Download Post-Operative Care: Navigating the Recovery Journey and more Exams Nursing in PDF only on Docsity! 1 / 16 PNG 2251 Health and iIlness Post-op care questions with expert solutions 2024 1.post op care: this begins immediately after surgery is complete and continues until discharge 2.PACU: this place is located adjacent to the OR to minimize transport to anaes- thesia and surgical personnel 3. to stabilize the patient before going to the unit: What is the Goal of the PACU? 4.Baseline: What do you compare post-op BP to? 5.ABC's, breathing quality, ECG, temp, skin condition/color, neurological con- dition, PERRLA, sensory. motor input, anaesthetic, ins/outs: What are some assessments done in the PACU? 6.pt must be awake, vitals must be stable, no excess bleeding or drainage, no RD, o2 sats over 90% and report given: What is the PACU discharge criteria 7.all PACU plus.... no narcotics for 30 mins, minimal N&V, pt has voided, able to ambulate, IV out, responsible adult with them, discharge plan in writing and understood: What is the discharge criteria for ambulatory day surgery? 8. transfer to bed, vitals compared to baseline, receiving nurse gets report from PACU, head to toe done, initiation of post-op orders, early ambulation: - What are some of the first things done when a patient is transferred to the unit from the PACU? 9.muscle tone, circulation, urinary function, and respiration function: Why is early 2 / 16 PNG 2251 Health and iIlness Post-op care questions with expert solutions 2024 ambulation after surgery important? 10.Analgesics, ints/out, vital frequency, labs, activity/ weight bearing, IV solu- tion and rate, dressing change and frequency, medications: What should you look for in post-op orders? 11.24-48 Hours: for how long should you only reinforce a surgical dressing? 12.time to unit, head to toe, VS, temp, airway, LOC and movement, wounds, dressings and Darins, catheter site, bladder distention, IV site, safety, basin for emesis, emotional assessment, emesis basin, post op orders: What is part of the ongoing care and assessments for patients who have had a general anaesthetic 13.all the same for general, site should have a dressing that is dry/intact, no CSF leak, motor/sensation to extremities tested if a catheter is present the potency: What is part of the ongoing care and assessments for patients who have had a regional/epidural or spinal anaesthetic? 14.headache: a CSF leak may lead to this 15.pruritus, headache, loss of motor or sensory function, incontinence, blad- der distention: What are some side effects of a regional/spinal or epidural anaes- thetic? 16.the top down: how does sensation from a regional/epidural or spinal anaesthet- ic come back? 5 / 16 PNG 2251 Health and iIlness Post-op care questions with expert solutions 2024 37.D-dimer test(blood), angiography, CXR and clinical S&S: What are some ways that PE is diagnosed? 6 / 16 PNG 2251 Health and iIlness Post-op care questions with expert solutions 2024 38.high flow o2 and anticoagulants: what are some treatments for a PE? 39.an imbalance of o2 supply and demand: shock is due to........ 40.Hypovolemic shock: most common shock post op, decrease in circulation, inadequate supply of o2 and nutrients to body tissues 41.trauma, hemorrhage, burns, GI losses, hyperglycaemia: What are some causes of hypovolemic shock? 42.cariogenic shock: this type of shock is due to pump failure 43.obstructive shock: this type of shock is due to inadequate circulating volume, sound be a tension pneumothorax, 44.distributive shock: poor distraction of blood, less blood at the because the heart can't get it back 45.septic shock: due to infection, capillaries become permeable and blood leaks into tissues the BP drops 46.Compensates: if the body looses 15% go blood what does the body do? 47.more SNS response (increase HR, decreased BP): What happens when the body looses 30% of the blood 48.irreversible tissue damage, they end up with kidney failure, MI and other complications: What happens when the body looses 40% of blood volume? 7 / 16 PNG 2251 Health and iIlness Post-op care questions with expert solutions 2024 49.1st STOP BLEEDING, o2 therapy, horizontal position, elevate legs, Large bore IV, catheter (measure output) Drugs: What are some treatments for hypov- olemic shock? 50.the patient has voided: the replacement of K+ should be done after the patient has done this 51.frequent vitals, compare to baseline, asses pulses, assess skin colour- : What nursing assessments should you do immediately post-op in order to cor- rect/prevent shock? 