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Postoperative Nursing Care

Stefanie Wortham RNC, MSN Postoperative period
  • From the surgical suite to the PACU
  • PACU is recovery room
  • 1:1 nurse/client ratio until recovery complete
  • Last 1-2 hours depending on complications with client
  • Transferred to floor following recovery
Recovery Room
  • Assessments made every 10-15 minutes
  • PCA pump is started and/or orders for pain medication obtained write on flow sheet every 5 minutes (after starts) for first 15 minutes, less frequent over time.
  • Anesthesiologist is readily available for any problems related to anesthesia and pain
  • Surgeon readily available for any postoperative complications
  • Pt needs to be stabilized, awake, & alert before transferring
Assessments Include:
  • Respiratory movement of chest - check for symmetry of expansion, equality auscultate, do continuous O2 sat, check ABC
  • Cardiovascular 3 lead EKG
  • Pain/Comfort pt may be cold, cover with blanket
  • Level of Consciousness
  • Fluid intake/Intravenous fluids
  • Wound/Dressing
  • Movement/Sensation
  • Anesthesia
  • Nausea and vomiting
  • Vital signs compare to baseline data
  • Color and temperature of skin
  • Other tubes check tube patency (chest tubes, endotrach. tube, Foley, NG, JP drain etc)
  • Position and safety initially side lying to prevent aspiration, face slightly down.
  • Blood sugar if diabetic
  • Return of Consciousness never leave unattended
  • Unconscious assess LOC & document on flow sheet
  • Response to touch and sounds orient to room, reassure
  • Drowsiness
  • Awake but not oriented
  • Awake and oriented

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