FUNDAMENTALS OF NURSING CHAPTER 50
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Questions and Answers

Which of the following factors is NOT considered a risk factor for obstructive sleep apnea according to the STOP-BANG Questionnaire?

  • Aged 55 years (correct)
  • A neck circumference greater than 40 cm
  • Being male
  • Snoring loudly

    • Which classification of a surgical procedure is performed on the basis of the patient’s choice?

  • Emergency
  • Major
  • Urgent
  • Elective (correct)

    • What characteristic must a surgical procedure meet to be classified as Major?

  • Involves extensive reconstruction or alteration (correct)
  • Requires immediate performance
  • Involves minimal alteration and risks
  • Is done at the patient’s convenience

    • Which of the following is considered an urgent surgical procedure?

    <p>Excision of cancerous tumor</p> Signup and view all the answers

    How does the STOP-BANG Questionnaire assess a patient's risk for obstructive sleep apnea?

    <p>By evaluating snoring and daytime tiredness</p> Signup and view all the answers

    What is a significant risk associated with obesity during and after surgery?

    <p>Higher likelihood of wound infections</p> Signup and view all the answers

    Which factor is NOT a surgical risk factor?

    <p>Dietary supplements</p> Signup and view all the answers

    What metabolic change can lead to a higher risk for fluid or electrolyte imbalance after surgery?

    <p>Change in total amounts of body potassium and water volume</p> Signup and view all the answers

    Which of the following is a common consequence of prolonged immobility during hospitalization?

    <p>Decreased cognitive function</p> Signup and view all the answers

    What condition is characterized by nonmechanical obstruction of the bowel post-surgery?

    <p>Ileus</p> Signup and view all the answers

    What is a common post-operative symptom that indicates a complication related to gastric emptying?

    <p>Nausea and vomiting</p> Signup and view all the answers

    What is a primary intervention to manage reduced red blood cells and hemoglobin levels post-surgery?

    <p>Administer necessary blood products</p> Signup and view all the answers

    Which of the following describes a potential effect of excess weight on skin during surgery?

    <p>Restricted blood flow leading to pressure injuries</p> Signup and view all the answers

    What is a patient-specific factor that increases the risk for post-operative urinary retention?

    <p>History of urinary retention</p> Signup and view all the answers

    Which of the following is FALSE regarding the impact of obesity on post-operative recovery?

    <p>It leads to quicker recovery times.</p> Signup and view all the answers

    What is a significant nursing consideration for patients at risk of thromboembolism during surgery?

    <p>Post-operative mobility assistance</p> Signup and view all the answers

    What can prolonged anesthesia contribute to after surgery?

    <p>Urinary retention at 6-8 hours post-op</p> Signup and view all the answers

    How does smoking influence surgical outcomes?

    <p>Increases risk of postoperative complications</p> Signup and view all the answers

    Which of the following symptoms is commonly associated with urinary tract infections following catheterization?

    <p>Cloudy urine</p> Signup and view all the answers

    What is the primary purpose of an exploratory laparotomy?

    <p>To confirm a diagnosis</p> Signup and view all the answers

    Which factor is most likely to contribute to wound dehiscence after surgery?

    <p>Nutritional deficiencies</p> Signup and view all the answers

    What is the typical time frame in which wound infection usually appears post-surgery?

    <p>3-6 days</p> Signup and view all the answers

    Which of the following surgical procedures is classified as ablative?

    <p>Cholecystectomy</p> Signup and view all the answers

    What is the main characteristic of palliative surgery?

    <p>It relieves symptoms without providing a cure.</p> Signup and view all the answers

    Which condition can trigger malignant hyperthermia during surgery?

    <p>Inhaled anesthetics</p> Signup and view all the answers

    During surgery, what should be monitored to protect an older adult's cardiovascular system?

    <p>Vital signs including heart rate and blood pressure</p> Signup and view all the answers

    Which patient demographic is particularly at risk for postoperative delirium?

    <p>Older patients</p> Signup and view all the answers

    What is the recommended principle for medication administration in older adults?

    <p>Start low and go slow</p> Signup and view all the answers

    What is a key risk factor from the integumentary system during surgery for older adults?

