Post operative nursing

care
LORIEGA, FAYE ANN V.
BSN-3C
The postoperative phase of the surgical""

experience extends from the time the

client is transferred to the recovery room
or postanesthesia care unit (PACU) to the
moment he or she is transported back to
the surgical unit, discharged from the
.hospital until the follow-up care
 POST OPERATIVE CARE UNIT OR POST
ANESTHETIC CARE UNIT[PACU]

Patients still under anesthesia or

recovering from anesthesia are placed
in the unit for observation by highly
skilled nurses,anesthetist and surgeon.
check the incisional site and dressing, and locate
any drains, tubes, or catheters that were placed
during surgery. Also check the IV site, solutions,
and infusion rate. Lastly, be sure to collect
information about the client’s medical history,
medications, allergies, the use of assistive devices
such as glasses, hearing aids, or walkers.
 Postoperative Phase
• Admission to the recovery room
• Maintain airway
• Monitor vital signs
• Assess effects of anesthesia
• Assess for complications of surgery
• Provide comfort and pain relief
• Ends with follow-up evaluation in clinical
setting or home
Nursing management in the post
:anesthesia care unit
I-Assessing the patient:
Frequent assessment of the patient oxygen saturation,
pulse volume and regularity, depth and nature of
respiration, skin color ,depth of consciousness.
II- Maintaining a patent airway:
− The primary objectives are to maintain pulmonary
ventilation and prevent hypoxia and hypercapenia.
− The nurse applies oxygen, and assesses respiratory
rate and depth, oxygen saturation
-Check their airway patency, and adequacy of gas
exchange. Encourage them to take deep breaths, and
show them how to use of incentive spirometer.
Nursing management in the post
:anesthesia care unit
III- Maintaining cardiovascular stability:
− The nurse assesses the patient’s mental
status, vital signs, cardiac rhythm, skin
temperature, color and urine output.
− Central venous pressure, arterial lines and
pulmonary artery pressure.
− The primary cardiovascular complications
include hypotension, shock, hemorrhage,
hypertension and dysarrythmias.
Nursing management in the post
:anesthesia care unit
IV- Assessing and managing the surgical site:
− The surgical site is observed for bleeding, type and
integrity of dressing and drains.
V- Assessing and managing gastrointestinal function:
− Nausea and vomiting are common after anesthesia.
− Check of peristalsis movement.
Nursing management in the post
:anesthesia care unit
VI- Assessing and managing voluntary voiding:
− Urine retention after surgery can occur for a verity of reasons.
Opioids and anesthesia interfere with the perception of bladder
fullness.
- Abdominal, pelvic ,hip may increase the like hood of retention
secondary to pain.
VII- Encourage activity:
− Most surgical are encouraged to be out of bed as soon as
possible. Early ambulation reduces the incidence of post
operative complication as ,atelectasis ,pneumonia,
gastrointestinal discomfort and circulatory problem.
To determine the patient’s readiness for discharge from the PACU certain
criteria must be met. Uncompromised cardiopulmonary status

1. Stable vital signs

2. Adequate urine output – at least 30 ml/ hour
3. Orientation to time, date and place
4. Satisfactory response to commands
5. Minimal pain
6. Absence or controlled nausea and vomiting
7. Pulse oximetry readings of adequate oxygen saturation
8. Satisfactory response to commands
9. Movement of extremities after regional anesthesia