RO-05 POST OPERATIVE CARE AND ITS COMPLICATIONS

Views:
 
Category: Education
     
 

Presentation Description

No description available.

Comments

By: dhiren2012 (9 month(s) ago)

its realy good one please allow to dawnload

Presentation Transcript

POST OPERATIVE CARE AND ITS COMPLICATIONS:

POST OPERATIVE CARE AND ITS COMPLICATIONS KIRAN RANDHAWA ARMY COLLEGE OF NURSING

INTRODUCTION:

INTRODUCTION NURSING CARE DURING POST OPERATIVE PHASE IS IMPORTANT FOR CLIENT RECOVERY.DUE TO ANAESTHESIA CLIENTS ABILITY TO RESPOND TO STIMULI IS IMPAIRED AND MAY HAVE COMPLICATIONS OF SURGERY.

DEFINITON:

DEFINITON POST OPERATIVE CARE IS THE CARE WHICH IS GIVEN TO THE PATIENT AFTER SURGERY TO PREVENT FURTHER COMPLICATIONS

POST ANAESTHESIA CARE UNIT:

POST ANAESTHESIA CARE UNIT GOAL OF PACU IS TO ASSIST AN UNCOMPLICATEDRETURN TO SAME PHYSIOLOGIC FUNCTIONAFTER THE SURGERY BY PROVIDING KNOWLEDGE AND INDIVIDUALISED NSG CARE PROPER POSITIONING OF SEDATED PATIENT

Slide 5:

ANASTHETIST SHOULD GIVE THOROUGH REPORTTO PACU NURSE.THIS INCLUDE THE FOLLOWING: TYPE OF SURGERY PERFORMED AND INTRAOPERATIVE COMPLICATIONS. TYPE OF ANAESTHESIA GIVEN.

Slide 6:

PRESENCE OF ET TUBE , AMOUNT OF O2 TO BE ADMINISTERED ETC. TYPE OF LINES AND ITS LOCATION. ANY DRUG ALLERGIES.

EQUIPMENTS USED IN PACU:

EQUIPMENTS USED IN PACU SPHYGMOMANOMETER STETHOSCOPE I.V SET SUCTION EQUIPMENT SUPPLIES TO SUPPORT RESPIRATION. EMERGENCY DRUGS

Slide 8:

NURSING PROCESS

INITIAL NSG ASSESSMENT:

INITIAL NSG ASSESSMENT CHECK THE PROPER FUNCTIONING OF ALL EQUIPMENTS BEFORE RECIVING THE PATIENT. RECIVE THE PATIENT AND GIVE PROPER POSITIONING. CHECK THE A B C I.E AIRWAY BREATHING CIRCULATION

NURSING DIAGNOSIS:

NURSING DIAGNOSIS RESPIRATORY SYSTEM . INEFFECTIVE AIRWAY CLEARENCE RELATED TO EFFECT OF ANAESTHESIA IMPAIRED GASEOUS EXCHANGE RELATED TO VENTILATION PERFUSION IMBALANCE.

MAINTAIN AIRWAY PATENCY:

MAINTAIN AIRWAY PATENCY ALLOW THE PATIENT TO REMAIN IN PLACE UNTIL THE PATIENT IS UNDER THE EFFECT OF ANAESTHESIA.

CONTD…:

CONTD… MAINTAIN THE ADEQUATE RESPIRATORY FUNCTION PLACE THE PATIENT IN LATERAL POSITION WITH NECK EXPANDED ENCOURAGE THE PATIENT TO TAKE DEEP RESPIRATION. ADMINISTER HUMIDIFIED OXYGEN

EVALUATION:

EVALUATION THE PATIENT TO BREATH EASILY AND LUNG SOUND ARE ALSO CLEAR TO AUSCULTATE

NURSING DIAGNOSIS:

NURSING DIAGNOSIS CARDIOVASCULAR SYSTEM. INEFFECTIVE TISSUE PERFUSIONRELATED TO HYPOTENSION. DECREASED CARDIAC OUTPUT RELATED TO HEMORRHAGE

NSG INTERVENTION:

NSG INTERVENTION TAKE THE VITALS AS THE CONDITION INDICATES. MAINTAIN INTAKE AND OUTPUT CHART REPORT IMMIDIATELY THE FALLING BP AND INCREASED HEART RATE. RECOGNIZE THE FACTORS THAT ALTERS THE CIRCULATING BLOOD VOLUME LIKE:

CONTD…:

CONTD… BLOOD LOSS DURING SURGERY. RREACTION TO ANAESTHESIA OR ANY OTHER MEDICATION. RECOGNIZE THE EARLY SIGNS OF SHOCK OR HEMORRHAGE. CCOOL EXTRIMITIES,DECREASED URINE OUT PUT,INCREASED HEART RATE AND LOW B.P. AADMINISTER I.V FLUIDS.