    <p>Reduced sensitivity to pressure injuries</p> Signup and view all the answers

    Which postoperative complication is increased due to decreased respiratory muscle strength in older adults?

    <p>Atelectasis</p> Signup and view all the answers

    What is a common complication associated with moderate sedation?

    <p>Respiratory depression</p> Signup and view all the answers

    Which of the following can result in skin breakdown post-surgery?

    <p>Pressure or shearing forces</p> Signup and view all the answers

    What is a nursing implication for managing dehydration risk in older adults undergoing surgery?

    <p>Assess baseline urinary output</p> Signup and view all the answers

    What is a plausible adverse effect of neuromuscular blocking drugs (NMBDs)?

    <p>Intraocular pressure</p> Signup and view all the answers

    What does procurement for transplant involve?

    <p>Removing organs for transplant from donors</p> Signup and view all the answers

    Which of the following factors increases the risk for perioperative complications?

    <p>Obstructive sleep apnea</p> Signup and view all the answers

    What condition predisposes older adults to clot formation in the lower extremities?

    <p>Rigidity of arterial walls</p> Signup and view all the answers

    Which surgical procedure is an example of reconstructive surgery?

    <p>Scar revision</p> Signup and view all the answers

    What is a potential symptom of wound evisceration?

    <p>Protrusion of internal organs</p> Signup and view all the answers

    Which of the following nursing interventions is important for assessing older adult patients post-surgery?

    <p>Frequent assessments for delirium</p> Signup and view all the answers

    What has decreased renal function in older adults been linked to during surgery?

    <p>Increased risk of shock and electrolyte imbalance</p> Signup and view all the answers

    What is a complication associated with local anesthesia?

    <p>Skin rash</p> Signup and view all the answers

    Why is orientation important for older adults post-surgery?

    <p>To avoid confusion and delirium</p> Signup and view all the answers

    Which of the following is not considered a key point of perioperative nursing?

    <p>Avoiding patient education</p> Signup and view all the answers

    Which factor increases susceptibility to skin tears in older adults during surgery?

    <p>Decreased skin elasticity</p> Signup and view all the answers

    What should be included in a nursing intervention to prevent postoperative pneumonia in older patients?

    <p>Introduce deep breathing exercises</p> Signup and view all the answers

    Which of the following factors contributes to increased surgical complications in a patient with type 2 diabetes?

    <p>Obesity</p> Signup and view all the answers

    What is the best question for a nurse to ask a preoperative patient regarding medication?

    <p>Do you have any medication allergies?</p> Signup and view all the answers

    What is the most effective method for enhancing communication between preoperative and operating room nurses?

    <p>Using a standardized SBAR tool</p> Signup and view all the answers

    Which intervention is most effective in preventing atelectasis after surgery?

    <p>Use of the incentive spirometer</p> Signup and view all the answers

    Which of the following factors increases surgical risk in an 85-year-old patient?

    <p>Reduced diaphragmatic excursion</p> Signup and view all the answers

    In the case of a postoperative patient experiencing tachypnea, what should the nurse prioritize?

    <p>Elevate the head of the patient’s bed.</p> Signup and view all the answers

    Which nursing intervention is crucial for promoting bowel function in postoperative patients?

    <p>Early ambulation</p> Signup and view all the answers

    What complication does deep breathing exercises primarily prevent after surgery?

    <p>Atelectasis</p> Signup and view all the answers

    When dealing with a saturated surgical dressing in the PACU, what is the nurse's first action?

    <p>Notify the surgeon immediately.</p> Signup and view all the answers

    Which response demonstrates effective hand-off communication in the perioperative setting?

    <p>Presenting a thorough SBAR report</p> Signup and view all the answers

    Which of the following is the first priority for postoperative care of a patient?

    <p>Maintaining airway patency</p> Signup and view all the answers

    Which nursing action is the most beneficial for the prevention of deep vein thrombosis?

    <p>Encouraging early ambulation</p> Signup and view all the answers

    For a patient with serosanguineous drainage from a surgical wound, what is the nurse's priority response?

    <p>Report to the surgeon.</p> Signup and view all the answers

    Which intervention should be prioritized to manage a patient’s pain level effectively post-surgery?

