OP Flashcards
informed consent
-explained by the surgeon
-nurse can be a witness
-nurse obtains pt signature
-ensure pt understanding & agreement
iv line
should be large enough for blood products
pt should void
immeadiately preop
within 6-8hrs post op >200ml
no smoking
24 hrs pre op
prevents pneumonia & atelectasis
deep breathing & coughing techniques
incentive spirometry
chest physiotherapy
postural drainage
prevent venous statis post op
ambulation
leg and foot exercises
wearing of compression stockings or sequential compression devices
pt valuables
surrendered to the family
or locked in the hospital safe
before first ambulation postop
instruct to sit at the edge of the bed with feet supported to assume balance
unless contraindicated, position post op
low-Fowler’s position to increase the size of the thorax for lung expansion
constipation
if no defecation 48 hrs after pt resumes full diet
pulmonary embolism
sudden
-dyspnea
-sharp upper abdominal or chest pain
-low bp
paralytic ileus
NGT TD
maintain NPO until + bowel sounds
+nausea vomiting
abdominal distention
-bowel movement/sounds
wound infection
3 to 6 days post op
(⬆️ risk if immunocompromised or diabetic)
wound dehiscence
6 to 8 days post op
separation of wound edges at the suture line
common in obese & poor healing
wound evisceration
emergency
6 to 8 days post op
protrusion of internal organs through an incision
common in obese & poor healing
wound evisceration mgt
-low fowlers, knees bent
-cover wound w/ sterile nss dressing & keep moist
-call surgeon, call for help
-monitor for s/s of shock
after receiving general anesthesia
not to drive, make important decisions, or sign any legal documents for 24 hours
during exercises post op
splinting the incision (w/ pillow or 1 hand over the other)
NSAIDs & aspirin
discontinued 48 hrs pre op
clopidogrel
discontinued 5 days pre op
corticosteroids
increased temporarily pre & post op
when are sutures & staples removed
sutures: 7 to 10 days post op
staples: 7 to 14 days post op
for 6 weeks…
avoid lifting, pushing, pulling more than 10lbs
incentive spirometry
-semi-Fowler’s or high-Fowler’s
-mouthpiece covered completely and tightly
-inhale slowly, with a constant flow -breath held for 5 seconds before exhaling slowly
