postoperative Flashcards
POD
post op day 1= day after surgery
potential respiratory complications
airway obstruction
- hypoxemia
- atelectasis
- pulmonary edema
- aspiration
- bronchospasm
how to position pt for lower risk of tongue obstructing airway
on their side
%O2 sat to be considered hypoxemia
less than 90
2 hallmarks of hypoxemia
- causes agitation
- number one cause of atelectasis
result of atalectasis on breathing pattern and lungs
hypoventilation
mucous plugs
sign of pulmonary edema
pink frothy sputum
positioning awake vs asleep
asleep: lateral side lying position
awake: fowlers
nursing interventions post op
- give O2
- incentive spirometer
- TC&DB
- position changes
post-op HTN signs and caused by?
pain
anxiety
bladder distention
respiratory distress
-CNS stimulation (stress response)
VTE
venous thromboembolism
high risk for VTE
obese, immobilized, previous VTE
3 specific cardiac things to monitor
BP, HR, rhythm
MOST significant general nursing intervention after surgery
early ambulation
how soon to start back on anticoagulants post-op
within 24 hours
what is a plexipulse
compression device for the feet
common post-op pain
- d/t local tissue damage
- muscle spasms
- sore throat
bad/abnormal type of pain post op
deep pressure in viscera
how long to give opioids post op
at least 48 hours
what not to give opioids for
gas pain – makes worse
causes of hypothermia post op
cold irritants and gases
prolonged anesthesia
open cavity procedure
what % does shivering increase your oxygen consumption
500%
when is a fever considered a fever post op
48 hours post op
what to treat shivering with
opioids
ways to provide warmth
warm blankets, radiant warmer, warmed IVF
fever before 48 hrs post op can be due to…
stress responses (p. 377 T. 20-7)
fever nursing actions
asepsis
antipyretics
incentive spirometer
antibiotics
common GI things post op
N/V most common
ileus
hiccups (singultus)
what is emergence delirium
a short-term neurologic change manifested by restlessness, agitation, disorientation, thrashing, and shouting.
causes of emergence delirium
anesthetic agents
bladder distention
pain
long duration of preoperative fasting
residual neuromuscular blockade
presence of endotracheal tube
potential oliguria cause
increased ADH and aldosterone-> increased retention
ideal urine output in 24 hours
800-1500mL
remove catheter within how many hours post op
24 hours
5 criteria for discharge
pt awake
VS stable
hemostasis
pain controlled
minimal N/V
hospital acquired pneumonia
developed 48 hours or more after admin
ventilator acquired pneumonia
developed 48-72 hours after intubation
possible cardiovascular recovery complications
fluid retention from stress response
hypokalemia
VTE
syncope
neurological complications in recovery
agitation
delirium (most common in elderly)
anxiety/depression
alcohol withdrawal
age related GI/GU changes
- increased gastric pH
- less peristalsis
- less freq. BMs (consistency is more important than freq.)
- fewer nephroms -> dec. GFR
- men: BPH
- women: stress incontinence
best wasy to prevent infection
hand washing
antibiotics
