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8/6/2019 JENNY.general Goal of Post-Operative Care
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J E N N I F E R A N N E Z A I D EB S N I I I 2
GENERAL GOAL OF
POST-OPERATIVE CARE
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RECOVERY FROM BOTH THE SPECIFIC PHYSIOLOGIC
CHANGES AND THE GENERAL INFLAMMATORY
RESPONSE DUE TO THE SURGICAL PROCEDURE
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CARING FOR WOUNDS
Types of wound healing:
Primaryintention
a.k.a.primary wound healing
Wound edgesare brought togetherso that theyareadjacentto each other
Secondaryintention
a.k.a.secondary wound healing orspontaneous healing
Wound isleft open to heal without surgicalintervention
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CARING FOR WOUNDS
Surgical drains
Allow escape of fluids
Drainage from wound systemsis recorded
Amount of blood drainage on thesurgical dressing isassessed frequently
Spots of drainage
Excessiveamounts of drainage
Increasing amounts of fresh blood on the dressing
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PENROSE DRAIN
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PENROSE DRAIN
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PENROSE DRAIN
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JACKSON-PRATT DRAIN
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JACKSON-PRATT
DRAIN
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JACKSON-PRATT DRAIN
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CARING FOR WOUNDS
Changing the dressing
Inform thepatient
Perform the dressing changeat asuitable time
ProvideprivacyProvideassurance
Teach thepatient
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MAINTAINING NORMAL BODY
TEMPERATURE
Low body temperatureis reported to thephysician
Roomismaintained at acomfortable temperature
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DECREASED PAIN, EARLY
MOBILIZATION, AND PROMPT RETURN
TO NORMAL FUNCTION
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RELIEVING PAIN
Opioid analgesics
Preventiveapproach ismoreeffective than the as
needed aproach
Use of nonpharmacologic pain relief measures
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ENCOURAGING ACTIVITY
Earlyambulation haspositiveeffects on recoveryand theprevention of complications
Ambulation reducespostoperativeabdominal
distention Assist thepostoperativepatient in getting out of
bed for the first time
Encourage bed exercises to improvecirculation
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MANAGING GI FUNCTION AND
RESUMING NUTRITION
Management of hiccups
Liquids
Soft food
Solid food
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MANAGING GI FUNCTION AND
RESUMING NUTRITION
Assessment and management of GI function
Anypostoperativepatient maysuffer from distention
Abdominal distention is furtherincreased byimmobility,
anestheticagents,and the use of opioid medicationsAssess bowelsounds
Paralyticileusand intestinal obstruction
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PROMOTING BOWEL FUNCTION
Constipation
Patientsareadvised to engagein earlyambulation
to prevent constipation
Improve dietaryintakeisadvised
Stoolssoftenersmay beprescribed by the doctor
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MANAGING VOIDING
Thepatient isexpected to void within 8 hoursaftersurgery
Allmethods to encourage thepatient to void
should be tried Bedpan must be warm
Straight intermittent catheterization ispreferred overin-dwelling catheterization
Take note of amount of urine voided Palpate thesuprapubic area for distention or
tenderness
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PREVENTION AND EARLY
DETECTION OF COMPLICATIONS
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PREVENTING RESPIRATORY
COMPLICATIONS
Common respiratorycomplications: atelectasis,pneumonia,and hypoxemia
Encourage deep breathing,coughing exercises,
and ambulation Watch out forsignsand symptoms of thecommon
respiratorycomplications
Administer oxygen asprescribed to prevent or
relieve hypoxia
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MAINTAINING A SAFE ENVIRONMENT
Assess thepatientslevel of consciousnessandorientation which mayplace thepatient at riskforinjury
All objects thepatient may need should be withinreach
Instruct patient to askforassistance with any
activity
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MANAGING POTENTIAL
COMPLICATIONS
Deep vein thrombosis (DVT)
Low-molecular-weight orlow-dose heparin and low-
dose warfarin
Advise to avoid the use of blanket rolls,pillow rolls, orany form of elevation that can constrict vessels undertheknees
Prolonged dangling is not recommended
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DEEP VEIN THROMBOSIS
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DEEP VEIN THROMBOSIS
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MANAGING POTENTIAL
COMPLICATIONS
Hematoma
Sometimesconcealed bleeding occurs beneath theskin atthesurgicalsite
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MANAGING POTENTIAL
COMPLICATIONS
Infection
Multiple factorsplace thepatient at riskof infection
Watch out forsignsand symptoms of infection
Increased PR and temperature;elevated WBC; wound swelling,warmth, tenderness, or discharge,and incisionalpain
Staphylococcusaureus
Antimicrobial therapyand wound care regimen
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MANAGING POTENTIAL
COMPLICATIONS
Wound dehiscenceand evisceration
Both areserioussurgicalcomplications
Abdominal binder
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WOUND DEHISCENCE
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WOUND DEHISCENCE
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WOUND DEHISCENCE
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WOUND EVISCERATION