POST OP CARE

DIVYA MEHTA
NURSING OFFICER
SIR GANGARAM HOSPITAL
 DEFINITION
• Post-operative care is the care that the patient receives
after a surgical procedure. The type of post-operative care
that the patient needs depends on the type of surgery as
well as the patient’s history. It often depends upon pain
management and wound care
 PHASES

Immediate (Post-anaesthetic) Phase 1

Intermediate (Hospital stay) Phase 2
Covaslescent (After discharge to full recovery)
 PURPOSES

 To enable a successful and faster recovery of the patient

post operatively.
 To reduce pst-operative mortality rate.
 To reduce the length of hospital stay of the patient.
 To provide quality care service.
 To reduce hospital and patient cost during post-operative
period.
 Post-Operative Care Unit (PACU)
PACU should be:-
 Sound proof
 Painted in soft colour
 Isolated
These features will help the patient to rduce anxiety and
promote comfort.
 Phase-1 Immediate (Post -anaesthetic)

 It is the immediate recovery phase and requires intensive

nursing care to detect early signs of complications.
 Receive a complete patient record from the operating
room to plan post operative care.
 It is designed for care of surgical patients immediately
after surgery and patient requiring close monitoring.
Nursing management in post operative care unit
1. ASSESSING THE PATIENT:
Frequent assessment of the patient for
 Oxygen saturation
 Pulse volume and regularity
 Depth and nature of respiration
 Skin colour
 Consciousness level
2. MAINTAINING A PATENT AIRWAY:
 The primary objectives are to maintain pulmonary
ventilation and prevent hypoxia and hypercapnia.
 To provide oxygen, assess respiratory rate and depth,
oxygen saturation.
3. MAINTAINING CARDIOVASCULAR STABILITY:
 Assess the patient’s mental status, vital signs, cardiac
rythm, skin temperature, color and urine output, central
venous press, arterial lines and pulmonary artery
pressure.
 The primary cardiovasclar complications include
hypotension, shock, hemorrhage, hypertension and
dysarrythmias.
4. RELIEVING PAIN AND ANXIETY:
 Opioid analgesics
5. ASSESSING AND MANAGING THE SURGICAL SITE:
 The surgical site is observed for bleeding, hematoma,
type integrity of dressing and drains.
6. ASSESSING AND MANAGING GI FUNCTION:
 Nausea and vomiting are common after anaesthesia.
 Check for peristalsis movement
7. ASSESSING AND MANAGING VOLUNTARY VOIDING:
Urine retension after surgery can occure for a variety of
reasons
Opioids and anaesthesia interfere with the perception of
bladder fullness.
8. ENCOURAGE ACTIVITY:
 Most patients are encouraged to get out of the bed as
soon as possible
 Early ambulation reduces the incidence of post GI
discomfort and circulatory problem.
 COMPLICATIONS
 Shock: It is the response of the body to a decrease in the
circulating volume of blood, impaired tissue perfusion,
cellular hypoxia and death.
 Hemorrhage: It is the escape of blood from the blood
vessel.
 Deep vein thrombosis: It occur in pelvic and lower
extremity surgeries where patient requires prolonged bed
rest
 Pulmonary Embolism: It is the obstruction of one or more
pulmonary rterioles by an embolus originating some
where in the venous system or in the right side of heart.
 Urinary Retention
 Intestinal Obstruction: Results in partial or complete
impairment to the forward flow of intestinal content.
 CAUSESOF COMPLICATIONS AND DEATH
 Acute Pulmonary Embolism
 Cardio-Vascular problems
 Fluid derangements
 PREVENTIONS
Recovery room:
 Anaesthetist responsibilities towards cardio-pulmonary
functions
 Surgeon’s responsibilities towards the operation site

Trained nursing staff:

 To handle instructions
 Continous monitoring of patient (vital signs etc.,)
• Discharge from recovery should be after complete
stabilization of cardio-vascular, pulmonar and neurological
functions which usually takes 2-4hours
• If not patient should be shifted to special care in ICU
THANK YOU