EVALUATION:

EVALUATION THE PATIENTS VITALS ARE WITH IN NORMAL LIMITS.

NURSING DIAGNOSIS:

NURSING DIAGNOSIS FLUID VOLUME RISK FOR FLUID VOLUME VOLUME DEFICIT RELATED TO BLOOD LOSS,FOOD AND FLUID DEPRIVATION AND VOMITING

NSG INTERVENTION:

NSG INTERVENTION ADMINISTER IV FLUIDS AS PRESCRIBED. MONITOR THE ELECTROLYTES. ASSESS THE SKIN FOR COLOR AND TEXTURE. RECOGNIZE THE SIGNS OF FLUID IMBALANCE. DEC B.P,URINE OUTPUT, DEC CVP

CONTD…:

CONTD… MAINTAIN THE INTAKE AND OUTPUT AND OBSERVE FOR BLADDER DISTENSION. CHECK THE SKIN AND SURROUNDING TISSUE NEAR THE SITE OF INTRCATH TO DETECT EARLY INFILTERATION.

EVALUATION:

EVALUATION THE PATIENTS INTAKE AND OUTPUT ARE EQUAL AND THERE IS NO SIGNS OF IMBALANCE

NURSING DIAGNOSIS:

NURSING DIAGNOSIS COMFORT. ACUTE PAIN RELATED TO SURGICAL INCISION AND TISSUE TRAUMA.

NSG INTERVENTION:

NSG INTERVENTION ASSESS THE PAIN BY OBSERVING THE BEHAVIORAL AND PHYSIOLOGIC MANIFESTATION. ADMINISTER THE ANALGESIC. POSITION THE PATIENT TO MAXIMIZE THE COMFORT.

EVALUATION:

EVALUATION THE PATIENTS PAIN IS IN CONTROL.

NSG DIAGNOSIS:

NSG DIAGNOSIS RISK FOR INJURY RELATED TO SENSORY DYSFUNCTION.

NURSING INTERVENTION:

NURSING INTERVENTION KEEP THE SIDE RAILS UP UNTILL THE PATIENT IS FULLY AWAKE. PROTECT THE EXTRIMITY INTO WHICH THE IV FLUIDS IS RUNNING. AVOID NERVE DAMAGE AND MUSCLE STRAIN BY PROPERLY SUPPORTING AND PADDING PRESSURE AREAS.

CONTD…:

CONTD… CHECK THE DRESSING FOR PUS AND BLEEDING. DETERMINE THE RETURN OF MOTOR CONTROL.

EVALUATIONS:

EVALUATIONS THE SIDE RAILS ARE UP, THE PATIENT IS POSITIONED CAREFULLY. THERE IS NO PUS OR ANY OTHER DISCHARGE FROM THE SURGICAL SITE.

Slide 29:

POST OPERATIVE COMPLICATIONS

INTRODUCTION:

INTRODUCTION POST OPERATIVE COMPLICATIONS ARE INHERENT IN SURGICAL PROCEDURES.THEY MAY INTERFERE WITH THE EXPECTED OUTCOME OF THE SURGERY AND MAY EXTEND THE PATIENTS HOSPITALIZATION.

DEFINITION:

DEFINITION SHOCK . SHOCK IS A RESPONSE OF THE BODY TO A DECREASE IN CIRCULATING BLOOD VOLUME

PREVENTIVE MEASURES:

PREVENTIVE MEASURES HAVE THE BLOOD READY IT MAY BE NEEDED. ACCURATELY MEASURE THE BLOOD LOSS AND MONITOR THE INTAKE AND OUTPUT. MONITOR THE VITALS UNTIL THEY ARE STABLE. PREVENT INFECTIONS TO MINIMIZE THE SEPTIC SHOCK

HEMORRHAGE:

HEMORRHAGE IT IS A COPIOUS ESCAPE OF BLOOD FROM BLOOD VESSELS. CLASSIFICATION OF HEMORRHAGE. PRIMARY INTERMEDIARY SECONDARY

CLINICAL MANIFESTATION:

CLINICAL MANIFESTATION RESTLESSNESS COOL AND MOIST SKIN DECREASED B.P INCREASED PULSE RATE INCREASED RESPIRATION DECREASED CARDIAC OUTPUT

NSG INTERVENTION:

NSG INTERVENTION MONITOR THE VITAL SIGNS. ACCURATELY MONITOR THE THE BLOOD LOSS. HAVE THE BLOOD ALWAYS AVAILABLE INSPECT THE SURGICAL AREA FOR BLEEDING. INCREASE I.V FLUIDS.

