Postoperative care is the care you receive after a surgical procedure. The type of postoperative care you need depends on the type of surgery you have, as well as your health history. It often includes pain management and wound care. Postoperative care begins immediately after surgery. It lasts for the duration of your hospital stay and may continue after you’ve been discharged. As part of your postoperative care, your healthcare provider should teach you about the potential side effects and complications of your procedure. Before you have surgery, ask your doctor what the postoperative care will involve. This will give you time to prepare beforehand. Your doctor may revise some of their instructions after your surgery, based on how your surgery went and how well you’re recovering. Ask as many questions as possible before your surgery, and ask for updated instructions before you’re discharged from the hospital. Many hospitals provide written discharge instructions. Ask your doctor questions such as:
The answers to these questions can help you prepare ahead of time. If you expect to need help from a caregiver, arrange for it before your surgery. It’s also important to learn how to prevent, recognize, and respond to possible complications. Depending on the type of surgery you have, there are many potential complications that can arise. For example, many surgeries put patients at risk of infection, bleeding at the surgical site, and blood clots caused by inactivity. Prolonged inactivity can also cause you to lose some of your muscle strength and develop respiratory complications. Ask your doctor for more information about the potential complications of your specific procedure. After your surgery is complete, you will be moved to a recovery room. You’ll probably stay there for a couple of hours while you wake up from anesthesia. You’ll feel groggy when you wake up. Some people also feel nauseated. While you’re in the recovery room, staff will monitor your blood pressure, breathing, temperature, and pulse. They may ask you to take deep breaths to assess your lung function. They may check your surgical site for signs of bleeding or infection. They will also watch for signs of an allergic reaction. For many types of surgery, you will be placed under general anesthesia. Anesthesia can cause an allergic reaction in some people. Once you’re stable, you’ll be moved to a hospital room if you’re staying overnight, or you’ll be moved elsewhere to begin your discharge process. Outpatient surgeryOutpatient surgery is also known as same-day surgery. Unless you show signs of postoperative problems, you’ll be discharged on the same day as your procedure. You won’t need to stay overnight. Before you’re discharged, you must demonstrate that you’re able to breathe normally, drink, and urinate. You won’t be allowed to drive immediately following a surgery with anesthesia. Make sure you arrange transportation home, preferably ahead of time. You may feel groggy into the following day. Inpatient surgeryIf you have inpatient surgery, you’ll need to stay in the hospital overnight to continue receiving postoperative care. You may need to stay for several days or longer. In some cases, patients who were originally scheduled for outpatient surgery show signs of complications and need to be admitted for ongoing care. Your postoperative care will continue after you’ve been transferred out of the initial recovery room. You will probably still have an intravenous (IV) catheter in your arm, a finger device that measures oxygen levels in your blood, and a dressing on your surgical site. Depending on the type of surgery you had, you may also have a breathing apparatus, a heartbeat monitor, and a tube in your mouth, nose, or bladder. The hospital staff will continue to monitor your vital signs. They may also give you pain relievers or other medications through your IV, by injection, or orally. Depending on your condition, they may ask you to get up and walk around. You may need assistance to do this. Moving will help decrease your chances of developing blood clots. It can also help you maintain your muscle strength. You may be asked to do deep breathing exercises or forced coughing to prevent respiratory complications. Your doctor will decide when you’re ready to be discharged. Remember to ask for discharge instructions before you leave. If you know that you’ll need ongoing care at home, make preparations ahead of time. It’s very important that you follow your doctor’s instructions after you leave the hospital. Take medications as prescribed, watch out for potential complications, and keep your follow-up appointments. Don’t overdo things if you’ve been instructed to rest. On the other hand, don’t neglect physical activity if you’ve been given the go ahead to move around. Start to resume normal activities as soon as you safely can. Most of the time, it’s best to gradually return to your normal routine. In some cases, you may not be able to care for yourself for a while after your surgery. You may need a caregiver to help tend your wounds, prepare food, keep you clean, and support you while you move around. If you don’t have a family member or friend who can help, ask your doctor to recommend a professional caregiving service. Contact your doctor if you develop a fever, increased pain, or bleeding at the surgical site. Don’t hesitate to contact your doctor if you have questions or aren’t recovering as well as expected. Appropriate follow-up care can help reduce your risk of complications after surgery and support your recovery process. Ask your doctor for instructions before you have your surgery and check for updates before you leave the hospital. Contact your doctor if you suspect you’re experiencing complications or your recovery isn’t going well. With a little planning and proactive care, you can help make your recovery as smooth as possible. ATI Targeted Assessment: Med-Surgical: Perioperative Care 1. A nurse is providing discharge teaching for a client who is postoperative following a rhinoplasty using general anesthesia. Which of the following instructions should the nurse include? 2. A nurse is planning care for a client who is postoperative and has a closed-wound drainage system in place. Which of the following interventions should the nurse plan to include? 3. A nurse is receiving evening shift report on four clients who returned from the PACU that morning. The nurse should assess which of the following clients first? ) 4. A nurse is caring for a client who has a surgical wound with a Penrose drain in place. Which of the following interventions should the nurse plan to perform? 