eveeas as Post-op Nursing Care: PACU assessment ‘© Induction: IV line inserted, pre-op meds given, airway Secured. ‘+ Maintenance: Surgery performed, maintenance of airway, = Emer Surgery Meds: ‘Anesthetics (ex: benzodiazepines, propofol) (Opioid analgesics (ex: fentany!) ‘Antiemetics (ex: ondansetron, meteclopramice) "Neuromuscular blocking agents (ex: succinyicholine) Anticholnergics (ex: atropine) ‘Completion of surgery, airway removed. ‘Assess airway. Check Sp02 (should be > 95% or at pre-op level), respirations, lung sounds. Suction secretions if needed, ‘Assess Circulation, Assess for signs of hemorrhaging (hypotension, tachycardia), skin coloritemp, peripheral pulses, ECG readings. ‘Assess vital signs (stable for dc from PACU). Monitor 8s, Ensure urine output >= 30 mis. ‘Assess surgical wounds, incisions, dressings Ensure return of gag and swallow reflexes. PERIOPERATIVE NURSING Informed Consent Nw | [Post-op Nursing Care: ws lursing care after PACU Provider responsibilities: + Communicate purpose of procedure, and complete ‘description of procedure i he patents mary language {use medical interpreter i needed), + Explain iss vs. benefits Describe other options to reat the contion AN responsibilities: * Make sure provider gave the patient the above information, 1 Ensure patent is competent to give informed consent (Le patent san adult or emancipated minor, not mpeared) «+ Have patient sign consent document ‘Notify provider patient as more questions or dossnit understand any information provided Encourage early ambulation. Prevent DVTs: apply SCDs, reposition frequently, administer anticoagulants, ‘Treat pain, nausea ‘Monitor for S&S of infection at surgical site (redness, extreme tendemess, purulent drainage) > Expected findings: pink wound edges, slight edema, slight crusting at incision line. ‘Teach patient to splint wicoughing and deep breathing, ana IN Malignant Hyperthermia Malignant hyperthermia: Hypermetabolic condition induced by anesthetic agents in surgery. ‘Symptoms: FEVER, tachycardia, hypotension, tachypnea, dysrhythmias, muscle rigidity, mottied skin, cyanosis, Treatment; ‘Discontinue surgery ‘+ Administer dantrolene (muscle relaxant) as ordered. ‘Administer 100% oxygen, obtain ABGS ‘© Administer iced NaCI IV tuids, apply cooling blanket.