    <p>Administering pain medication as prescribed</p> Signup and view all the answers

    Which factor related to neck measurement is considered a risk factor for obstructive sleep apnea according to the STOP-BANG Questionnaire?

    <p>Neck circumference greater than 40 cm</p> Signup and view all the answers

    Which classification describes a surgical procedure that is necessary for health but is not an emergency?

    <p>Urgent</p> Signup and view all the answers

    What is a characteristic of a major surgical procedure?

    <p>Involves extensive reconstruction and poses great risks</p> Signup and view all the answers

    What age factor is considered a risk for obstructive sleep apnea in the STOP-BANG Questionnaire?

    <p>Over 50 years old</p> Signup and view all the answers

    Which type of surgical procedure is typically performed based on the patient's choice?

    <p>Elective</p> Signup and view all the answers

    What is the primary goal of palliative surgery?

    <p>To relieve or reduce the intensity of disease symptoms</p> Signup and view all the answers

    What type of surgical procedure involves inspection of the abdominal organs through an incision in the peritoneal cavity?

    <p>Exploratory laparotomy</p> Signup and view all the answers

    Which surgical procedure involves the repair of congenital anomalies?

    <p>Constructive surgery</p> Signup and view all the answers

    What nursing implication is critical for a patient with decreased renal function undergoing surgery?

    <p>Assess urinary output for 24 hours</p> Signup and view all the answers

    What is a significant risk associated with cardiovascular system changes in older adults during surgery?

    <p>Decreased cardiac reserve leading to shock</p> Signup and view all the answers

    Which of the following is a common nursing intervention for preventing postoperative complications in older adults?

    <p>Instruct on proper coughing and deep breathing techniques</p> Signup and view all the answers

    Which physiological change may place an older adult at an increased risk for skin injuries during surgery?

    <p>Decreased subcutaneous tissue</p> Signup and view all the answers

    What intervention is important to manage the risk of postoperative respiratory complications in older adults?

    <p>Encourage frequent ambulation after surgery</p> Signup and view all the answers

    What complication can arise from decreased respiratory muscle strength in older patients after surgery?

    <p>Atelectasis</p> Signup and view all the answers

    Which of the following describes a key nursing consideration for older adults at risk of thromboembolism during surgery?

    <p>Administer anticoagulants as needed</p> Signup and view all the answers

    What is a primary reason for conducting a breast mass biopsy?

    <p>To confirm diagnosis</p> Signup and view all the answers

    Which term refers to the removal of organs and/or tissues for transplantation purposes?

    <p>Procurement for transplant</p> Signup and view all the answers

    What factor contributes to the increased risk of clot formation in lower extremities of older adults post-surgery?

    <p>Rigidity of arterial walls</p> Signup and view all the answers

    Which of the following best defines reconstructive surgery?

    <p>Surgery restoring function or appearance to malfunctioning tissues</p> Signup and view all the answers

    What is the best way to manage reduced red blood cells and hemoglobin levels post-surgery?

    <p>Ensure adequate nutritional intake and administer blood products as needed</p> Signup and view all the answers

    Which co-morbid condition is commonly associated with obesity in the bariatric population?

    <p>Obstructive sleep apnea</p> Signup and view all the answers

    What complication arises from excess weight on skin over bony prominences during surgery?

    <p>Pressure injuries</p> Signup and view all the answers

    What condition results from prolonged immobility during hospitalization?

    <p>Hospital-associated deconditioning (HAD)</p> Signup and view all the answers

    Which factor is commonly monitored to manage fluid or electrolyte imbalance post-surgery?

    <p>Electrolyte levels</p> Signup and view all the answers

    What is a significant risk factor contributing to venous thromboembolism (VTE) in obese patients post-surgery?

    <p>Impaired physical mobility</p> Signup and view all the answers

    Which surgical risk factor is linked to difficulties in wound healing?

    <p>Obesity</p> Signup and view all the answers

    What symptom is commonly associated with the development of a paralytic ileus post-surgery?

    <p>Abdominal distension</p> Signup and view all the answers

    What is a characteristic sign of urinary retention after surgery?

    <p>Bladder distension</p> Signup and view all the answers

    Which factor can complicate the closure of surgical wounds in obese patients?

