Nursing Postoperative Care Flashcards

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Questions and Answers

The nurse monitors the patient for which of the following major postop complications after an abd hysterectomy? (Select all that apply)

  • Infection (correct)
  • Hemorrhage (correct)
  • DVT (correct)
  • Bladder dysfunction (correct)

The nurse is aware that signs and symptoms indicating a postop hemorrhage include which of the following? (Select all that apply)

  • Decreased hemoglobin (correct)
  • Decreased blood pressure (correct)
  • Increased hemoglobin
  • Increased blood pressure

Which of the following interventions should the nurse consider to minimize the risk of postop DVT? (Select all that apply)

  • Avoid pillows under knee (correct)
  • Encourage early ambulation (correct)
  • Apply anti-embolic stockings (correct)
  • Keep the patient immobilized

The nurse should assess the effectiveness of the pain medication within 30 minutes after administration.

<p>True (A)</p> Signup and view all the answers

The nurse monitors the patient's response to pain medications, especially opioid medications such as morphine, for adverse effects. Which of the following would reverse the effects of morphine?

<p>Naloxone (Narcan) (D)</p> Signup and view all the answers

The nurse identifies a decrease in urine output in the postop patient and considers which of the following as a potential cause? (Select all that apply)

<p>Hypovolemia (A), Decreased cardiac output (B), Urinary retention (C)</p> Signup and view all the answers

Mrs. Bowman underwent an abd hysterectomy with salpingo-oophorectomy. In addition to the removal of the uterus, this procedure involves the removal of which of the following?

<p>Both fallopian tubes and ovaries (C)</p> Signup and view all the answers

Which of the following nursing actions are appropriate for a patient receiving opioid therapy for pain? (Select all that apply)

<p>Monitor sedation and respirations (D)</p> Signup and view all the answers

If Bowman is found unresponsive and not visibly breathing, which of the following should be the nurse's priority intervention?

<p>Check the pulse (C)</p> Signup and view all the answers

If Bowman had been found unresponsive with no pulse, the nurse's next immediate priority intervention would be which of the following?

<p>Start chest compressions (B)</p> Signup and view all the answers

What does the nurse determine was the cause of Bowman's unresponsiveness?

<p>Opioid intoxication</p> Signup and view all the answers

Bowman is receiving ondansetron (Zofran) for nausea. Which lab value should the nurse monitor related to potential adverse effects of this drug?

<p>AST, ALT (A)</p> Signup and view all the answers

What are the specific assessments that the nurse monitors to detect the complication of hemorrhage following a hysterectomy? (Select all that apply)

<p>Perineal pad count (A), Abdominal dressing (B), Vital sign trends (D)</p> Signup and view all the answers

Flashcards

Hysterectomy complications

Infection, hemorrhage, bladder dysfunction, and deep vein thrombosis (DVT).

Signs of Hemorrhage

Decreased blood pressure and hemoglobin levels signify postoperative hemorrhage.

Minimizing DVT Risk

Apply anti-embolic stockings, encourage early ambulation, avoid pillows under knees.

Pain Management Assessment

Assess effectiveness of pain meds, especially within 30 minutes.

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Opioid reversal agent

Naloxone (Narcan) reverses opioid effects like respiratory depression.

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Decreased urine output

Assess pulse, cardiac output, hypovolemia, or urinary retention.

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Hysterectomy Defined

Uterus, fallopian tubes, and ovaries are removed.

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Opioid Therapy Monitoring

Monitor sedation and respirations to prevent respiratory depression.

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Unresponsive patient

First, check for a pulse.

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Treating pulseless patient

Start chest compressions, following the “C-A-B” sequence.

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Unresponsiveness cause

Opioid intoxication caused respiratory depression and drowsiness.

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Monitoring Ondansetron effects

Essential to monitor AST and ALT to detect potential hepatic side effects

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Hemorrhage Detection

Monitor perineal pad counts, vital signs, and abdominal dressing drainage.

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Study Notes

Postoperative Complications

  • Major postoperative complications after an abdominal hysterectomy include infection, hemorrhage, bladder dysfunction, and deep vein thrombosis (DVT).

Signs of Hemorrhage

  • Signs indicating postoperative hemorrhage encompass decreased blood pressure and decreased hemoglobin levels.

Minimizing DVT Risk

  • Interventions to reduce the risk of postoperative DVT include applying anti-embolic stockings, encouraging early ambulation, and avoiding the use of pillows under the knees.

Pain Management

  • Nurses need to assess the effectiveness of pain medications, particularly within 30 minutes after administration to ensure proper pain management.

Opioid Adverse Effects

  • Monitoring for adverse effects of opioid medications such as morphine is essential, with naloxone (Narcan) being the reversal agent for opioid effects.

Urine Output Concerns

  • Decreased urine output in postoperative patients may indicate potential causes such as decreased cardiac output, hypovolemia, or urinary retention.

Surgical Procedure Details

  • An abdominal hysterectomy with salpingo-oophorectomy involves removing the uterus, fallopian tubes, and ovaries, while the vagina, ureters, and bladder remain intact.

Opioid Therapy Monitoring

  • Patients on opioid therapy require close monitoring of sedation levels and respirations to prevent respiratory depression.

Emergency Response Protocols

  • In cases where a patient is unresponsive and not visibly breathing, the first priority intervention is to check for a pulse.

Cardiac Arrest Procedure

  • If a patient is unresponsive and lacks a pulse, the immediate action is to start chest compressions, following the "C-A-B" sequence for CPR.

Opioid Intoxication Cause

  • Opioid intoxication, leading to respiratory depression and drowsiness, was determined to be the cause of the patient's unresponsiveness.

Monitoring Ondansetron Effects

  • When administering ondansetron (Zofran) for nausea, it is crucial to monitor liver function tests, specifically AST and ALT, to detect potential hepatic side effects.

Hemorrhage Detection Assessments

  • To identify hemorrhage complications post-hysterectomy, nurses should monitor perineal pad counts, observe vital sign trends, and inspect abdominal dressings for drainage.

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