Postoperative Nursing Interventions and Complications Flashcards

A set of 51 vocabulary flashcards detailing postoperative nursing interventions, complications, precautions, and physician notification guidelines based on lecture notes.

Atelectasis and Pneumonia Interventions

Interventions including patient positioning, incentive spirometer (I/S), turn (Q2), cough & deep breathe (TCDB), ambulation, and pain control so patients can perform these activities.

Incentive Spirometer (I/S)

A respiratory device used postoperatively as an intervention to prevent atelectasis and pneumonia.

TCDB

Stands for Turn (Q2), cough & deep breathe, an intervention designed to prevent atelectasis and pneumonia.

Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE) Interventions

Prevention measures including Ted hose, sequential compression devices (SCDs), leg exercises, ambulation, hydration, and anti-coagulants (enoxaparin, heparin, etc.).

Sequential Compression Devices (SCDs)

Inflatable sleeve devices applied to the legs to prevent deep vein thrombosis (DVT) and pulmonary embolism (PE).

Anti-coagulants

Medications such as enoxaparin and heparin used as preventive interventions for DVT and PE.

Non-pharmacological Pain Interventions

Pain management strategies without medication including ice & heat packs, repositioning, and splinting.

Non-narcotic Pain Medications

Analgesic medications including acetaminophen and NSAIDs used for pain management.

Narcotics

Opioid pain medications including morphine, hydromorphone, and hydrocodone.

Patient-Controlled Analgesia (PCA)

A pain medication system that can cause a decreased respiratory rate ($\downarrow\text{RR}$), requiring patient/family teaching and having Narcan ready.

ON-Q

A continuous localized pain pump used for postoperative pain control.

Hypothermia Definition

A postoperative temperature drop defined as $\downarrow 95\,^\circ\text{F} / 35\,^\circ\text{C}$.

Hypothermia Interventions

Therapeutic measures including warm IV fluids, warm blankets, and a Bair Hugger.

Bair Hugger

A warming unit used as an intervention to treat hypothermia ($\downarrow 95\,^\circ\text{F} / 35\,^\circ\text{C}$).

Third Space Shifting Interventions

Management strategies including daily weights, $\uparrow\text{IV}$ fluids, diuretics, and parenthesis (if severe & not responding to diuretics).

Parenthesis

An invasive procedure performed for severe third space shifting that is not responding to diuretics.

Constipation Interventions

Management including $\uparrow\text{Fluids}$, ambulation, prune juice (warmed with a little butter), $\uparrow\text{Fiber}$, stool softeners (Colace), laxatives (Miralax or milk of magnesia), and assessing if opioids can be discontinued.

Colace

A stool softener medication used as an intervention for constipation.

Laxatives

Medications such as Miralax or milk of magnesia used as interventions to treat constipation.

Nausea and Vomiting Non-pharmacological Interventions

Non-medication strategies including smelling an alcohol wipe, aromatherapy, oral hygiene, and minimizing unpleasant sights and smells.

Anti-emetics

Medications such as Ondansetron and metoclopramide used to manage nausea and vomiting.

Diet as Tolerated Progression

Postoperative dietary advancement sequence starting from ice chips $\rightarrow$ clear liquids $\rightarrow$ full liquids $\rightarrow$ soft foods.

Paralytic Ileus Interventions

Bowel interventions including ambulation, NPO (bowel rest), and nasogastric tube (NG) low intermittent suction.

Nasogastric (NG) Tube Low Intermittent Suction

A decompression intervention used for paralytic ileus or severe nausea and vomiting.

Non-invasive Urinary Retention Interventions

Methods to encourage voiding including the sound of running water, applying a warm wash cloth to the perineal area, and taking a warm shower.

Intermittent Catheterization Criteria

An intervention used if a bladder scan shows urinary retention after $8\,\text{hours}$.

Postoperative Delirium Interventions

Care strategies including placing the patient in a room near the nurses station, sunlight exposure, family & friend visitors, reorientation & redirection, maintaining normal bodily functions, avoiding restraints (if possible), and administration of Haloperidol (Haldol).

Haloperidol (Haldol)

A medication used as an intervention for postoperative delirium.

Fall Risk Interventions

Safety measures including placing the call light in reach, non-skid socks, orienting to room & keeping paths clear, hourly rounding, dangling before ambulating (1st time with RN), and assistive devices if needed.

Hourly Rounding ("6 Ps")

Regular safety and comfort checks covering pain, potty, position, personal items, picnic, and pump.

First-time Postoperative Ambulation

A safety protocol requiring the patient to dangle first and undergo the initial ambulation with the RN.

Postoperative Activity Showering Guidelines

Patients may shower and pat dry, but no tub baths or swimming are allowed.

Postoperative Lifting Restriction

A weight limitation restricting lifting to a maximum of $10\,\text{lbs}$.

Care of Drains, Catheters, and Wound Vac

Care protocols including measuring intake & output (I/Os), assessing color, clarity, and odor, cleaning & compressing correctly, securing to the patient, and watching for kinks and blockages.

Sutures and Staples Management

Incisional care involving assessing for complications, keeping clean & dry, and knowing when and how to remove them.

Wound Dehiscence Intervention

An incisional support intervention utilizing splinting.

Abdominal Binder

A supportive abdominal wrap used in the context of wound evisceration management.

Wound Evisceration Positioning

Placing the patient in Low fowlers position with feet slightly elevated if evisceration occurs.

Wound Evisceration Dressing

Applying a sterile saline dressing over the surgical site if wound evisceration occurs.

Wound Evisceration Action Sequence

If evisceration occurs: place in Low fowlers with feet slightly elevated, apply sterile saline dressing over surgical site, and notify surgeon $\rightarrow$ OR.

Wound Infection Interventions

Preventative and reactive care including hand hygiene, sterile/aseptic wound care, nutrition & hydration, and obtaining cultures & antibiotics if infection occurs.

Doctor Notification Criteria: Fever

An indication to call the doctor when the patient has an infection with fever $>100.4\,^\circ\text{F}$ and chills.

Doctor Notification Criteria: MI or PE

An urgent condition requiring doctor notification when the patient experiences chest pain or shortness of breath.

Doctor Notification Criteria: DVT

An indication to call the doctor when the patient experiences pain or swelling in the leg.

Doctor Notification Criteria: Abdominal Pain

An indication to call the doctor if the patient has increasing abdominal pain or bloating.

Doctor Notification Criteria: Surgical Site Changes

An indication to call the doctor for swelling, redness, heat, pus, & changes at the surgical site.

Doctor Notification Criteria: Urinary Retention

An indication to call the doctor when the patient is unable to urinate.

Ted Hose

Anti-embolism stockings used as an intervention to prevent DVT and PE.

Narcan Readiness

Keeping Narcan ready at the bedside when a patient is receiving PCA narcotics due to the risk of decreased respiratory rate ($\downarrow\text{RR}$).

NPO Fluid Protocol

Administering IV fluids when a patient is NPO to maintain hydration and balance electrolytes.

Uncontrollable Surgical Pain

A specific postoperative pain condition that serves as a criteria to call the doctor.