Monitoring Techniques and Postoperative Care

Study Notes

Monitoring Techniques and Symptoms

Enhanced monitoring techniques are critical for identifying early symptoms of complications like increasing end-tidal CO2 and heart rate.
Late symptoms can include hyperthermia, which indicates a serious condition requiring immediate intervention.

Treatment Protocols

Administer Dantrolene Sodium at 2.5 mg/kg IV every 5 minutes until symptoms resolve; it's a skeletal muscle relaxant.
Provide 100% oxygen and address hyperkalemia and arrhythmia as necessary.
Regular renal function monitoring, including Foley catheter output assessment, is vital.
Implement cooling strategies to reduce body temperature, such as:
- Cooling blankets
- Cold saline IV solution
- Ice packs
Treatment should cease once core temperature falls below 38°C.

Postoperative Phase

Begins upon entry into the post-anesthesia recovery area and lasts until hospital discharge.
The Post-Anesthesia Care Unit (PACU) focuses on immediate recovery.
Ongoing nursing assessment covers several areas:
- Pulmonary: Verify the airway, check gag reflex, assess bilateral breath sounds, and encourage deep breathing.
- Circulatory: Compare vital signs to baseline and evaluate tissue perfusion for any mottling.
- Neurological: Monitor level of consciousness, reflexes, and movement.
- Genitourinary: Track intake/output and evaluate urinary output for color, clarity, and quantity.
- Gastrointestinal: Check bowel sounds and watch for abdominal distention.
- Integument (Skin): Assess skin color, wound condition, and drainage from insertion sites.

Postoperative Nursing Interventions

Verify IV fluid type, flow rate, and administration site.
Inspect dressing for drainage type and volume to monitor for complications.
For NG tubes, record suction type and quantity.
Position patients in Semi-Fowler’s to enhance oxygenation.
Monitor oxygen saturation levels and maintain thermoregulation by checking temperature every 4 hours.
Ensure pain management while keeping the patient NPO until alertness and a gag reflex return.
Pay special attention to discharge instructions for ambulatory surgery patients, who go home on the same day.

NCLEX Practice Scenario

For a client post-total hip arthroplasty in the PACU who is unresponsive to verbal stimuli, the first action for the nurse should be to assess dressings, ensuring prompt identification of any potential complications.

Description

This quiz explores essential monitoring techniques and treatment protocols for postoperative care. Focused on early symptom detection and intervention strategies, it includes key measures for managing complications like hyperthermia and hyperkalemia. Test your knowledge on the critical aspects of patient recovery and effective interventions.