Postoperative Nursing Care

Postoperative care involves the management of a patient’s health during the postoperative period, which begins after the surgical procedure is complete and lasts until the patient is discharged from the health care facility. As a nurse, you’ll closely monitor your patient for postoperative complications and intervene as needed. Now, some of the most common postoperative complications include respiratory complications, hemorrhage, pain, and emotional distress. Starting with respiratory complications, these can include problems with airway obstruction and gas exchange. First, airway obstruction can result from laryngospasm, or a spasm of the vocal cords, caused by laryngeal irritation from intubation. This can narrow your patient’s airway and obstruct the flow of air into the lungs. Then, gas exchange can be impaired due to the effects of anesthesia, because it reduces surfactant production in the lungs, which is needed to keep the air sacs, called alveoli, open and full of air. When there’s less surfactant, the walls of the alveoli tend to collapse, leading to atelectasis, where portions of the lungs are not fully expanded. Likewise, anesthesia tends to depress respirations, causing hypoventilation, resulting in the buildup of carbon dioxide, a decrease in oxygen, and hypoxemia, or low blood oxygen levels.

Next, hemorrhage can occur when blood is lost at or around the surgical site either internally or externally due to incomplete hemostasis, or clotting. Now, although some blood loss is expected during surgery, hemorrhagic blood loss typically means that at least 15 percent, or 750 milliliters of total blood volume is lost. Excessive blood loss can lead to hypotension, impaired perfusion, and hypovolemic shock. Then there’s postoperative pain, which is typically related to the disruption of tissue integrity caused by the surgical procedure or by improper body alignment during the surgical procedure. Now, pain is an expected finding after surgery but uncontrolled pain, as well as pain that’s out of proportion to what’s expected, can lead to delayed healing and anxiety.

Lastly, patients may experience emotional distress because of fatigue, activity restrictions, limited self-care abilities, or an altered body image, due to scarring or amputation of a body part.

Okay, so, when providing postoperative care, you’ll collaborate with the registered nurse to monitor your patient for complications, starting with their vital signs. According to your facility’s policy, you’ll measure your patient’s vital signs regularly, typically every 5 to 15 minutes for the first hour of care. Be sure to compare their vital signs to their baseline to identify any significant differences which could indicate a complication, like tachycardia due to hemorrhage or uncontrolled pain.