    <p>Thick adipose layer</p> Signup and view all the answers

    How does increased coagulability of blood contribute to thrombus formation?

    <p>By predisposing the blood to clot more readily</p> Signup and view all the answers

    What complication may occur as a result of inadequate gastric emptying post-surgery?

    <p>Nausea and vomiting</p> Signup and view all the answers

    What physical change in older adults during hospitalization can lead to decreased muscle strength?

    <p>Prolonged bedrest</p> Signup and view all the answers

    What mechanism plays a role in developing pressure injuries during surgery?

    <p>Altered nutritional status</p> Signup and view all the answers

    What is a common sign indicating a wound infection post-surgery?

    <p>Warm, red, and tender skin around incision</p> Signup and view all the answers

    Which of the following conditions increases the risk of wound evisceration?

    <p>Wound dehiscence</p> Signup and view all the answers

    What is the primary concern when caring for older adults postoperatively?

    <p>Risk of postoperative delirium</p> Signup and view all the answers

    What complication may arise from the use of neuromuscular blocking drugs (NMBDs)?

    <p>Intraocular pressure increase</p> Signup and view all the answers

    Which nursing intervention is crucial for preventing skin breakdown after surgery?

    <p>Regular repositioning of the patient</p> Signup and view all the answers

    Which practice is part of the 7 Ps of purposeful hourly rounds?

    <p>Personal needs</p> Signup and view all the answers

    What is a common sign of malignant hyperthermia?

    <p>Increased heart rate</p> Signup and view all the answers

    What is a likely cause of wound dehiscence?

    <p>Poor aseptic technique</p> Signup and view all the answers

    What is the recommended approach for administering medication to older adults?

    <p>Start low and go slow</p> Signup and view all the answers

    What condition can contribute to respiratory depression during moderate sedation?

    <p>Obstructed airflow</p> Signup and view all the answers

    Which of the following can lead to intractable pain post-surgery?

    <p>Anxiety and positioning</p> Signup and view all the answers

    What factor is known to contribute to skin breakdown in postoperative patients?

    <p>Prolonged immobility</p> Signup and view all the answers

    What is a typical time frame for the appearance of wound infection after surgery?

    <p>3-6 days</p> Signup and view all the answers

    What is a risk associated with spinal anesthesia?

    <p>Headache</p> Signup and view all the answers

    What is the primary reason for postoperative exercises?

    <p>To prevent pulmonary and vascular complications</p> Signup and view all the answers

    Which factor should a nurse assess to minimize risks associated with a patient’s positioning on the operating room table?

    <p>Skin integrity</p> Signup and view all the answers

    Which component is NOT part of effective hand-off communication in surgical settings?

    <p>History</p> Signup and view all the answers

    What is a key postoperative priority related to airway management?

    <p>Maintaining a patent airway</p> Signup and view all the answers

    Which statement best describes the focus of intraoperative care?

    <p>Preparing patients for recovery</p> Signup and view all the answers

    What should be prioritized when caring for patients undergoing ambulatory surgery?

    <p>Patient education involvement</p> Signup and view all the answers

    Which intervention is most effective in preventing postoperative atelectasis?

    <p>Incentive spirometry usage</p> Signup and view all the answers

    Which is a significant nursing action when a patient shows signs of tachypnea in the PACU?

    <p>Elevate the head of the patient's bed</p> Signup and view all the answers

    Which complication is best addressed by early ambulation post-surgery?

    <p>Atelectasis</p> Signup and view all the answers

    Which assessment finding increases a patient’s risk for surgical complications?

    <p>Obesity</p> Signup and view all the answers

    What is a key benefit of structured protocols for hand-off communications?

    <p>Minimizes surgical risks</p> Signup and view all the answers

    Upon assessing a saturated surgical dressing with serosanguineous drainage, which action should be prioritized?

    <p>Notify the surgeon</p> Signup and view all the answers

    What is the fundamental goal of reflective learning in the context of preoperative patient assessment?

    <p>Identify patient-specific risk factors</p> Signup and view all the answers

    Which preoperative inquiry is essential for assessing safety in surgery?