52.systolic is below 90mmhg or over 160mmhg, pulse less than 60bpm or greater than 120, narrow pulse pressure, , irregular rhythm, signification vari- ation from pre-op vitals: When should you notify the anaesthesiologist something is wrong? 53.O2 therapy: what does treatment of a cardiovascular problem begin with pot-op in the PACU? 54.o2 therapy, volume status, drugs, re-warming: what are some treatments that can help with cardiovascular problems in the PACU? 55.analgesics, voiding (full bladder), pain, RD: what might cause hypertension? 56.re-warming: what corrects hypothermia induced hypertension 57.Dysrythmia: most of these seen in the PACU have an underlying cause 10 / 16 PNG 2251 Health and iIlness Post-op care questions with expert solutions 2024 75.infection: after 48 hours a moderate to marked elevation (higher than 37.7) usually indicates this? 11 / 16 PNG 2251 Health and iIlness Post-op care questions with expert solutions 2024 76.vitals, skim temperature and color, temperature assesements, observe patient for inflammation and infection: What are some nursing assessments that the nurse should pay attention to when dealing with temperature complications? 77.passive and active rewarming, monitor the pt q15mins with warming de- vices on, skin care, o2 therapy, monitoring for malignant hyperthermia?: What are some PACU nursing implementations to deal with temperature complications in the patient? 78.temps q4h, aseptic technique with IV site and wounds, encourage airway clearance, CXR and cultures if infection is spread, antipyretics for fevers over 39.4: What are some nursing implementations the clinical unit nurse can do to deal with temperature complications 79.unanticipated admission, discomfort and discharge delays: N&V are re- sponsible for significant problems in the post-op period and may be responsible for...... 80.POI post-op ileus: transient cessation of bowel motility prevents passage of intestinal contents and may affect oral intake most resolve 2-3 days with treatment 81.paralytics ileus: small bowel obstruction results when peristalsis stops, 12 / 16 PNG 2251 Health and iIlness Post-op care questions with expert solutions 2024 bowel lumen patent but contents not propelled forwards, N&V occurs 82.NG tube, chewing gum and swallowing air: What can the nurse to to help the pt with a paralytic ileus? 83.document characteristics and ask about the feeling of nausea?: What should the nurse assess in regards to nausea and vomiting? 84.osculate the abdomen in all 4 quadrants to asses bowel sounds, assess for flatulence: what are some nursing assessments for paralytic ileus and abdominal distention 85.antiemetics, oral fluids as tolerated, upright position, suction at the bed- side, slow deep breathing: What can the PACU nurse do to help with the patients nausea and vomiting 86.may resume intake upon the return of the gag reflex, NPO until bowel sounds, clear liquids, mouth care, antiemetics, NG tube or rectal tube, early ambitions, assess for peristalsis, relief of gas pains by repositioning, en- courage flatulence, suppositories, slowly progress diet: What are some nursing implementation that happen on the clinical unit? 87.urine output: low may be expected in the first 28 hrs post-op regardless of intake 88.less than 500 ml output: post-op oliguria 89.increased aldosterone and ADH from surgery stress, fluid loss/restriction, 15 / 16 PNG 2251 Health and iIlness Post-op care questions with expert solutions 2024 surgical site? 100. sanginous to serotonin-sang to serous: How should the type of drainage from a surgical site progress? 101. wound dehiscence: separation of previously joined edges may be preceded by sudden brown, pink clear discharge? 102. wound evisceration: protrusion of visceral organs through a wound 103. type of wound, color and consistency of drainage, assess position change on drainage, number of drains: What should the nurse assess when assessing wounds? 104. excessive or abnormal drainage: What should you notify the surgeon about in regards to drainage? 105. anxiety and depression: this may be more pronounced after surgery 106. fluid/electrolyte imablance, hypoxemia, sleep deprivation, sensory alter- ation or overload , drug effects, alcohol: What might contribute to confusion and delirium? 107. listen to pt, explain what is happening, reassure them, discuss activities that are expected of them: What can the nurse do to help somebody who is depressed/anxious following surgery? 108. treatment and diagnosis: the nurse should report any unusual 16 / 16 PNG 2251 Health and iIlness Post-op care questions with expert solutions 2024 behaviour to the doctor for this