevent pneumonia from developing post surgery?

A

get the patient mobile at least 3 times a day

45
Q

what are some risk factors for pulmonary edema?

A
  • fluid overload
  • left ventricular failure
  • prolonged airway obstructions
  • sepsis
  • aspiration
46
Q

if a pt has pulmonary edema what assessment data does the nurse expect to find?

A
  • crackles on auscultation
  • infiltrates on CXR
  • fluid overload
  • decreased SpO2
  • productive cough with clear to pink sputum
47
Q

what interventions can the nurse implement for a pt with pulmonary edema?

A
  • diuretics
  • increased O2
  • fluid restriction
48
Q

what are some risk factors for a pulmonary embolism (PE)?

A
  • DVT
  • other peripheral thrombosis
  • AFib
  • fat emboli
  • air emboli
49
Q

what assessment data should the nurse expect to find for a pt with a pulmonary embolism?

A
  • acute tachypnea
  • dyspnea
  • chest pain
  • hypotension
  • decreased SpO2
50
Q

what are some interventions a nurse can implement for a pt with a pulmonary embolism (PE)?

A
  • O2 therapy
  • CVS support
  • anticoagulations
51
Q

what are some risk factors for hemorrhage/ bleeding?

A
  • truama
  • long surgical time
  • blood thinners
52
Q

what assessment data should the nurse expect to find in a pt with a hemorrhage/ bleeding?

A
  • assess dressing
  • VS and lab values
  • increase pulse
  • symptoms of shock for internal bleeding
53
Q

what interventions can the nurse implement for a pt with a hemorrhage/ bleed?

A
  • change dressing prn after 24-48hrs postop unless directed otherwise
  • hold pressure/ call for help if needed/ notify doctor
  • empty/ measure drains
54
Q

where do you expect to see a hematoma post surgery?

A

area immediate to surgical site that continues to swell, filling with blood

55
Q

what are some risk factors for a hematoma?

A
  • trauma
  • long surgical time
  • blood thiners
56
Q

what assessment data should the nurse expect to find if a pt has a hematoma?

A
  • firmness
  • swelling
  • discolouration/ bruising
  • mark it with a pen
57
Q

what are some interventions the nurse can implement for a pt with a hematoma?

A
  • apply pressure to dressing
  • call surgeon if continues
  • occasionally needs to be drained
58
Q

what are some risk factors for hypotension?

A
  • fluid/ blood loss
  • fluid deficit
  • peripheral pooling of blood
  • vasodilation from anaesthetic
  • medications
59
Q

what assessment data should the nurse expect to find in a pt with hypotension?

A
  • decreased LOC
  • decreased BP
  • dizzy
  • nausea
  • pale
  • hypovolemic shock
60
Q

what would you expect to find in a pt with hypovolemic shock?

A
  • decreased BP
  • increased pulse
  • cold
  • clammy
  • pale
61
Q

patient’s can develop orthostatic hypotension when changing from ____ to ____ to quickly

A

lying to standing

62
Q

what intervention can a nurse implement for a pt with hypotension?

A
  • replace lost fluids
  • insure strick I&O measuring
63
Q

what are some causes of hypertension?

A
  • pain
  • delirium
  • hypoxia
  • gastric or bladder distention
  • fluid overload
64
Q

what should the nurse assess for a pt with hypertension?

A
  • PRN BP
  • pulse
  • cap refill
  • absence of chest pain
  • RR
  • extremities
  • crackles
  • edema
65
Q

what are some different cardiac dysfunctions?

A
  • myocardial infarctions/ ischemia
  • CVA/ TIA
  • dysrhythmias
  • hypo/hypertension
  • pulmonary embolism
66
Q

what causes cardiac dysfunctions ?

A
  • effects of drugs
  • prolonged surgical time
  • trauma
  • comorbidities
  • acid/base imbalances
  • fluid/ electrolyte imbalances
67
Q

what should you assess for pts with cardiac dysfunctions?

