Wk 3 Postoperative Care Flashcards
When someone comes out of the order, all orders need to be
rewritten by the surgeon
What should a PACU hand off report look like?
General information
Patient history
intraoperative management and evens
What does intraoperative management and events include?
Most recent vital signs, lab and test results, how much blood the patient has lost
What is included in the initial PACU assessment? (6 things)
ABCs Neurological Surgical and IV site GU/GI Pain Patient safety needs
Why is hypoxia a potential complication for post op patients? (4 things)
Shallow breathing, anesthesia, resp depression
Obesity
Airway obstruction
Laryngospasm
What are two other potential respiratory complications to be aware of for post op patients?
Atelectasis
Pneumonia
What are nursing interventions for hypoxia?
Reposition if can Keep head of bed elevated VS O2 sat Oxygen Suctioning Coughing, splint prn Incentive spirometry Turn q2 Early ambulation Pain management
What is splinting?
Keep pressure of incision site, such as squeezing a pillow when coughing or keeping the incision together with hands
What are possible cardiovascular issues for a post op patient?
Decreased CO
DVT/PE
What should the nurse monitor for decreased CO?
BP
HR
Pulses
skin temp/color
DVTs are most often seen in patients who are…
Elderly
Obese
Immobilized
What is a good technique to teach patients to promote venous return?
Dorsi/plantar flexion, and circumducting feet
What BP should you notify the provider of?
Less than 90, greater than 160
What should you do for a patient with hypotension with a normal pulse, and warm/pink skin who is post op?
Just monitor, this is usually vasodilation from anesthesia
What should you do for a patient who is hypotensive with rapid or weak pulse, and cold/clammy skin?
They need immediate intervention, notify HCP, could be hypovolemic shock
If a patient has an abnormally low BP but is asymptomatic…
Compare to baseline, you may not need to notify provider if that is normal for them
You should notify the provider of a pulse of…
Less than 60 or greater than 120, depending on other signs and symptoms
What is pulse pressure?
Difference between systolic and diastolic pressure
What does it mean if someone has a narrow (small) pulse pressure?
Could be an indication of hemodynamic compromise
A blood pressure that gradually increases or decreases over several readings should… or a change in heart rhythm should….
Catch your eye!
How to prevent cardiovascular post op problems (4 things)
SCDs
Ambulation
Phlebitis assessment
Monitor and protect wound
Why are SCDs more often used than TEDs?
Because if the TED hose doesn’t fit correctly it can lead to pressure injuries
Restless patients… Always think __
Hypoxia