Care after any surgical procedure is called post-operative care. Post-operatively a patient is likely to experience surgical complications, and to prevent this, keen monitoring of the following is essential
- Respiratory rate
- Saturation levels of oxygen
- Blood pressure
- Pulse rate
- Level of consciousness and orientation
Also assess for signs of shock, hemorrhage, and the effects of anesthetic agents or analgesia administered. Strictly monitor fluid balance, intravenous infusions received, surgical site, drainages like nasogastric tubes and wound drainages, ventilators if connected, peripheral venous catheters and blood transfusion done. Provide adequate pain management and record all events appropriately. Nurses play a pivotal role in various post-operative settings as given below.
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Role of Nurses in Post Operative Care
Post laparotomy care
Laparotomy is a major surgical procedure and needs comprehensive care. Type of anesthesia can heavily affect the breathing status. Wound care and prevention of bleeding need to be focused. Restoration of gastrointestinal function through assessment of bowel sounds is primarily important. Prevention of skin damage due to bed rest, intake and output monitoring, prevention of surgery-related complications, pain management are all imperative in post-laparotomy care. The establishment of stabilized hemodynamic status is required. Strict observation of diagnostic or laparotomy related complications is mandatory. Start fluids only after the bowel sounds are auscultated.
Nursing care after Cesarean section
C-section plays a pivotal role in childbirth in the present scenario. As we know, it is similar to laparotomy, but deals with the pelvic organs specifically, the opening of the uterus. Care post-C-section is similar to laparotomy care. But the emphasis is placed to help the uterus regain its function and structures, pre-pregnancy. You must be aware to restore fluid levels, prevent bleeding, manage pain related to wound and uterine contractions, monitor and manage hemodynamics, provide proper wound care, intake and output management, and focus on early ambulation. Nursing care measures should also focus on managing the mother’s emotional status.
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Tracheostomy is the surgical opening of the trachea, made when there is an obstruction in the airway. Tracheostomy care involves suctioning and adequate cleaning of the cannula. Standard precautions must be followed in tracheostomy care. Assessing the tracheostomy wound for infections is highly important. The correct sized catheter must be chosen while suctioning. Be careful not to induce pain or cause bleeding while suctioning. For this correct sized catheter must be used. Avoid the tight place of gauzes over the tracheal opening to prevent blockage. Do not remove the cannula unless indicated by the physician. Use tracheostomy covers to prevent the entry of dust. Help the patient communicate through writing or using gestures after tracheostomy.
Post-operative eye care
Post-operative eye care can be made a smooth one with the help of well-planned care measures. Advice the patient to avoid strenuous activities for a few weeks. Avoid strenuous exercises and lifting activities. Avoid driving. Help the patient follow the physician’s orders. Teach the patient about the use of eye drops, preventing infections in the surgical area, and advice not to rub the eyes. Educate about the dietary measures, bathing, daily activities to be followed and resuming normal activities, wound care and signs of complications.
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As detailed above, nurses need comprehensive knowledge on the care of patients in post-operative settings. The given post-operative care, are a few examples of settings were nurses work in a skillful way. A wide variety of surgical procedures is carried out every day, and nurses should possess good knowledge of all aspects of care. This enhances nurses skill in reducing mortality and morbidity rates associated with any surgical procedure, and prevent complications.
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