POST-OPERATIVE complications
Surgical Drains
Reasons for applying a surgical drain:
1. To collapse surgical dead space
2. To drain abscess3. To provide early warning
notice of a surgical leak
4. To control an established fistula
leak
JP Drain
Penrose DrainNephrostomy Tube
General Management postopeartive
Liquid Diet Vs Soft diet
Clear liquid Full liquid Soft diet
CoffeeTeaCarbonated drinkBouillonClear fruit juicePopsicleGelatinHard candy
Clear liquid PLUS:Milk/Milk prodVegetable juicesCream, butterYogurtPuddingsCustardIce cream and sherbet
All CL and FL plus:MeatVegetablesFruitsBreads and cerealsPureed foods
Chest Physiotherapy
Post Operative Care
Objectives of Postop CareRe-establishment of physiologic equilibrium
Prevention of pain and complication
Goal of Care for Post-operative Patients
1.Promotion of
respiratory function
Goal of Care for Post-operative Patients
2. Promote cardio-
vascular function and
tissue perfusion
Goal of Care for Post-operative Patients
3. Promotion of fluid and electrolyte
balance
Goal of Care for Post-operative Patients
4. Promotion of nutrition
and elimination
Goal of Care for Post-operative Patients
5. Promotion of renal function
Goal of Care for Post-operative Patients
6.Promotion of comfort,
rest and freedom
from pain
Goal of Care for Post-operative Patients
7. Promotion of wound healing
Goal of Care for Post-operative Patients
8. Promotion of early
movement and ambulation
Goal of Care for Post-operative Patients
9. Prevention of post-
operative complications
Post-operative Complications
POST OP COMPLICATIONS
CIRCULATORY COMPLICATIONS:
a. Shockb. Hemorrhagec. Thrombophlebitis / deep
thrombophlebitis
PULMONARY COMPLICATIONSa. Atelectasisb. Pneumonia
URINARY DIFFICULTIES
a. Urinary retention
GASTROINTESTINAL COMPLICATIONS
a. Paralytic ileusb.Gas painc. Intestinal obstructiond.Hiccups
Rule of ThumbFever 1st 24 - Pulmonary infection
Within 48 - UTI Within 72 - wound infection
A. Pulmonary (48 hrs PO)
1. Pneumonia
A. Pulmonary (48 hrs PO)
2.Atelectasis
B. Cardiovascular
1. 2.Hemorrhage
Bleeding Hemorrhage
B. Cardiovascular
2.Shock
B. Cardiovascular
3.Thrombophlebitis (7-14days PO)
C. Wound complication
1.Wound infection
C. Wound complication
2.Wound Dehiscence
Wound dehiscence
Wound evisceration
D. Urinary Retention
inability to void (voiding
should return 6-8hrs
PO)
E. Gastrointestinal
1. Abdominal distention or
paralytic ileus
E. Gastrointestinal
2. Hiccups
G. Hypothermia
Immobility
Summary of Complications Respiratory
Atelectasis Pneumonia
(aspiration, hypostatic, infectious)
Embolism Cardiovascular
Hemorrhage-shock Cardiac arrest DVT Thrombophlebitis
Musculoskeletal System Muscle atrophy Contractures Osteoclast – Fx -
↑Ca Nervous System
Coma Paralysis
GIT Nausea and
vomiting Constipation Ulcer (Cushing’s) Adynamic ileus
GUT Urinary retention UTI
Wound Wound infection Wound dehiscence Wound evisceration
Integumentary Bed sore
Psychologic Depression
Postop Discharge Teaching
Assess readiness for HTAssess the need for home careWound careFollow up (sutures are removed 7-14 days)
Resume normal activities gradually
Avoid lifting for 6 weeks (>10 lbs.)
Can return to work 6-8 weeks after
Teach the s/sx of complications
To emphasizeThe over-all goal of nursing care during the PRE-OPERATIVE phase is to prepare the patient mentally and physically for the surgery
To emphasizeThe over-all goal of nursing care during the INTRA-OPERATIVE phase is to maintain client safety
To emphasizeThe over-all goals of nursing care during the POST-OPERATIVE phase are to promote healing and comfort, restore the highest possible wellness and prevent associated risk
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