When monitoring a client 24 to 48 hours after surgery the nurse would assess for which problem?

1. Pritchard MJ. Pre-operative assessment of elective surgical patients. Nurs Stand. 2012;26(30):51–6. [PubMed] [Google Scholar]

2. Scottish Intercollegiate Guidelines Network (SIGN) Postoperative management in adults : a practical guide to postoperative care for clinical staff. SIGN publication [Internet] Available from: http://www.sign.ac.uk/ 2004.

3. Ravindra P, Fitzgerald E. Surgical preoperative assessment: What to do and why. Student BMJ [Internet] [cited 2012 September 08];Available from: http://student.bmj.com/student/view-article.html?id=sbmj.d7816 . 2012 Jan 12;20 [Google Scholar]

4. Behar J, Gogalniceanu P, Bromley L. Anaesthesia: Introduction and preoperative assessment. Student BMJ [Internet] [cited 2012 September 10];Available from: http://student.bmj.com/student/view-article.html?id=sbmj070112 . 2007 15 [Google Scholar]

5. Brun S. Initial assessment of the injured shoulder. Aust Fam Physician. 2012;41(4):217–20. [PubMed] [Google Scholar]

6. Johnson JP. Preoperative assessment of high-risk orthopedic surgery patients. Nurse Pract. 2011;36(7):40–7. [PubMed] [Google Scholar]

7. Brun S. Shoulder injuries - management in general practice. Aust Fam Physician. 2012;41(4):188–94. [PubMed] [Google Scholar]

8. Garcia-Miguel FJ, Serrano-Aguilar PG, Lopez-Bastida J. Preoperative assessment. Lancet. 2003;362(9397):1749–57. [PubMed] [Google Scholar]

9. Kerr IH. Preoperative chest x ray. Br J Anaesth. 1974;46:558–63. [PubMed] [Google Scholar]

10. Rucker L, Frye EB, Staten MA. Usefulness of screening chest roentgenograms in preoperative patients. JAMA. 1983;250:3209–11. [PubMed] [Google Scholar]

11. National study by the Royal College of Radiologists. Preoperative chest radiology. Lancet. 1979;2:83–6. [PubMed] [Google Scholar]

12. Roberts CJ, Fowkes FG, Ennis WP. Possible impact of audit on chest X-ray requests from surgical wards. Lancet. 1983;2:446–8. [PubMed] [Google Scholar]

13. Lee HP, Chang YY, Jean YH, et al. Importance of serum albumin level in the preoperative tests conducted in elderly patients with hip fracture. Injury. 2009;40(7):756–9. [PubMed] [Google Scholar]

14. National Institute for Clinical Excellence. Preoperative Tests: The use of preoperative tests for elective surgery. NICE Clinical Guideline [Internet]. 2003; (CG3). Available from: http://www.nice.org.uk/CG003 .

15. Goldberger AL, O'Konski M. Utility of routine electrocardiogram before surgery and on general hospital admission. Ann Intern Med. 1986;105:552–7. [PubMed] [Google Scholar]

16. Barnard NA, Williams RW, Spencer EM. Preoperative patient assessment: a review of the literature and recommendations. Ann R Coll Surg Engl. 1994;76:293–7. [PMC free article] [PubMed] [Google Scholar]

17. Mukherjee D, Eagle KA. Perioperative cardiac assessment for noncardiac surgery: eight steps to the best possible outcome. Circulation. 2003;107(22):2771–4. [PubMed] [Google Scholar]

18. Pasternak LR. Preoperative Testing. In: Cohn SL, editor. Perioperative Medicine. London: Springer; 2011. [Google Scholar]

19. Rohrer MJ, Michelotti MC, Nahrwold DL. A prospective evaluation of the efficacy of preoperative coagulation testing. Ann Surg. 1988;208(5):554–7. [PMC free article] [PubMed] [Google Scholar]

20. Brown FM., Jr Nursing care after a shoulder arthroplasty. Orthop Nurs. 2008;27(1):3–9. [PubMed] [Google Scholar]

21. The Association of Anaesthetists of Great Britain & Ireland. Immediate postanaesthetic recovery. Available from: http://www.aagbi.org/sites/default/files/postan aes02.pdf . 2002. [cited 2012 September 15].

22. Lorenzl S, Fusgen I, Noachtar S. Acute confusional States in the elderly--diagnosis and treatment. Dtsch Arztebl Int. 2012;109(21):391–9. [PMC free article] [PubMed] [Google Scholar]

23. Nesbitt I. Postoperative monitoring. Curr Anaesth Crit Care. 2006;17:55–64. [Google Scholar]

24. Vimlati L, Gilsanz F, Goldik Z. Quality and safety guidelines of postanaesthesia care: Working Party on Post Anaesthesia Care (approved by the European Board and Section of Anaesthesiology, Union Europeenne des Medecins Specialistes) Eur J Anaesthesiol. 2009;26(9):715–21. [PubMed] [Google Scholar]

25. Thompson JS, Baxter BT, Allison JG, et al. Temporal patterns of postoperative complications. Arch Surg. 2003;138(6):596–602. [PubMed] [Google Scholar]

26. Fleisher LA, Beckman JA, Brown KA, et al. ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2007;50(17):159–241. [PubMed] [Google Scholar]

27. Kassavin DS, Kuo YH, Ahmed N. Initial systolic blood pressure and ongoing internal bleeding following torso trauma. J Emerg Trauma Shock. 2011;4(1):37–41. [PMC free article] [PubMed] [Google Scholar]

28. Schouten O, Bax JJ, Poldermans D. Assessment of cardiac risk before non-cardiac general surgery. Heart. 2006;92(12):1866–72. [PMC free article] [PubMed] [Google Scholar]

29. Agostini P, Cieslik H, Rathinam S, et al. Postoperative pulmonary complications following thoracic surgery: are there any modifiable risk factors? Thorax. 2010;65(9):815–8. [PubMed] [Google Scholar]

30. Mathew JT, D'Souza GA, Kilpadi AB. Respiratory complications in postoperative patients. J Assoc Physicians India. 1999;47(11):1086–8. [PubMed] [Google Scholar]

31. Kelley DM. Hypovolemic shock: an overview. Crit Care Nurs Q. 2005;28(1):2–19. [PubMed] [Google Scholar]

32. Ronco C, Kaushik M, Valle R, et al. Diagnosis and management of fluid overload in heart failure and cardio-renal syndrome: the "5B" approach. Semin Nephrol. 2012;32(1):129–41. [PubMed] [Google Scholar]

33. Matot I, Sprung CL. Definition of sepsis. Intensive Care Med. 2001;27(Suppl 1):3–9. [PubMed] [Google Scholar]

34. Rivers EP, Ahrens T. Improving outcomes for severe sepsis and septic shock: tools for early identification of at-risk patients and treatment protocol implementation. Crit Care Clin. 2008;24(Suppl 3):1–47. [PubMed] [Google Scholar]

35. Angus DC, Linde-Zwirble WT, Lidicker J, et al. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001;29(7):1303–10. [PubMed] [Google Scholar]

36. Rashid A, Abdul-Jabar H, Lam F. Nerve injury associated with shoulder surgery. Curr Orthop. 2008;22:284–8. [Google Scholar]

37. Singelyn FJ, Deyaert M, Joris D, et al. Effects of intravenous patient-controlled analgesia with morphine, continuous epidural analgesia, and continuous three-in-one block on postoperative pain and knee rehabilitation after unilateral total knee arthroplasty. Anesth Analg. 1998;87(1):88–92. [PubMed] [Google Scholar]

38. Viscusi ER. Patient-controlled drug delivery for acute postoperative pain management: a review of current and emerging technologies. Reg Anesth Pain Med. 2008;33(2):146–58. [PubMed] [Google Scholar]

39. Ramsay MA. Acute postoperative pain management. Proc (Bayl Univ Med Cent) 2000;13(3):244–7. [PMC free article] [PubMed] [Google Scholar]

40. Tzortzopoulou A, McNicol ED, Cepeda MS, et al. Single dose intravenous propacetamol or intravenous paracetamol for postoperative pain. Cochrane Database Syst Rev. 2011;(10):CD007126. [PubMed] [Google Scholar]

41. Barden J, Edwards J, Moore A, et al. Single dose oral paracetamol (acetaminophen) for postoperative pain. Cochrane Database Syst Rev. 2004;(2):CD004768. [PubMed] [Google Scholar]

42. Cepeda MS, Carr DB, Miranda N, et al. Comparison of morphine, ketorolac, and their combination for postoperative pain: results from a large, randomized, double-blind trial. Anesthesiology. 2005;103(6):1225–32. [PubMed] [Google Scholar]

43. Bays RA, Barry L, Vasilenko P. The use of bupivacaine in elective inguinal herniorrhaphy as a fast and safe technique for relief of postoperative pain. Surg Gynecol Obstet. 1991;173(6):433–7. [PubMed] [Google Scholar]

44. Holst P, Erichsen CJ, Dahl JB, et al. Effects of lidocaine aerosol on postoperative pain and wound tenderness following minor gynaecological laparotomy. Acta Anaesthesiol Scand. 1992;36(2):112–4. [PubMed] [Google Scholar]

45. Peng PW, Chan VW. Local and regional block in postoperative pain control. Surg Clin North Am. 1999;79(2):345–70. [PubMed] [Google Scholar]

46. Fredrickson MJ, Krishnan S, Chen CY. Postoperative analgesia for shoulder surgery: a critical appraisal and review of current techniques. Anaesthesia. 2010;65(6):608–24. [PubMed] [Google Scholar]

47. Jameson SS, James P, Howcroft DW, et al. Venous thromboembolic events are rare after shoulder surgery: analysis of a national database. J Shoulder Elbow Surg. 2011;20(5):764–70. [PubMed] [Google Scholar]


Page 2

Assessment of Shoulder Dysfunction

Which movements are limited? This can help isolate the structure
Consider the following if movements are limited by:
  ▪   pain: tendinopathy, impingement, sprain/strain, labral pathology
  ▪   mechanical block: labral pathology, frozen shoulder
  ▪   night pain (lying on affected shoulder): rotator cuff pathology, anterior shoulder instability, ACJ injury, neoplasm (particularly unremitting pain)
  ▪   sensation of ‘clicking or clunking’: labral pathology, unstable shoulder (either anterior or multidirectional instability)
  ▪   sensation of stiffness or instability: frozen shoulder, anterior or multidirectional instability