Deep Vein Thrombosis

Deep Vein Thrombosis - can get from lower abdominal surgery

1. cause

2. signs & symptoms

3. management

4. pulmonary embolism

Respiratory Complications – cigarette smokers, chest surgery, abdominal surgery pts,

1. Aelectasis – primarily, temp > 100

2. bronchitis (is a form of COPD, as is asthma), can produce muco-pus

3. bronchopneumonia - 2^nd most common complication. productive cough, ↑T, ↑pulse, ↑resp.

4. lobar pneumonia – lobe of the lung, chill, ↑TPR, flushed cheeks, little or no cough, give antibiotics, expectorant, fluids

5. hypostatic pulmonary congestion – old, weak, poor ambulation, secretions pool in lungs, crackles in lungs, dullness in lower lung, semi-Fowlers

6. pleurisy – inflammation, knife-like pain in chest on inspiration, slight T, resp. rapid, ↓O₂ ,

restless, apprehension, give pain meds & antibiotics, ambulate, inspirometer

know pulmonary embolism S&S postop

Urinary Complications

1. urinary retention – caused by spasms of bladder sphincter (assess bladder) can use ultrasound

2. urinary incontinence - elderly

GI Complications

1. nausea – postop prevent aspiration

2. constipation

3. paralytic ileus (no bowel sounds). bowel sounds should be back within 24 hrs. in 36 hrs if not present, it is paralytic ileus

4. intestinal obstruction – twist or scar tissue blockage

   a. hyperactive bowel sounds above obstruction

   b. hypoactive bowel sounds below obstruction

Postop Psychosis

1. physiological

   a. cerebral anoxia

   b. meds

   c. * electrolyte imbalance

   d. thromboembolism to brain

2. psychological

   a. fear & anxiety (to prevent: inform pt, orient, be positive, talk about familiar things)

   b. pain

   c. depression

   d. obscured vision, confinement (ICU pts)

severe: need mental health expert, use same nurse each day, well-lit room, restraint if necessary