A
  • monitor VS
  • telemetry/ ECG monitor
  • CWMS
  • I&O balance
68
Q

what interventions can be done for cardiac dysfunctions?

A
  • DVT heparin protocol
  • replace/ excrete fluids and electrolytes
69
Q

what are different types of fluid and electrolyte imbalances?

A
  • hypo/hypervolemia
  • hypo/hypercalcemia
  • hypo/hyperkalemia
  • hypo/hypernatremia
70
Q

what causes fluid and electrolyte imbalances?

A
  • trauma
  • blood loss
  • to much fluid replaced in OR
  • prolong surgical time
  • drugs
  • gastric losses
71
Q

what do you need to assess for fluid and electrolyte imbalances?

A
  • monitor for S&S
  • full CVA assessment
  • lab values
  • telemetry/ ECG monitoring
  • monitor I&O
72
Q

what are some interventions that can be put in place for fluid and electrolyte imbalances?

A

treatment based on:
- levels of fluid replacement
- diuretics
- electrolyte replacement/ excretion

73
Q

what causes nausea and vomiting post surgery?

A
  • anesthetic
  • drugs
  • pain
  • NPO status
74
Q

what should you assess for pts with nausea and vomiting?

A
  • monitor VS
  • monitor pain level
  • monitor I&O
75
Q

what are some interventions that can be put in place for pts experiencing nausea and vomiting?

A
  • administer anti-emetics
  • HOB elevated
  • slow progression of diet
76
Q

what causes a paralytic ileus?

A

delayed return of GI peristalsis

77
Q

what should the nurse assess for pts with a paralytic ileus?

A
  • presence of bowel and abdomen sounds
  • distension
  • abdomen pain
  • N/V
78
Q

what are some interventions that can be put in place for pts with paralytic ileus?

A
  • encourage ambulation
  • use splinting for any abdominal surgeries
  • start bowel protocol
  • NP tube for severe vomiting
79
Q

define urinary retention

A

inability to void 6-8hours post-op

80
Q

what causes urinary retention?

A
  • anesthesia
  • drugs
  • not voiding for prolonged period
  • ureter trauma
  • spinal/ epidural anaesthesia
81
Q

what should the nurse assess for a pt with urinary retention?

A
  • distended bladder
  • discomfort
  • bladder scan
82
Q

what interventions can a nurse implement for a pt experiencing urinary retention?

A
  • regular toileting
  • fluids
  • decrease use of narcotics
  • catheter if needed
83
Q

what interventions can a nurse implement for a pt experiencing urinary retention?

A
  • regular toileting
  • fluids
  • decrease use of narcotics
  • catheter if needed
84
Q

define dehiscence

A
  • opening of wound edges
  • wound wont close
85
Q

what can cause dehiscence?

A
  • coughing/ vomiting
  • distention
  • decreased circulation
  • internal hematoma formation under incision
86
Q

is dehiscence a serious completion? what is the mortality rate? When does it occur?

A
  • yes
  • up to 30%
  • occurs between 7-10 days postoperatively
87
Q

what causes dehiscence ?

A
  • obesity
  • malnutrition
  • older age
88
Q

what are some interventions that can be done for dehiscence?

A
  • sterile dressing to wound
  • opiate analgesia
  • fluid resuscitation
  • early return to OR
89
Q

what can the nurse do to decrease the likelihood of dehiscence occurring?

A

remove/ alternate sutures/ staples during removal

90
Q

define evisceration

A

protrusion of bowel through incision

91
Q

what causes evisceration?

A
  • malnutrition
  • obesity
  • older age
92
Q

what interventions can be done for evisceration ?

A
  • cover entire area with sterile NS soaked dressing and cover dressing
  • monitor for shock
  • place pt in bed with knees to chest
  • call surgeon ASAP
93
Q

what is considered a pre-high BP?

A

systolic between 121-139
OR
diastolic between 81-89

94
Q

what is considered a high BP?

A

systolic 140 or above
OR
diastolic 90 or above

nrsg 302 (8 decks)

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