    <p>Do you take any medications?</p> Signup and view all the answers

    Study Notes

    STOP-BANG Questionnaire

    • The STOP-BANG questionnaire is a tool used to assess the risk of obstructive sleep apnea.
    • Each "Yes" answer to the questionnaire represents a risk factor for OSA.
    • The questionnaire includes questions about snoring, daytime sleepiness, observed pauses in breathing during sleep, and high blood pressure.

    Surgical Procedure Classification

    • Surgical procedures can be classified based on seriousness, urgency, and purpose.
    • Major procedures involve extensive reconstruction or alterations and pose significant risks to a patient's well-being.
    • Minor procedures involve minimal alterations with minimal risks.
    • Elective surgeries are performed based on a patient's choice and are not essential or always necessary for their health.
    • Urgent surgeries are necessary for a patient's health and prevent further complications, but are not considered emergencies.
    • Emergency surgeries must be performed immediately to save a patient's life or preserve function.
    • Diagnostic surgeries confirm a diagnosis with the removal of tissue for testing.
    • Ablative surgeries involve the removal of a diseased body part.
    • Palliative surgeries relieve or reduce disease symptoms but do not cure the condition.
    • Reconstructive/restorative surgeries restore function or appearance to traumatized or malfunctioning tissues.
    • Procurement for transplant surgeries involve removing organs or tissues from deceased or living donors for transplantation.
    • Constructive surgeries restore function lost due to congenital anomalies.
    • Cosmetic surgeries improve a patient's personal appearance

    Risks for Older Adults During Surgery

    • Older adults face several physiological risks during surgery.
    • Cardiovascular: Increased risk for decreased cardiac output, hemorrhage, and clot formation in the lower extremities.
    • Integumentary: Increased risk for pressure injuries and skin tears due to decreased subcutaneous tissue and fragility.
    • Pulmonary: Decreased respiratory muscle strength and cough reflex, reduced range of movement in the diaphragm, and stiffened lung tissue, leading to increased risk for atelectasis and reduced blood oxygenation.
    • Gastrointestinal: Delayed gastric emptying, decreased saliva production, and increased risk for reflux, indigestion, and constipation.
    • Renal: Decreased renal function, reduced blood flow to the kidneys, reduced glomerular filtration rate, and reduced bladder capacity.
    • Neurological: Sensory losses, increased pain tolerance, increased risk for confusion and delirium after anesthesia, and altered febrile response with potential for hypothermia and infection.
    • Metabolic: Lower basal metabolic rate, reduced red blood cell count and hemoglobin levels, and altered potassium and water volume.

    Surgical Risk Factors

    • Several factors can increase a patient's risk for surgical complications.
    • Smoking: Contributes to respiratory complications and delays wound healing.
    • Obesity: Diminishes ventilatory and cardiac function, increases risk for postoperative atelectasis, pneumonia, and death.
    • Obstructive Sleep Apnea (OSA): Increases risk for complications during and after surgery; often coexists with other conditions like hypertension, coronary artery disease, diabetes, and heart failure.
    • Immunosuppression: Compromises immune function, leading to increased susceptibility to infections.
    • Fluid and electrolyte imbalance: Affects physiological processes and can worsen existing conditions.
    • Risk for postoperative nausea and vomiting (PONV): Can lead to discomfort and complications.
    • Risk for postoperative urinary retention (POUR): Can cause bladder distention and discomfort.
    • Risk for thromboembolism (VTE): Blood clots during surgery or recovery increase risk of pulmonary embolism or stroke.

    Pressure Injury Prevention

    • Pressure injuries are a significant risk factor for patients undergoing surgery, particularly due to prolonged immobility and altered physiological factors.
    • Intrinsic risks include factors related to the patient's tolerance for pressure injuries, like malnutrition, immobility, and reduced sensation.
    • Extrinsic factors include external pressures exerted on the body.
    • Specific OR risk factors involve positioning, medical devices, and surgical procedures.

    Venous Thromboembolism (VTE)

    • VTE involves blood clots in the veins, which can travel to the lungs causing pulmonary embolism.
    • Risk factors include prolonged immobilization, surgery, trauma, obesity, cancer, and certain medications.
    • Prevention strategies include compression stockings, early mobilization, and medications like heparin or warfarin.

