Week 3 : Post Op Flashcards
PACU/recovery room
pt is in recovery
what does the setting look like in pacu
no individual rooms, no walls, open space ( therefore nurse can watch all )
emergency equipments are in the head of the bed and the sides
if a pt has a problem whats the time frame usually like
1 to 2 hours post op
pacu/recovery room
stay until awake, stable
discharge from pacu if
loc, vs, bleeding/drainage is normal
resp status, 02 sats
reports given
true or false. for a pt to be discharged they have to be back on their loc ( understand, foloow comman,ds tlak )
protect their airway
no access bleeding or drianage
controlled or expected amount ( breathing on their own ) -> back on their own
true
pacu/recovery room
discharge from day surgery
what is the big thing here ?
if they had day surgery ( big thing here is responsible adult with them and take them home, understand and written discharge instructions )
discharge from day surgery
characteristics
- PACU D/C criteria met, IV opioids, N&V
- Voided, ambulate,
- Responsible adult with them, written D/C criteria
what are some thing that dont happen in pacu/rr
visitors, meals and they dont eat here, not up and walking, no consults , no social work would be involve and coming into he recovery area
- Patient’s Name/ Age/Surgeon/Procedure
- Reason for Surgery / comorbidities/ Past history/Allergies * Type of Anesthetic /Blood loss and fld replacement totals * Any complications in OR or in PACU
- Most recent report of LOC/Vital Signs/02 sats
- Urine output
- Surgical site/drsg
- Lines/tubes /drains and amount drained
- Lab results if taken
- Pain and Nausea control and what was given for it
- Family present and where they are
are things for report from or/recovery to clinical unit - on the phone “ get report on the phone”
recall that those are important now give a bit of description
the pt stays in the recovery room until they are ready
caring for the rest of their shift
list of what they need to talk about
preparing for the post op pt on the unit
what are we checking item wise
check ward routine
iv pole, iv pump, kidney basin, mouth swabs
vs record, pen, stethoscope
post op bed
pillows, blanket
are these important when it comes to preparing for the post op pt on the unit ?
- Suction/Oxygen – hook it up, check it…
- Post-op Sponge bath – Assessment**- talk to patient
- IV access, dressings (mark ‘shadowing’), do thorough head to toe and chart it! Get full baseline assessment. What does pt look like NOW?
- Check skin…pressure/redness? Look at their body – you are the nurse!
yes
what is a good thing to do for the pt when u are preparing for the post op patient on the unit
good assesment and putting on a fresh gown and changing sheets
looking at their entire body
turn them on their sides and back
( any pressure or redness ) = skin
a good HEAD TO TOE!!!!
PACU - common problems seen with pts and rns intervene
airway - obstruction
resp insuffiency
*Cardiac issues – BP, rhythm
* Neurological
* Temperature
are pain and n and v in PACU - common problems seen with patients & RNs intervene
yes
why is obstruction or airway a common problem ?
from the block the pts tongue, if they are sedated , there tongues could be closed down
why could resp insufficiency be common problem in pacu
hypoxemia or hypoventilation or hypercapnia
too shallow or too slow and not able to get oxygen or clear c02
why is the typical intervention if the bp is too low when it comes to pacu patient
too low = give iv fluids common thing ( bolus ) 250 or 500 ml ringers lacte or saline
if its too high - pain or needing antihypertensive
we need it normal range
arrhythmia could also be seen
what is an example of neurological that could be a common problem in pacu
emergency delirium
aggressive and med is given is impacting their neurological status ( narcotics or sedatives )
true or false.
alot of adipose tissue= they take longer to wake up
true
initial post op assessment and. are priorities
airway/assess LOC
- 02 per NP
VS- T, P, RR, BP
- rule of 4
fluid - input ( iv) and output ( tubes )
- any kinks? running well? interstitial ?
true or false. this is initially talking about the frequencies when u are checking the fluid.
true
true or false. by the time goes to the unit, the surgeon comes down or change abt iv fluid or watching for those.
true
initial post op assessment and care priorities
surgical site : what undergoes this
small amount blood on drainage is okay - dont change it , can reinforce it
what is okay, during initial post op assessment that could be seen as a ‘risk’ ?
small amount of blood is fine in the dressing