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45 terms

Surgery Ch 27 Postoperative

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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