    Hospital-Associated Deconditioning (HAD)

    • HAD is a decline in physical function due to prolonged immobilization during hospitalization.
    • Older adults are particularly vulnerable, and HAD can lead to muscle weakness, reduced muscle mass, cognitive decline, and overall functional impairment.

    Gastrointestinal Complications

    • Paralytic ileus is a non-mechanical bowel obstruction caused by decreased gut motility.
    • Abdominal distention occurs due to air retention during gastrointestinal surgery.
    • Nausea and vomiting can be caused by delayed gastric emptying or chemical stimulation of the vomiting center.

    Genitourinary Complications

    • Urinary retention occurs due to involuntary urine accumulation in the bladder.
    • Urinary tract infections typically result from bacterial or yeast contamination.

    Integumentary Complications

    • Wound infection: Inflammation of wound tissues due to bacterial contamination.
    • Wound dehiscence: Separation of wound edges along the suture line.
    • Wound evisceration: Protrusion of internal organs through the incision.
    • Skin breakdown: Pressure injury resulting from prolonged immobilization or shearing forces leading to tissue damage.

    Nervous System Complications

    • Intractable pain: Persistent pain that is unresponsive to various pain relief strategies.
    • Malignant hyperthermia: A rare and potentially fatal condition triggered by anesthesia and leading to muscle rigidity and fever.

    Postoperative Care for Older Adults

    • Older adults require careful postoperative care due to their reduced physiological reserves.
    • Increased risk for decreased cardiac output, fluid depletion, and delirium.
    • Careful medication management is necessary due to altered pharmacokinetics.
    • Specialized interventions like hourly rounds and 7 Ps assessments are crucial to optimize care and prevent complications.

    Complications of Anesthesia

    • General anesthesia: Potential for hypotension, heart rate abnormalities, lowered body temperature, respiratory depression, and emergence delirium.
    • Spinal anesthesia: Headaches, hypotension, decreased cardiac output, breathing difficulties, and cyanosis.
    • Neuromuscular blocking drugs (NMBDs): Increased intraocular and intracranial pressure.
    • Local anesthesia: Skin rash, allergic reactions, restlessness, bradycardia, hypotension, necrosis at injection site.
    • Moderate (conscious) sedation: Respiratory depression, bradycardia, hypotension, nausea, and vomiting.
    • Epidural anesthesia: Cyanosis, breathing difficulties, decreased and irregular heart rate.

    Key Points

    • Perioperative nursing encompasses the preoperative, intraoperative, and postoperative phases of a patient's surgical experience.
    • Preoperative assessment of risk factors helps anticipate needs and prevent complications.
    • Key risk factors include smoking, obesity, OSA, malnutrition, diabetes, cardiac disorders, and age.
    • Preoperative teaching empowers patients and reduces anxiety.
    • Postoperative exercises promote pulmonary and cardiovascular function, prevent deconditioning, and manage pain.
    • Intraoperative assessment ensures patient safety and identifies potential complications.
    • Early identification and management of complications improve postoperative outcomes.### Perioperative Care
    • Intraoperative Phases:
      • Monitoring: Increases with each phase.
      • Focus: Shifts from acute recovery to convalescence and recovery preparation.
    • Hand-off Communication:
      • Purpose: Ensures the patient receives the correct surgery at the correct site.
      • SBAR: Situation, Background, Assessment, Recommendations.
      • Standardized Protocols: Minimize surgical risks and facilitate seamless transitions.
    • Postoperative Priorities:
      • Airway maintenance.
      • Circulation and perfusion regulation.
      • Temperature control.
      • Pain management.
      • Fluid and electrolyte balance.
      • Wound care.
    • Postoperative Education:
      • Relevant, specific, culturally appropriate, and accurate.
      • Enhances self-care for patients at home.
      • Prioritize education for ambulatory surgery patients due to limited time.
      • Involve family or support systems.

    Patient Assessment & Risks for Complications

    • Risk Factors for Surgical Complications:
      • Obesity.
      • Prolonged bleeding time.
      • Delayed wound healing.
      • Ineffective vital capacity.

    Preoperative Assessment

    • Key Questions:
      • Pain assessment.
      • Exercise routine.
      • Medication schedule.
      • Allergies.
      • Drug and/or tobacco use.

