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.You’ll also closely monitor your patient’s respiratory status.

Check for signs of airway obstruction, such as inspiratory stridor; signs of atelectasis like decreased breath sounds or an oxygen saturation less than 95 percent; or other indications of respiratory compromise such as tachypnea, dyspnea, or chest wall retractions.To promote gas exchange, administer supplemental oxygen, as prescribed, and reposition your patient with their head of bed elevated to allow for full chest expansion.

Also, encourage them to cough, deep breathe, and to use their incentive spirometer to promote lung expansion, prevent atelectasis, and mobilize airway secretions.Additionally, watch your patient closely for clinical manifestations of hemorrhage.

Visualize your patient’s surgical dressings to check for new or increased bloody drainage; and remember to check the bedding underneath your patient for blood that may have leaked from the surgical site and pooled beneath them; and monitor the amount of blood in surgical drains.Measure and document the amount of blood loss; and notify the registered nurse for any blood loss more than the expected amount or for signs and symptoms of hemorrhage such as a weak, rapid, thready pulse; hypotension; or cool, clammy skin.

Apply pressure to sites of active external bleeding; and work with the registered nurse to administer supplemental oxygen; increase the IV flow rate; and administer volume expanders or blood products as prescribed.To control your patient’s postoperative pain, you’ll use pharmacological and nonpharmacological measures.

Ask them about their pain level and compare this with their tolerable level of pain. Then, administer the prescribed analgesics as needed, and offer non-pharmacological distraction activities, like listening to music, or assist them with guided imagery.

Be sure to determine the effectiveness of each intervention and notify the registered nurse for pain that’s uncontrolled.Lastly, if your patient experiences emotional distress following surgery, be sure to provide them with emotional support, assist them with coping strategies, and refer them to the case manager or social worker, as needed.

If your patient has an altered self-image, encourage them to verbalize their feelings and provide them resources for support groups, if indicated.Alright, as a quick recap....

Postoperative care involves the management of your patient’s health during the postoperative period, which begins after the surgical procedure is complete, and lasts until the patient is discharged.

During this period, you’ll closely monitor your patient for post-operative