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Potential cardiovascular problems
- Fluid volume excess
- Blood clots
Potential neurologic/ psychologic problems
- Emergency delirium
- Post op cognitive dysfunction
- Anxiety and depression
Low urine output
Due to NPO Preop, fluid retention (due to stress response), immobilization.
Intervention: Ambulation (It normally returns within 6-8 hours)
Due to anesthesia, opioids, immobility, recumbent position, pain
Interventions: Position pt in natural urinating position, increase water intake, provide reassurance, ambulation
Due to opioids, delayed ambulation, decreased peristalsis
Interventions: Early ambulation
Due to opioids and anesthesia, delayed gastric emptying, duration of surgery, of drinking and eating too soon post op
Interventions: Give antiemetic and prokinetic meds, IV fluids while NPO, O2 therapy, early mobilization
Due to wound infection or latent sign DVT
Interventions: Prophylactic antibiotics, antipyretic, surgical asepsis with wound care.
Due to cold irrigants, redistribution of body heat heat in long surgeries, and unwarmed inhaled gases
Interventions: warm IV fluids, active rewarming (warm blankets, socks, etc.)
Due to anesthesia, pain, bladder distention, hypoxia, or endotracheal tube.
Interventions: O2 therapy, analgesics for pain, voiding, sedatives if O2 doesn't work.
Due to increase in platelets due to stress response (increased risk for deep vein thrombosis and pulmonary embolism
Fluid volume excess
Due to stress response related to surgery
Interventions: monitor for S&S or FVE, don't infuse IV fluids too rapidly, diuretics, monitor I&O
Due to fluid and electrolytes imbalances, blood loss, hypoxemia, or preexisting heart complications
Due to sympathetic nerve stimulation (pain, anxiety, bladder distention, respiratory compromise)
Interventions: Replaces fluids or specific electrolytes, replace blood, O2 therapy
Due to fluids and/or blood loss or cardiac dysfunction
Interventions: Always start with O2 (for hypoperfused organs), replaces fluids and blood, vasoconstrictors, drugs for dysrhytmias
Due to tongue falling back or laryngeal edema
Interventions: thrust jaw forward, chin lift, intubate/ O2 or antihistamines
Due to atelectasis, aspiration, bronchospasm, pulmonary edema, pulmonary embolism
Interventions: DB & C, incentive spirometer, early mobilization, O2 therapy, diuretics, bronchodilators
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