Peri-operative (Pre-operative and Post-operative) Flashcards
PACU/Recovery Room purpose
ongoing evaluation and stabilization of patients
anticipate, prevent and manage complications after surgery
hand off report
two way verbal interaction
report between two health care professionals is required to communicate the patient’s condition and needs
Assessments in PACU
history
initial assessment- LOC and awareness, Respiratory assessment, temp, pulse, resp, BP, O2 sat, examine surgical site for bleeding and drainage
discharge from PACU
determined by health care team
criteria for discharge: stable VS, normal temp, no overt bleeding, return of swallow and gag reflux, ability to take liquids, adequate UO
places people can be discharged to
hospital unit- ICU, telemetry, med surg
home
respiratory complications of surgery
atelectasis
pneumonia
PE
laryngeal edema
ventilator dependence
pulmonary edema
cardiovascular complications of surgery
HTN
hypotension
hypovolemic shock
dysrhythmias
VTE (venous thromboembolism)
DVT
heart failure
General complications of surgery
sepsis
anemia
anaphylaxis
pressure ulcer
wound infection
wound dehiscence
wound evisceration
skin rashes or contact allergies
gastrointestional complications of surgery
paralytic ileus
gastrointestinal ulcers and bleeding
neuromuscular complications of surgery
hypothermia
hyperthermia
nerve damage/paralysis
joint contractures
kidney/urinary complications from surgery
UTI
acute urinary retention
electrolyte imbalance
AKI
stone formation
focused assessment after discharge from PACU
airway
breathing
mental status
surgical incision site
vital signs
IV fluids
tubes (foley, NG monitor output)
pain assessment and management
common reactions after surgery
postoperative n/v
decreased or no peristalsis for up to 24 hours
paralytic ileus
constipation
Labs for after surgery
electrolytes
CBC
ABGs
Urinanalysis
Creatinine
Priority patient problems after surgery
potential for hypoxemia
potential for wound infection and delayed healing
acute pain
interventions to prevent hypoxemia
airway maintenance
monitor O2 sat/pulse ox
positioning
oxygen therapy
breathing exercises
movement/mobility
preventions for wound infection and delayed healing
dressing changes
asses wound for infection
assess drains
drug therapy
wound complications
dehiscence- partial or complete separation
evisceration- total separation of all wound layers and protrusion of internal organs
managing pain
drug therapy
relaxation
distraction
massage
positioning
patient teachings on discharge
prevention of infection
care and assessment of surgical wound
management of drains and catheters
nutrition therapy
pain management
drug therapy
peri-operative
combination of pre op, intra op and post op
pre-operative
begins when the patient is scheduled for surgery and ends at the time of transfer to the surgical site
post-operative
starts with completion of surgery and transfer of the patient to a specialized area of monitoring such as the PACU and may continue after discharge from the hospital until all activity restrictions have been lifted
primary roles of the nurse
educator, patient advocate, and promoter of health
1st priority ALWAYS
patient safety