DEEP VEIN THROMBOSIS:

DEEP VEIN THROMBOSIS DVT CAN OCCUR IN PELVIC VEINS.IT DEPENDS UPON THE COMPLEXITY OF THE SURGERY. IT IS COMMON IN HIP SURGERY, GENERAL THORACIC AND ABDOMINAL SURGERY

CAUSES:

CAUSES INJURY TO INTIMA. VENOUS STASIS. POLYCYTHEMIA. RISK FACTORS: OBESITY, ALCOHOL INTAKE , SMOKING ETC.

NSG INTERVENTION:

NSG INTERVENTION HYDRATE THE PATIENT ADEQUATELY. ENCOURAGE LEG EXERCISES AND AMBULATE THE PATIENT. AVOID PROLONGED SITTING OR STANDING. INITIATE ANTICOAGULENT THERAPY

CLINICAL MANIFESTATIONS:

CLINICAL MANIFESTATIONS DYSPNOEA. CHEST PAIN. CYANOSIS. TACHYCARDIA. DECREASED B.P

PREVENTIVE MEASURES:

PREVENTIVE MEASURES REPORT URTI. PROPER POSITIONING TO PREVENT REGURGITATION AND ASPIRATION ASPIRATE THE VOMITUS AND AVOID OVER SEDATION.

NSG INTERVENTION:

NSG INTERVENTION DETECT EARLY S/S OF BREATHING DIFFICULTIES. ADMINISTER THE OXYGEN. ASSIST IN COUGHING TO BRING UP THE MUCUS SECRETIONS

URINARY RETENTION:

URINARY RETENTION CAUSES. SPASM OF BLADDER SPHINCTER.. URINARY TRACT INFECTION. ACUTE RENAL FAILURE

CLINICAL MANIFESTATION:

CLINICAL MANIFESTATION INABILITY IN VOIDING. PASSING OF SMALL AMOUNT OF URINE . FREQUENT URINATION. LOWER ABDOMINAL DISCOMFORT

NSG INTERVENTION:

NSG INTERVENTION PROVIDE PRIVACY. USE WARMTH TO RELAX SPHINCTER. ASSIST THE PATIENT IN VOIDING. CATHETERIZATION THE PATIENT IF ALL MEASURES FAILS.

INTESTINAL OBSTRUCTION:

INTESTINAL OBSTRUCTION BOWEL OBSTRUCTIONS RESULT IN IMPAIRMENT TO THE FORWARD FLOW OF INTESTINAL CONTENTS

NSG INTREVENTION:

NSG INTREVENTION MONITOR FOR ADEQUATELY BOWEL RETURN AFTER SURGERY. ASSESS BOWEL SOUNDS AND DEGREE OF ABDOMINAL DISTENSION. MONITOR FLUID AND ELECTROLYTE BALANCE.

WOUND INFECTION:

WOUND INFECTION IT IS INVASION OF MICRO ORGANISMS INTO THE WOUND WHICH CAN LEAD DELAYED WOUND HEALING

NSG INTERVENTION:

NSG INTERVENTION KEEP THE DRESSING INTACT. USE STRICT STERILE TECHNIQUE. MONITOR THE AMOUNT, TYPE AND LOCATION OF DRAINAGE. ANTIBIOTICS SHOULD BE PRESCRIBED. CULTURE SHOULD BE TAKEN AND SENT FOR ANALYSIS. WOUND IRRIGATION SHOULD BE DONE

BIBLIOGRAPHY:

BIBLIOGRAPHY SMELTZER, SUZANNE C. AL BRUNNER & SUDDHARTS TEXT BOOK OF MEDICAL-SURGICAL NURSING-I-10 th ED. USA: REVEN PUBLISHERS; 1996:PP: LIPPINCOTT. MANUAL OF NURSING PRACTICE. INDIA:JAYPEE BROTHERS MEDICAL PUBLISHERS; 2006:PP:

CONTD…:

CONTD… BLACK JOYCE M.MEDICAL SURGICAL NURSING-7 th ED.2005:INDIA PVT. LTD;THOMSON PRESS;2005:PP: