Post operative complications
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Transcript of Post operative complications
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POST-OPERATIVE complications
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Surgical Drains
Reasons for applying a surgical drain:
1. To collapse surgical dead space
2. To drain abscess3. To provide early warning
notice of a surgical leak
4. To control an established fistula
leak
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JP Drain
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Penrose DrainNephrostomy Tube
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General Management postopeartive
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Liquid Diet Vs Soft diet
Clear liquid Full liquid Soft diet
CoffeeTeaCarbonated drinkBouillonClear fruit juicePopsicleGelatinHard candy
Clear liquid PLUS:Milk/Milk prodVegetable juicesCream, butterYogurtPuddingsCustardIce cream and sherbet
All CL and FL plus:MeatVegetablesFruitsBreads and cerealsPureed foods
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Chest Physiotherapy
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Post Operative Care
Objectives of Postop CareRe-establishment of physiologic equilibrium
Prevention of pain and complication
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Goal of Care for Post-operative Patients
1.Promotion of
respiratory function
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Goal of Care for Post-operative Patients
2. Promote cardio-
vascular function and
tissue perfusion
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Goal of Care for Post-operative Patients
3. Promotion of fluid and electrolyte
balance
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Goal of Care for Post-operative Patients
4. Promotion of nutrition
and elimination
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Goal of Care for Post-operative Patients
5. Promotion of renal function
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Goal of Care for Post-operative Patients
6.Promotion of comfort,
rest and freedom
from pain
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Goal of Care for Post-operative Patients
7. Promotion of wound healing
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Goal of Care for Post-operative Patients
8. Promotion of early
movement and ambulation
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Goal of Care for Post-operative Patients
9. Prevention of post-
operative complications
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Post-operative Complications
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POST OP COMPLICATIONS
CIRCULATORY COMPLICATIONS:
a. Shockb. Hemorrhagec. Thrombophlebitis / deep
thrombophlebitis
PULMONARY COMPLICATIONSa. Atelectasisb. Pneumonia
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URINARY DIFFICULTIES
a. Urinary retention
GASTROINTESTINAL COMPLICATIONS
a. Paralytic ileusb.Gas painc. Intestinal obstructiond.Hiccups
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Rule of ThumbFever 1st 24 - Pulmonary infection
Within 48 - UTI Within 72 - wound infection
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A. Pulmonary (48 hrs PO)
1. Pneumonia
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A. Pulmonary (48 hrs PO)
2.Atelectasis
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B. Cardiovascular
1. 2.Hemorrhage
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Bleeding Hemorrhage
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B. Cardiovascular
2.Shock
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B. Cardiovascular
3.Thrombophlebitis (7-14days PO)
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C. Wound complication
1.Wound infection
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C. Wound complication
2.Wound Dehiscence
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Wound dehiscence
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Wound evisceration
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D. Urinary Retention
inability to void (voiding
should return 6-8hrs
PO)
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E. Gastrointestinal
1. Abdominal distention or
paralytic ileus
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E. Gastrointestinal
2. Hiccups
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G. Hypothermia
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Immobility
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Summary of Complications Respiratory
Atelectasis Pneumonia
(aspiration, hypostatic, infectious)
Embolism Cardiovascular
Hemorrhage-shock Cardiac arrest DVT Thrombophlebitis
Musculoskeletal System Muscle atrophy Contractures Osteoclast – Fx -
↑Ca Nervous System
Coma Paralysis
GIT Nausea and
vomiting Constipation Ulcer (Cushing’s) Adynamic ileus
GUT Urinary retention UTI
Wound Wound infection Wound dehiscence Wound evisceration
Integumentary Bed sore
Psychologic Depression
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Postop Discharge Teaching
Assess readiness for HTAssess the need for home careWound careFollow up (sutures are removed 7-14 days)
Resume normal activities gradually
Avoid lifting for 6 weeks (>10 lbs.)
Can return to work 6-8 weeks after
Teach the s/sx of complications
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To emphasizeThe over-all goal of nursing care during the PRE-OPERATIVE phase is to prepare the patient mentally and physically for the surgery
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To emphasizeThe over-all goal of nursing care during the INTRA-OPERATIVE phase is to maintain client safety
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To emphasizeThe over-all goals of nursing care during the POST-OPERATIVE phase are to promote healing and comfort, restore the highest possible wellness and prevent associated risk