5. A nurse is caring for a client who has bradycardia following a surgical procedure using spinal anesthesia. The nurse should plan to administer which of the following medications to the client? 6. A client had an open transverse colectomy 5 days ago. The nurse enters the client's room and recognizes that the wound has eviscerated. After covering the wound with a sterile, saline-soaked dressing, which of the following actions should the nurse take? 7. A nurse is reviewing the medication administration record for a client who is scheduled for surgery the next day. The nurse should identify that which of the following medications places the client at risk for complications during surgery and should be reported to the provider? 8. A nurse is reviewing the medical record of a client who is scheduled for an elective surgery. Which of the following medications should the nurse expect the provider to discontinue prior to surgery to minimize the risk of complications? 9. A surgical nurse enters a surgical suite to ensure surgical asepsis is maintained. Which of the following findings requires intervention by the nurse? 10. A nurse is providing discharge instructions for a client who is postoperative following abdominal surgery. Which of the following client statements indicates an understanding of the teaching? 11. A nurse is caring for a client who is preoperative and is asking multiple question about risk of the procedure. Which of the following actions should the nurse take? 12. A nurse is assessing a client who is 2 days postoperative following a total prostatectomy. The nurse notes that the client's right calf is red, edematous, and warm to the touch. Which of the following actions should the nurse take? 13. A nurse is assessing a client's recovery from spinal anesthesia. Which of the following sensations should the nurse expect to return to the client first? 14. A nurse is caring for a client who is 12 hours postoperative from a gastrectomy and has an NG tube set to continuous low suction. Which of the following findings requires intervention by the nurse? 15. A nurse is providing teaching for a client who is scheduled to undergo moderate sedation for a bronchoscopy. The nurse should verify that the client understands the procedure when the client states which of the following? 16. A nurse is monitoring a client who received succinylcholine during a surgical procedure. Which of the following actions should the nurse take if the client develops manifestations of malignant hyperthermia? 17. A nurse is assessing a client who is preoperative. The nurse should identify that which of the following factors reported by the client increases the risk for a postoperative wound infection? 18. A nurse is providing teaching for a client who is in the immediate postoperative period and has a PCA pump. Which of the following statements should the nurse include in the teaching? 19. A nurse is reviewing the medical record of a client who is to undergo general anesthesia for surgery. The nurse should report which of the following findings to the provider? 20. A circulating nurse is monitoring the temperature in a surgical suite. The nurse should identify that cool temperatures reduce a client's risk for which of the following potential complications of surgery? 21. A nurse is caring for a client who is postoperative following abdominal surgery. Which of the following nursing interventions should the nurse perform to prevent respiratory complications? Advise the client to splint the surgical incision when coughing and deep breathing. 22. A nurse in the PACU is assessing a client who is postoperative. Which of the following findings should the nurse report to the provider? Presence of inspiratory stridor (This indicates tracheal edema and requires intervention) 23. A nurse is providing preoperative teaching to a client who is scheduled to have a mastectomy with reconstructive surgery. Which of the following statements by the client indicates an understanding of the teaching? "I will be able to shower after the doctor removes the drain." 24. A nurse is caring for a client who is 2 days postoperative following a cholecystectomy. The client has been vomiting for the past 24 hr and reports a pain level of 8 on a scale from 0 to 10. The nurse notes a hard, distended abdomen and absent bowel sounds. After conferring with the provider, which of the following actions should the nurse take first? Insert an NG tube 25. A nurse is providing preoperative teaching to a client who is scheduled for a gastrectomy in 1 week. The client is anxious about the upcoming surgery. Which of the following actions should the nurse take? Provide concise, factual information 26. A nurse is assessing a client who is 2 hr postoperative following an appendectomy. Which of the following findings should the nurse report to the provider? Urine output of 20mL/hr. (The nurse should notify the provider if the urine output is less than 30 ml/hr, meaning the client could be hypovolemic and have decreased perfusion to the kidneys) 27. A nurse is caring for a client who is receiving moderate (conscious) sedation with midazolam. The client's respiratory rate decreases from 16/min to 6/min, and the oxygen saturation decreases from 92% to 85%. Which of the following medications should the nurse administer? Flumazenil. (The client’s RR and o2 levels indication respiratory sedation caused by a benzodiazepine. The nurse should administer Flumazenil, a benzo agonist, to reverse the sedative effects of the medication) 28. A nurse is creating a plan of care for a client who is preoperative for a total hip arthroplasty, practices Judaism, and adheres to a kosher diet. Which of the following interventions is the nurse's priority? Determine if the client's faith conflicts with the treatment plan. (The nurses priority is to assess first. By finding out the clients religion, the nurse can inform the surgeon and prevent any issues during or after the surgery) 29. A client is transferred from the surgical suite to the PACU following oral surgery. While monitoring the client's vital signs, the nurse finds that the client's tongue has become swollen and is obstructing the airway. Which of the following actions should the nurse take first? Use the head-tilt, chin-lift method to open the airway. 30. A nurse is providing preoperative teaching for a client who is about to have a below- the-knee amputation. Which of the following instructions should the nurse include? "Your surgeon might prescribe an antibiotic before surgery." Table of Contents
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