Surgery Ch 27 Postoperative

Created by lisadmo 

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1

Postanesthesia phase _____ begins with the arrival of the patient and focuses on the recovery of physiological homeostasis and protective mechanisms

2

Postanesthesia phase _____ begins when the patient becomes more alert and functional, requiring less intensive nursing

Preparing patient and family for discharge home

The focus of postanesthesia phase 2 is __________

fast-tracking

Term used for transferring patient directly to PACU phase 2 and bypassing phase 1

lateral

Preferred position for postoperative patients immediately after surgery

every 15 minutes

During the first hour in the PACU, how often is LOC documented

PARS (post-anesthesia recovery score)

Score that is the criterion for moving a patient from phase 1 to phase 2

8

A PARS score of ____ or higher is needed to move out of the PACU.

pain

Patient may be discharged if they have minimal to no _______, or if it is moderate but controlled

respiratory complications

Most frequent postoperative problem in the PACU

laryngospasm

occurs when the muscles of the larynx contract forcefully, causing a closure or partial closure of the airway

internal bleeding

When the patient has a drop in BP, increased HR or a decrease in cardiac output, the nurse should suspect ______.

2500

______ mL/day is the average needed for routine fluid replacement after surgery

30, 0.5

Urine output less than ______mL/hr or ______mL/kg/hr should be reported to the health care provider.

Meperidine (Demerol)

Drug given to treat postoperative shivering.

Early PONV

N/V that occurs within 2-6 hours of surgery

Late PONV

N/V that develops 6-24 hours after surgery

Delayed PONV

N/V that extends beyond the first 24 hrs after surgery

antiemetic

Dexamethasone, Droperidol, Ondansetron and Prochlorperazine are ___________ drugs.

narcotic analgesics

Morphine, hydromorphone and fentanyl are ____________.

20,20

When using ice for pain control, use for _____ minutes, then remove for ____ minutes

Lorazepam (Ativan)

anti-anxiety med that can be given IV, IM or orally

PADS

Score that determines a patient's readiness for discharge home

8,9

Patients being transferred to an inpatient unit need a PADS score of ____, those being discharged home need a PADS score of _____

turning, coughing, deep breathing, ambulation

Name 4 interventions to reduce the risk of respiratory complications in the postoperative patient

pneumonia, atelectasis

2 most common respiratory complications that occur post-surgery

evening of surgery or first postoperative day

Unless contraindicated, ambulation begins on the ________

3

Most postoperative patients should ambulate ____ times per day

chest and abdomen

Surgeries of these areas have the highest risk of postoperative pulmonary complications

3, 5-10

Postoperative patients are encouraged to take deep breaths, holding the maximal inspiration for _____ seconds, ______ times per hour

POI (post operative ileus)

occurs when peristalsis does not return as expected after surgery

passing of flatus and stool

The return of bowel mobility and function in the post-op patient is marked by _______, not simply the presence of bowel sounds

6-8

Once an indwelling catheter is removed the patient should void in ________ hours

Initial stage

Stage of wound healing that lasts for 1-4 days

Second stage

Stage of wound healing that lasts 1-2 weeks

Third stage

Stage of wound healing that lasts from 2-3 weeks to one year

30

To qualify as a surgical site infection, the infection must occur within _____ days of the surgery.

surgeon

Who is generally responsible for the first dressing change?

evisceration

complete separation of the wound layers with protrusion of internal organs or viscera

dehiscence

partial or complete separation of the wound layers with an opening of the wound

8

A J-P drain should be emptied at a minimum of every ___ hours

T-tube

used to prevent biliary obstruction

DVT

With pelvic surgery, orthopaedic surgery and multiple trauma surgery, there is an increased risk for ______

Lovenox, coumadin

Name 2 meds given to reduce risk of DVT

intermittent pneumatic compression devices, graduated compression stockings

Name 2 non-pharmaceutical ways to reduce DVT risk

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