    Perioperative Communication

    • Best Practices:
      • Standardized SBAR tool for clear communication.
      • Non-verbal communication techniques.
      • Specific information to transport technician.
      • Active listening to OR nurse's questions.

    Postoperative Interventions

    • Preventing Atelectasis:
      • Incentive spirometer use.
    • Postoperative Tachypnea:
      • Prioritize oxygen administration.
    • Promoting Bowel Function:
      • Early ambulation.

    Postoperative Complications

    • Risk Factors in Elderly Patients:
      • Stiffened lung tissue.
      • Reduced diaphragmatic excursion.
      • Reduced blood flow to kidneys.
    • Nursing Interventions to Prevent Complications:
      • Glasses or hearing aid for delirium prevention.
      • Early ambulation for DVT prevention.
      • Strict aseptic technique for infection prevention.
      • Deep breathing exercises for atelectasis prevention.
      • Hydration for various complications.

    Postoperative Monitoring & Interventions

    • Saturated Surgical Dressing:
      • Notify surgeon.
      • Monitor vital signs.
      • Maintain IV fluid infusion.
    • Unmanaged Surgical Pain:
      • Delayed ambulation.
      • Reduced ventilation.
      • Reduced appetite.

    Perioperative Care Phases

    • Monitoring and focus change progressively with each intraoperative phase, from acute recovery to convalescence and recovery preparation.
    • Hand-off communication uses the SBAR acronym, which includes the patient's situation, background, assessment data, and recommendations.
    • Standardized protocols for hand-off communication between perioperative healthcare providers minimize surgical risks and promote a smooth transition between each surgical phase.

    Postoperative Care

    • Postoperative priorities include maintaining a patent airway, regulating circulation and perfusion, controlling temperature, pain, fluid and electrolyte balance, and ensuring wound care.
    • Postoperative patient education should be relevant, specific, culturally appropriate, and accurate to enhance patients' ability to care for themselves at home.
    • When caring for patients undergoing ambulatory surgery, prioritize education and involve the patient's family or support system due to limited time.

    Risk Factors for Surgical Complications

    • Obesity increases the risk of surgical complications.
    • Prolonged bleeding time can lead to excessive bleeding during and after surgery.
    • Delayed wound healing affects wound closure and recovery.
    • Ineffective vital capacity compromises lung function, increasing complications.

    Preoperative Assessment

    • The nurse should assess pain, exercise routine, medication schedule, allergies, drug, and tobacco use in preoperative patients.

    Facilitating Communication

    • Standardized tools like SBAR enhance communication between healthcare providers, especially during patient hand-off.
    • Use of nonverbal communication techniques is essential for effective communication.
    • Providing specific information to transport technicians ensures accurate and timely patient transfer.
    • Listening to the operating room nurse's questions fosters collaborative communication.

    Postoperative Interventions

    • Incentive spirometer use prevents atelectasis (collapsed lung).
    • Early ambulation is a crucial intervention for preventing deep vein thrombosis.
    • Strict aseptic technique minimizes wound infection risk.
    • Deep breathing exercises prevent atelectasis and improve lung function.

    Preventing Postoperative Complications in the Elderly

    • Stiffened lung tissue, reduced diaphragmatic excursion, and reduced blood flow to the kidneys can pose challenges for elderly surgical patients.

    Addressing Postoperative Tachypnea

    • Elevating the head of the bed promotes proper ventilation and oxygenation, which are crucial for addressing postoperative tachypnea.

    Promoting Bowel Function

    • Early ambulation stimulates bowel function and prevents constipation following surgery.

    Postoperative Assessment and Intervention

    • A saturated surgical dressing requires immediate notification of the surgeon.
    • Continuous monitoring of vital signs is essential for identifying and addressing complications.
    • Maintaining intravenous fluid infusion supports hydration, particularly for patients with significant fluid loss.
    • Reinforcing the dressing should not be done without notifying the surgeon.

    Consequences of Unmanaged Surgical Pain

    • Complications associated with unmanaged surgical pain include delayed ambulation, reduced ventilation, reduced appetite, and retained pulmonary secretions.

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