surgery- post-op Flashcards
before discharge from the PACU unit, what do pt’s sats need to be?
> 95% or baseline
pt has excessive bleeding in the PACU, can they go to stepdown?
no!
6 things I need to do when about to receive a post-op patient
- check ward routine
- get supplies IV pole, pump, kidney basin, mouth swabs
- supplies for assessment - VS record, pen, steth
- make the “post-op bed”
- pillows and blankets
- suction and oxygen checked
number one priority for post-op assessment!
airway and LOC!
how often do we take vs post-op?
use rule of 4 (q15x4, q30x4 and so on)
what are we most worried about for post-op vitals?
decreasing bp
what should i do as soon as patient is awake?
DB and C and leg exercises! (as long as pain is managed)
two interventions to prevent obtruction from tongue
artificial airway (if still sedated), recovery position.
when do we worry about a change in BP?
if S<90 or >160 or 25% change from baseline
the bigger the surgery, the greater the risk is for _______ (temp)
hypothermia.
how long post op do we worry about a high temp?
48 hrs after (its expected until then)
5 complications of spinal & epidural
- resp depression
- hypotension
- epidural hematoma
- infection (meningitis!)
- posdural puncture headache
how long would a pt be on IV fluids after surgery?
until they are eating and drinking well
whats the best way to know if a patients bowel is working?
ask if they’ve been passing gas
what intervention might be used for paralytic ileus?
NG to prevent green bilious vomiting
what is a life threatening complication of surgery? what are the two types?
shock, anaphylactic and hypovolemic
can a day surgery patient go home if they just stopped receiving IV opioids 14 minutes ago?
no, must wait 30
can we send a day surgery pt home with active vomiting and nausea?
no, shouuld be minimal
what are two huge things I’d want to know when receiving a patient from the OR?
how much blood/fluid was given, how much blood loss, and URINE OUTPUT
how do we treat hypoventilation post-op?
wake pt up, db&c, O2, incentive spirometry
what do we give first, fluids or vasoconstrictive agents if hypotensive/
fill then tank, then squeeze the pipes
regarding CVS, we monitor for:
dysrhythmias and DVT
what probelms related to CNS do we monitor for?
slow to waken post op, motor and sensory functions not back to baseline, signs of stroke
if pt doesn’t void for _____ hrs after surgery, then we assess
6-8
two early signs of anaphylactic shock
anxiety and impending doom, swelling of lips, tongue
if pt with anaphylactic shock has cold, clammy, mottled skin, are they likely to survive?
no
nursing care for anaphylactic shock r/t
drugs to give:
fluids to-do list:
CVS:
Urinary:
Plan:
epi, bronchodilator, steroids
get 2 large bore ivs in, NS, colloids (albumin), blood transfusion
get on tele and frequent VS
insert foley
prepare to transfer to ICU
is treatment for hypovolemic shock much different than anaphylactic?
no, just not giving EPI and cause we are looking for is different
