Perioperative: Chpt. 16.1 Postoperative Nursing Care and PACU Management

What is dehiscence in wound care?

Dehiscence is the partial or complete separation of wound edges.

What does evisceration refer to in surgical terms?

Evisceration refers to the protrusion of organs through a surgical incision.

What is first-intention healing?

First-intention healing is a method where wound edges are surgically approximated and integumentary continuity is restored without granulation.

What is the role of phase I PACU?

Phase I PACU is designated for the care of surgical patients immediately after surgery and for those needing close monitoring.

What characterizes phase II PACU?

Phase II PACU is for patients who have been transferred from phase I because they no longer require close monitoring and are prepared for transfer to an inpatient unit or discharge.

What is the purpose of the postanesthesia care unit (PACU)?

The PACU is where postoperative patients are monitored as they recover from anesthesia.

What is second-intention healing?

Second-intention healing is when wound edges are not surgically approximated and healing occurs through the process known as granulation.

What are the focuses of nursing care during the postoperative period?

Nursing care focuses on reestablishing the patient’s physiologic equilibrium, alleviating pain, preventing complications, and educating the patient about self-care.

What criteria must patients in PACU meet before discharge?

Patients must meet predetermined discharge criteria related to their type of surgery and preexisting conditions.

What are the primary objectives of nursing management in the PACU?

To provide care until the patient has recovered from the effects of anesthesia and to stabilize vital signs.

What complications are monitored for in the PACU?

PACU nurses monitor for complications such as hemorrhage, respiratory distress, hypotension, and shock.

What are some signs of hypovolemic shock?

Signs include pallor, cool moist skin, rapid breathing, cyanosis of lips, weak pulse, low blood pressure, and concentrated urine.

What is postoperative nausea and vomiting (PONV)?

PONV occurs in about 30% to 50% of surgical patients and should be managed promptly at first report of nausea.

How is pain typically managed in the PACU?

Pain is managed primarily with opioid analgesics, often delivered intravenously for immediate effect.

What should be done if the patient's vital signs fluctuate significantly in PACU?

The nurse should assess the patient further, administer fluids or medications as needed, and notify the physician of significant changes.

What is indicated if a patient does not void within eight hours after surgery?

If a patient does not void, urinary retention may be assessed using a portable bladder ultrasound; catheterization may be necessary.

What are common gerontologic considerations in postoperative care?

Older patients recover more slowly and have a higher risk of complications; care includes monitoring for delirium and ensuring thermoregulation.

What is wound dehiscence?

Wound dehiscence is the disruption of a surgical incision or wound.

What are the management strategies for preventing venous thromboembolism (VTE) in postoperative patients?

Prevention includes early ambulation, use of compression stockings, and possibly pharmacologic prophylaxis.