Med Surg: Postoperative Flashcards
What should report from the ACP to the circulating nurse be
General patient information surgeon and surgical procedure indication for surgery unexpected events type of anesthesia; tolerance and reaction other medications given pre operation job current vital sign blood loss; Flooter placement/blood transfusions respiratory status; intubated or oxygen urinary status; foley or urine output Iv line and location; IV fluids dressings and Drain Intraoperative labs
When does the postoperative begin
Immediately after surgery and continues until the patient is discharged medical care, immediate postop stage; completion of surgery until four hours after surgery
Intermediate; 4 to 24 hours after surgery
Extended; 24 hours until discharge from medical care
What should the initial patient assessment consist of
Vitals airway breathing: ET tube, sounds, depth circulation: rate, rhythm, BP, capillary refill, temp, skin color neurologic: LOC, pupils genitourinary surgical site: dressing Pain
What is the criteria for discharging from the PACU
Achievement assessment score of eight out of 10 and recovery score involving activity, respiration, circulation, consciousness, and oxygen saturation Stable vital signs No overt bleeding Adequate pain control Return of gag, cough or swallow reflex
Once a patient is deemed stable to be discharged from the PACU what happens
Home or admitted to a nursing unit
What items should be included on Postop Orders?
Diet: NPO, clear liquids
Activity: restrictions,
IV fluid: what and how long
Analgesics: pain control, PCA or routine oral, several may be used
Antiemetics
Drain/NG care: closed/open, suctions, strip tubing, heparin
Voiding
DVT prevention measures: leg exercise, low wt
VS parameters
Wound/dressing care
Respiratory care/incentive spirometry: cough, deep breath, nebulize
Follow up labs
Resume of home meds
What to assess and care for upon admission to unit
Time of arrival: basic airway, breathing and circulation check Vital signs and pulse ox Neurologic status Pain level Would, dressing, drains Skin color and appearance Urinary status Position of patient Check IV infusion Place call light and orient to unit Emesis basin and tissues Emotional assessment and support Caregiver Check and carry out any other post-op orders.
