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68wm6 p2 post-op

Post operative PT care

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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