Fast Facts_Pre Post Op Care-2.docx

**Fast Facts- Pre and Post Op Care** Pre-Op Care CV: history of MI before the age of 50; HTN? On blood thinners (eg heparin, warfarin, Plavix, etc) GI: ? History of constipation? Nausea? History of diabetes? GU: History of difficulty voiding? Renal failure? Skin: ?Intact CONSENT: role to the n...

**Fast Facts- Pre and Post Op Care** Pre-Op Care CV: history of MI before the age of 50; HTN? On blood thinners (eg heparin, warfarin, Plavix, etc) GI: ? History of constipation? Nausea? History of diabetes? GU: History of difficulty voiding? Renal failure? Skin: ?Intact CONSENT: role to the nurse in witnessing consent Pre-Op Checklist Post Operative Care +-----------------------+-----------------------+-----------------------+ | System | Complication | Nursing Action | +=======================+=======================+=======================+ | Neurological | Waking Up Wild | Give oxygen -- use | | | | due to hypoxia | +-----------------------+-----------------------+-----------------------+ | | Pain | Give pain medicine; | | | | non-pharmacological | | | | axns -- ice, deep | | | | breathing, | | | | distraction, etc | +-----------------------+-----------------------+-----------------------+ | | Decreased Mobility | Assess and know | | | | mobility status | | | (decreased from | pre-op | | | Pre-op assessment) | | | | | Be realistic to help | | | | patients get OOB and | | | | ambulate | +-----------------------+-----------------------+-----------------------+ | Cardiovascular | Hypertension | Usually from pain -- | | | | assess and give | | | | medication | +-----------------------+-----------------------+-----------------------+ | | Hypotension | Consider blood loss? | | | | Hypovolemia -- get | | | | hct -- look for s/s | | | | of bleeding | | | | | | | | Force fluids if they | | | | can drink | +-----------------------+-----------------------+-----------------------+ | | VT (embolism) | Look for s/s of | | | | thrombosis (discuss | | | | later in semester) | +-----------------------+-----------------------+-----------------------+ | Resp | Pneumonia/Atelectasis | Listen assess lungs | | | | for abnormal lung | | | - Decreased lnd | sounds | | | sounds, O2 sats | | | | low; with | Ambulate patient | | | pneumonia -- | | | | fever and | ~~Force fluids (if | | | discolored sputum | they can drink)~~ | | | | | | | Aspiration (inhaling | Deep breathing | | | gastric contents) | | | | | Incentive spirometry | | | | | | | | Get patient OOB | | | | | | | | Monitor breathing, | | | | look for s/s of | | | | infection | +-----------------------+-----------------------+-----------------------+ | GI | Ileus (no bowel | Assess abdomen for | | | sounds, no flatus, | tenderness and | | | patient nauseated) | presence of bowel | | | | sounds | | | | | | | | Ambulate patient | | | | | | | | Chew Gum (do not | | | | swallow) | +-----------------------+-----------------------+-----------------------+ | | Constipation | Ambulate | | | | | | | | Force fluids | | | | | | | | Hi fiber diet | +-----------------------+-----------------------+-----------------------+ | GU | Low urine output | Obtain bladder scan | | | | | | | (less than 0.5 | Consider patient (is | | | ml/kg/hr or less than | there an | | | 30 ml/hr) | obstruction?) | | | | | | | | Give fluids if | | | | ordered | | | | | | | | Check body for edema | | | | (legs, arms, lungs, | | | | etc) | | | | | | | | Possibly insert | | | | catheter | +-----------------------+-----------------------+-----------------------+ | Skin | Abnormal | Ambulate patient | | | skin/decubitus | | | | | Turn patient every 2 | | | | hours | | | | | | | | High protein/ high | | | | H2O intake | +-----------------------+-----------------------+-----------------------+ | | Dressing (bleeding) | Assess amount of | | | | bleeding -- draw an | | | | outline around bloody | | | | drainage -- date/time | | | | | | | | If saturated, notify | | | | team, take BP | | | | | | | | If staples or sutures | | | | make sure intact | +-----------------------+-----------------------+-----------------------+ | Immune | Fever | Bath patient | | | | | | | (increased WBC, fever | Monitor fever -- look | | | above 101.5F) | for area of infection | | | | (skin, lungs, etc) | | | | | | | | Give antibiotics as | | | | ordered | +-----------------------+-----------------------+-----------------------+ | | | | +-----------------------+-----------------------+-----------------------+