chapter 19: postop care Flashcards
______ ____ is admitting ambulatory surgery pts directly to phase 2 care
fast tracking
which phase of post anesthesia?
care during immediate post anesthesia period
phase 1
which phase of post anesthesia?
ECGs used and more intensive monitoring
phase 1
which phase of post anesthesia?
ambulatory surgery pts
phase 2
if pt received regional aesthetic, check ______
dermatomes
in PACU the most common causes of airway compromise include (3)
obstruction
hypoventilation
hypoxemia
greatest risk for respiratory distress occurs in first _____ following surgery
24 hours
an airway obstruction is commonly caused by blockage of airway by ____ ______
pts tongue
hypoxemia is a partial pressure of arterial oxygen less than ____
60
______ is the most common cause of atelectasis
hypoxemia
common causes of respiratory problems for postop pts in the clinical unit are _____ and ______
atelectasis
pneumonia
the use of _____ and _____ muscles can indicate respiratory distress
abdominal
accessory
most common cause of hypotension in PACU is _____ and _____ _____
fluid and blood loss
primary heart dysfunction results in
acute drop in cardiac output
secondary heart dysfunction occurs as a result of
negative chronotropic and negative inotropic effects of drugs
_______ in PACU most frequently result of SNS stimulation
hypertension
hypertension in the PACU is most frequently the result of _____ ______
SNS stimulation
fluid retention is caused by the secretion and release of ______, ______, and activation of ______
-antidiuretic hormone (ADH)
-ACTH
-RAAS
antidiuretic hormone release leads to increased ____ _______ and decrease ____ _____
water reabsorption
urine output
ADH release results in increased ______ ______
blood volume
urine output indicative of adequate renal function
0.5mL/kg/hr
if delirium occurs, first suspect ______
hypoxia
most common cause of postop agitation is ______
hypoxemia
hypothermia is body temp less than
96.8 F
wound infection from ____ organisms often accompanied with fever that spikes in afternoon or night and returns to near normal levels by morning
aerobic
surgical pts who take antibiotics for a period of time at risk for ___ ____
c diff
intermittent high fevers accompanied with shaking chills and diaphoresis suggests ______
septicemia
increased ______ _____ levels seen with malignant hyperthermia
creatine kinase
_____ and _______ are the most common post op complications
nausea
vomiting
most common health care acquired infection
surgical site infection
after abdominal surgery motility in the large intestine may be reduced for ____-____ days
2-5
sudden discharge that is brown, pink, or clear would indicate
wound dehisenence
if the pt responds to verbal stimuli postop, gradually elevate the head of the bed to ____ _____ position
semi fowlers
urine output less than ____mL/hr can indicate hypovolemia
30
in order to be discharged from the PACU the pt must have an Aldrete score of ___-____
8-10
encourage gum chewing post op to stimulate _____ _____ and promote the return of ______ _____
gastric secretions
intestinal peristalsis
an airway obstruction often manifests as _____ or _______
stridor
snoring
______ can prolong QT
zofran
pt can be discharged from ambulatory surgery if no IV ____ were given in the past ________
opioids
30 mins
