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68wm6 p2 post-op
Post operative PT care
| Question | Answer |
|---|---|
| The 'ABCs' of post-op care | *A-Airway *B-Breathing *C-Circulation *C-Consciousness *S-System review |
| What do you assess for 'A-Airway'? | Head position, Gag/swallow reflex, Suction, Oxygen |
| What do you assess for 'B-Breathing'? | Evaluate depth/rate/rhythm/chest, movement, Mucous membranes, Coughing and deep breathing exercises, Chart time oxygen is discontinued, Oxygen saturation levels (Sa02) |
| What do you assess for 'C-Circulation'? | *Monitor T, P, R, and B/P every 10 to 15 min *Assess pulse *Evaluate skin and nail beds *Peripheral pulses as indicated *Incision/dressing *Monitor wound drainage output *IVs: solution, rate, and site *Cardiac monitors |
| What do you assess for 'C-Conscious'? | *Able to extubate, *Patient responds to commands, *Verbalizes responses, *Reacts to stimuli |
| What do you assess for 'S-System'? | *Neurological functions *Drains and tubes *Dressings *Pain *Allergic reactions *Urinary output |
| How often are vital signs checked in the post-anesthesia care unit (PACU)? | Minumum of every 15 minutes |
| How far can spinal anesthesia extend? | Anesthesia can extend from the tip of the xiphoid process down to the feet. |
| What can influence the movement of spinal anesthesia? | Position |
| List 3 procedures spinal anesthesia is used for. | *Lower abdominal *Pelvic procedures *Lower extremity procedures *Urology procedures *Surgical obstetrics |
| What are some risks of spinal anesthesia? | *Migration (due to PT position) *Vasodilation/ decrease in BP *Respiratory paralysis |
| How often are the vitals to be monitored in spinal anesthesia until the PT is stable? | Every 3-5 minutes. |
| What should the nurse assess for in PTs who recieve spinal anesthesia? | *Monitor the vital signs (q 3 to 5 minutes until patients is stable) *Level of consciousness *Level of anesthesia *Physical assessment *Proper position |
| What vital signs are most important to monitor in the recovery of a patient with spinal anesthesia? | Respiratory rate and blood pressure |
| List 3 potential postoperative complications | *Nausea and vomiting *Aspiration *Hypothermia / Hyperthermia *Laryngospasm *Hypoxia *Hemorrhage *Unresolved Pain *Hypovolemic shock *Decreased / absent urine output *Increase / Decrease IV input |
| In a post anasthesia PT, which is considered MORE severe; Hypothermia or Hyperthermia? | Hyperthermia. However, hypothermia is also a complication and should not be ignored. |
| List 3 methods of preventing veinous stasis (Thrombus) | *Move legs frequently and do leg exercises *Do not use pillows under knees or calves *Avoid pressure to lower extremities *Use antiembolism stockings *Ambulate as ordered *Heparin *Sequential compression device |
| What is Dehiscense? | A breakage of sutures and seperation of flesh. |
| When is Eviceration a major concern? | 3 days to two weeks post-op |
| What do you do in the event of evisceration? | *Notify physician immediately *Cover with sterile towel moistened with warm sterile saline |
| Generally when does acute pain begin to subside? | Within 24-48hrs |
| What can ease PT anxiety? | Ventilation of feeling/concerns. |
| How often should the post-op PT be assessed for pain? (corelates to how often you should ask if the PT needs anything for pain) | Every 3-4 hours. |
| The PCA (Patient Controlled Analgesia) should be closely monitered how often? | Every 3-4 hours. |
| What does TENS stand for? | Transcutaneous electric nerve stimulation. |
| How does a TENS device work? | It applies electrical impulses to block pain signals to the brain. |
| Define: post-operative PT | The postoperative patient is one who has any type of surgical procedure performed. |
| What can affect the length of time for recovery of the post-op PT? | *Physical and mental preparation *Type and magnitude of the surgical procedure |
| When does the recovery period begin? | When the patient arrives in the hospital room or a post-surgical unit |
| How far does the recovery period extend? | Extends until after discharge from the hospital. |
| When does the recovery period end? | Ends when full activity is resumed. |
| Pain medication should be timed in relation to? | Activities, such as dressing changes or ambulation |
| Because a surgical patient's condition may change rapidly during the immediate postoperative recovery, the nurse should monitor the patient's status at least every______ minutes. | 15 minutes |
| List at least 3 S&S of a pulmonary embolism | *SHARP, STABBING CHEST PAIN *Cyanosis *Anxiety *Profuse diaphoresis *Rapid, irregular pulse *Dyspnea, tachypnea |
| Nursing interventions for a pulmonary embolism | *Notify charge nurse STAT *Administer oxygen *Have patient sit in an upright position *Reassure and comfort patient. *Monitor vital signs, EKG, and ABGs *Administer analgesics as ordered *Initiation of thrombolytic therapy |
| What is an inflammation of the alveoli as a result of an infectious process or foreign material. | Pneumonia |
| List at least 3 S&S of pneumonia | *Elevated temperature *Chills *CRACKLES OR WHEEZES ON AUSCULTATION *Dyspnea *Chest pain *Productive cough |
| Nursing interventions for pneumonia | *Semi-Fowler's for lung expansion *Administer oxygen as ordered *Maintain nutritional/fluid status *Encourage turning, coughing, and deep breathing *Frequent oral hygiene *Teach proper disposal of tissue and sputum |
| How often should leg excersizes be done to prevent thrombosis? | At least every 2 hours |
| Medical term for hiccups | Singultus |
| Nursing interventions for singultus | *Place gentle pressure over the eyelids *Rebreathe into a paper bag |
| Nursing interventions for hyperthermia | *Administer antipyretics as ordered *Apply hypothermia blanket as ordered |
| Nursing interventions for waste elimination | *Auscultate bowel sounds *Assess for abdominal distention *Assess patient's ability to pass flatus or stool *Assist with ambulation *fruit juices and high fiber foods |
| When should the nurse monitor for bladder distension post-op? | *The first 8 hours after surgery *PT voids <50cc frequently |
Created by:
Shanejqb
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