Post operative nursing needs Flashcards
What are some nursing considerations for post operative care?
- stress reduction
- life stage
- nutrition
- surgery type
- infection control
- wound care
Why should a nurse consider stress reduction for a patient?
Stress greatly increases healing time.
There should be separate wards for different species. Consider use of a hormone spray such as feliway or pet remedy. The ward should be kept quiet and dimmed if possible - photoperiod should be observed.
Rabbits specifically should have a friend brought with them
Why should a nurse consider life stage for a patient?
Particularly old or arthritic animals will large beds and bottom kennels. Neonates will need to be kept warmer as they cannot thermoregulate. Life stage may also affect things like IVFT
Why should a nurse consider a patient’s nutrition?
Neonates will require higher calories and more regular meals. Rabbits should not be starved to prevent ileus. No new diets should be started to prevent the Garcia effect
Why should a nurse consider the type of surgery a patient has had?
Type of surgery will affect positioning and handling e.g. ophthalmic patients should not have slip leads
Define an OTOMY
A temporary opening. It denotes a procedure for cutting open tissue during surgery
What are some examples of ‘otomies’?
Rhinotomy, tracheotomy, thoracotomy, gastrotomy, enterotomy, urethotomy, cystotomy, , myotomy
What is a rhinotomy?
A surgical procedure that involves making an incision in the nose for a variety of purposes
What is a tracheotomy?
A surgical procedure that creates an opening in the neck into the trachea
What is a thoracotomy?
A surgical procedure that allows access to the chest cavity and organs, such as the heart, lungs, oesophagus, aorta or spine
What is a myotomy?
A surgical procedure that involves cutting muscle to relieve constriction. Often performed in the gastrointestinal or urological system
What is an enterotomy?
A surgical procedure that involves making an incision in to the intestine
What is a gastrotomy?
A surgical procedure that involves making an incision into the stomach wall to access the stomach. Common to remove foreign objects from the stomach, or to take gastric biopsies
What is a cystotomy?
A surgical procedure that creates an opening in the bladder to drain urine
What is a urethrotomy?
A surgical procedure that involves cutting a stricture in the urethra to improve urine flow and relieve blockages
Define an OSTOMY
A maintained opening. It is an opening which communicates with the outside through the skin
What are some examples of ‘ostomies’?
Pharyngostomy, tracheostomy, gastrostomy, jejunostomy
What is a pharyngostomy?
A small rubber tube that allows food to bypass the mouth and be delivered to the stomach. It is inserted through a small incision in the side of the neck and enters the oesophagus through the pharynx
What is a tracheostomy?
A surgical procedure that creates an opening in the neck to insert a tube into the trachea
What is a jejunostomy?
A surgical procedure that creates an opening in the abdomen and the jejunum to allow for a feeding tube to be inserted
What is a gastrostomy?
A surgical procedure that creates an opening in the abdomen that allows a feeding tube to be inserted into the stomach
Define an ECTOMY
Surgical removal of part or all of a structure
What are some examples of ‘ectomies’?
Lung lobectomy, pancreatectomy, cholecystectomy, colectomy, nephrectomy, orchidectomy, ovariohysterectomy, splenectomy, ostectomy,
What is a pancreatectomy?
As surgical procedure to remove part or all of the pancreas. Often performed to treat pancreatic cancer, or severe chronic pancreatitis
What is a cholecystectomy?
A surgical procedure to remove the gall bladder
What is a lung lobectomy?
A surgical procedure to remove the lobe of a lung
What is a colectomy?
A surgical procedure to remove part or all of the colon
What is a nephrectomy?
A surgical procedure to remove part or all of a kidney
What is an orchidectomy?
A surgical procedure to remove one or both testicles
What is an ovariohysterectomy?
A surgical procedure to remove the ovaries and the uterus
What are some particular nursing needs for abdominal surgery patients?
- regular pain scoring
- INVFT
- warming to prevent hypothermia
- the wound may require a dressing
- appropriate nutrition
- may require catheterisation due to reduced movement
What is a splenectomy?
A surgical procedure to remove the spleen, either partially or fully
What are some examples of abdominal surgeries?
Ex laps, ovariectomy/ovariohystectomy, splenectomy, cholecystectomy, enterectomy/enterotomy, laparotomy, c-section, diaphragmatic hernia repair
What is an ostectomy?
A surgical procedure that removes part or all of a bone
What is an effective method of warming abdominal surgery patients when under GA?
Fluid warmers can be used to warm fluids that will be used to lavage the abdomen
What is open peritoneal drainage?
The abdomen is not fully closed, and it is lavaged again during abdominal surgery
Which of the plasma proteins is most likely to be lost by patients undergoing abdominal surgery?
Albumin
Define LAVAGE
To wash out an area with sterile fluid
What type of drape should be used when lavaging?
A waterproof one, to prevent hypothermia
What is the technique for abdominal lavage?
- take abdominal fluid for sensitivity and culture if needed
- use sterile isotonic fluids at body temperature
- repeat until the fluids come out clear
- remove all fluids when finished
- use omentum to cover any potential sites of leakage
- when redraping - place new drapes over the top of contaminated ones
- do not use topical antibiotics or antiseptics
Define OMENTUM
The peritoneal folds
What are some examples of orthopaedic surgery?
Fracture repair, lateral suture, TPLO, TTA, femoral head and neck excision, CCWO, amputation
What are some specific nursing needs for orthopaedic patients?
- strong and frequent analgesia
- antibiosis
- management of a cast/dressing/fixture
- increase protein in the diet
- controlled and restricted exercise
- physiotherapy
- urinary catheter, especially if non ambulatory
What dietary change is often beneficial in orthopaedic patients?
Increased protein to assist muscle regrowth and bone healing
What are some examples of spinal surgeries?
Discectomy, laminectomy, spinal fracture repair
What is a discectomy?
Removal of a full or part of a herniated spinal disc
What is a laminectomy?
The removal of bone spurs and tissues associated with things like arthritis to remove the pressure on the spine
Spinal surgery candidates are at particular risk from what?
- pneumonia (hypostatic changes)
- decubitus ulcers
- dermatitis
- limb oedema
- muscle wastage due to lack of movement
- cauda equina - affects the lower back, bladder and bowel function
- UTI from repeated catheterisation
What are some specific nursing considerations for spinal patients?
- Urinary catheter placement
- analgesia, and regular pain scoring
- regular turning (q2 hours) to prevent decubitus ulcers
- regular reflex checks to monitor function
- mental stimulation
What are some examples of respiratory tract surgeries?
- laryngeal paralysis surgery
- rhinotomy
- oronasal fistula repair
- tracheostomy
- thoracotomy