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Postoperative care

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QuestionAnswer
Care in the PACU Post Anesthesia Care Unit Goal: identify actual and potential problems that may occur as a result of anesthesia drugs and surgery interventions and to apply interventions appropraiately
Care in the PACU II Monitoring and management of respiratory and circulatory functions as well as pain, temperature and surgical site.
Respiratory Assessment Airway patency, rate and quality of respirations, auscultation of breath sounds, oxygen therapy and pulse oximetry.
Circulatory Assessment Heart rate and rhythm, blood pressure, art or central line monitoring, temperature, skin color and pulses.
Neurologic Assessment Level of consciousness Orientation Pupils Pain Motor/Sensory status
Urinary Assessment I & O Electrolytes Fluid totals Presence of all IV lines Irrigation solutions & infusions Surgical site: any dressings, type & amount of any drainage.
Prepare the room for the patient Bed selection Equipment Towels/basin IV pole Blood pressure machine/O2 Sats
Postoperative Patient on the Clinical Unit PACU nurse report vs Receiving nurse Reports to the receiving nurse and summarizes the operative and post operative periods. Receiving nurse transfers the patient to the bed.
Postoperative Patient on the Clinical Unit Neurological Assessment LOC Orientation Ability to follow commands Pupils assessed Sensory/motor status
Postoperative Patient on the Clinical Unit Respiratory Assessment Respiratory rate & depth of breathing. O2 Stats Skin Color Chest sounds
Nursing intervention: Respiratory Deep breathing and coughing helps to prevent alveolar collapse. Also other Interventions include: Incentive spirometer Splinting Diaphragmatic breathing Changing position Q2H Oxgenation
Postoperative Patient on the Clinical Unit Cardiac Assessment Blood pressure Heart Rate Pulse Skin color Temperature Compare with preoperative status and postoperative status. Radial & apical pulses taken.
Clinical Unit Fluid & Electrolyte imbalances Fluid deficit & overloads can occur. Monitor I & O.
Clinical Unit Urinary Assessment Examine the Urine for quantity & quality. Color, amount, consistency & odor. Assess patency of indwelling catheter. If no catheter, patient should void after surgery. If no voiding, inspect the ab, palpate the ab & percuss for distention.
Clinical Unit GI Assessment Assess for bowel sounds & distention. N & V may be caused by the anesthetic drug, delayed anesthetic drugs or resumption of oral intake too soon after surgery.
GI Implementaions Assess for ability to expel flatus. Relief of gas pains via frequent walking and repositioning. Use antiemetics for N & V.
Clinical Unit Surgical site Healing is major concern in post-op care. Type of wound, drains and expected drainage. Sanguineous-serosanguineous to serous with decreasing output.
Potential Alterations of Skin Wound infection is evident by 3rd to 5th post-op care. Redness, edema, pain & tenderness. Leukocytosis & fever Dressing changes are dictated by physician/standing orders.
Post-op Pain assessed Caused by trauma to the skin Muscle spasms
Initiation of Post-op orders Good for 24 hours. Know the correct meds
Provide information to patient & family member Wound care and dressings Side effects of drugs Correct way to take the drugs Dietary restrictions Activity level Appointments
Created by: libbygal_77
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