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21 terms

Postop potentional problems

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Potential respiratory problems
- Airway obstruction
- Hypoxemia
- Hypoventilation
Potential cardiovascular problems
- Hypotension
- Hypertension
- Dysrhythmias
- Fluid volume excess
- Blood clots
Potential neurologic/ psychologic problems
- Emergency delirium
- Post op cognitive dysfunction
- Anxiety and depression
Potential alterations in temperature
- Hypothermia
- Fever
Potential GI problems
- Nausea and vomiting
- Abdominal distention
Potential urinary problems
- Urinary retention
- Low urine output
Low urine output
Due to NPO Preop, fluid retention (due to stress response), immobilization.

Intervention: Ambulation (It normally returns within 6-8 hours)
Urinary retention
Due to anesthesia, opioids, immobility, recumbent position, pain

Interventions: Position pt in natural urinating position, increase water intake, provide reassurance, ambulation
Abdominal distention
Due to opioids, delayed ambulation, decreased peristalsis

Interventions: Early ambulation
Nausea/ vomiting
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
Fever
Due to wound infection or latent sign DVT

Interventions: Prophylactic antibiotics, antipyretic, surgical asepsis with wound care.
Hypothermia
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.)
Emergency delirium
Due to anesthesia, pain, bladder distention, hypoxia, or endotracheal tube.

Interventions: O2 therapy, analgesics for pain, voiding, sedatives if O2 doesn't work.
Blood clots
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
Dysrhythmias
Due to fluid and electrolytes imbalances, blood loss, hypoxemia, or preexisting heart complications
Hypertension
Due to sympathetic nerve stimulation (pain, anxiety, bladder distention, respiratory compromise)

Interventions: Replaces fluids or specific electrolytes, replace blood, O2 therapy
Hypotension
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
Airway obstruction
Due to tongue falling back or laryngeal edema

Interventions: thrust jaw forward, chin lift, intubate/ O2 or antihistamines
Hypoxemia
Due to atelectasis, aspiration, bronchospasm, pulmonary edema, pulmonary embolism

Interventions: DB & C, incentive spirometer, early mobilization, O2 therapy, diuretics, bronchodilators
Hypoventilation
Due to anesthesia, weak respiratory muscles, or pain

Interventions: Stimulation, reversal of opioids, O2 therapy, analgesics in low dose,