Peri-Operative Nursing and Post-Operative Care

These flashcards review essential peri-operative nursing concepts: focused assessments, common postoperative complications and interventions, safety protocols, pre-operative preparation, types of surgery, and factors influencing surgical outcomes.

What postoperative vital-sign changes may indicate fluid volume deficit (shock)?

Tachycardia and hypotension.

Which minimum hourly urine output signals adequate renal perfusion after surgery?

At least 0.5 mL/kg/hr (≈30 mL/hr for most adults).

Name the six major areas included in a focused postoperative physical assessment.

Vital signs; neurologic status; skin/incision; abdomen; extremities; thorax/heart.

During a neurologic check, how are pupils evaluated?

For size, equality, and response to light.

What does a sudden increase in drainage from a closed-suction drain (e.g., Jackson-Pratt) suggest?

Possible hemorrhage or disruption of the surgical site and must be reported.

Expected urine output from an indwelling catheter in the first 2 hours post-op is ****.

800–1500 mL of clear, yellow urine.

Why are compression stockings or SCDs applied pre- and post-operatively?

To prevent deep-vein thrombosis (DVT) and promote venous return.

List two nursing actions when DVT is suspected in an extremity.

Place the leg on bedrest/avoid pressure and notify the provider for anticoagulation orders.

Before ambulation of a post-anesthesia patient, what three assessments are essential?

Level of consciousness, motor function, and sensation.

Define paralytic ileus.

Cessation of intestinal peristalsis leading to abdominal distention and absence of bowel sounds.

First nursing intervention for suspected paralytic ileus.

Insert or maintain an NG tube for gastric decompression as ordered.

Which medication class is given to treat postoperative constipation?

Laxatives or suppositories (e.g., bisacodyl).

List three key measures to prevent postoperative pneumonia.

Frequent position changes, cough & deep-breathing exercises, and incentive spirometer use.

Early sign of inadequate oxygenation to monitor every hour during the first 24 h.

Declining SaO₂ (pulse oximetry).

What respiratory finding often accompanies postoperative pneumonia?

Crackles or wet lung sounds on auscultation.

Time frame when a surgical wound infection usually appears.

3–5 days after the operation.

Initial nursing action when wound infection is suspected.

Obtain a wound culture to identify the causative organism.

List four items the pre-operative Time-Out verifies.

Right patient, right procedure, right site, and availability of required documents/equipment.

Why must patients void before receiving pre-op opioids or anxiolytics?

To prevent falls and urinary retention when drowsiness occurs post-medication.

Give two examples of pre-op medications and their purposes.

Opioids to reduce pain/anxiety; anticholinergics to decrease secretions and prevent bradycardia.

How long after surgery should a patient void spontaneously before further action is taken?

Within 6–8 hours post-op.

Priority nursing action when bladder scan shows >300 mL retained urine.

Perform straight catheterization per provider order.

Why are nail polish and jewelry removed before surgery?

To allow accurate assessment of circulation/oxygenation and prevent electrical burns or loss.

Which identification bands must remain in place for surgery?

ID band, allergy band, DNR band, limb-alert band, fall-risk band.

Type of surgery performed to relieve symptoms without curing disease.

Palliative surgery.

What is ablative surgery?

Removal of diseased tissue (e.g., cholecystectomy).

Two nutrition-related factors that increase postoperative complications.

Malnourishment (poor wound healing) and obesity (respiratory & wound problems).

How does smoking affect surgical outcomes?

Impairs wound healing and increases pulmonary complications.

Which herbal supplement increases bleeding risk during surgery?

Garlic (as well as ginkgo, ginseng).

Kayexalate is used to treat which electrolyte imbalance?

Hyperkalemia (high serum potassium).

Key nursing concern after giving Kayexalate.

Monitor for hypokalemia signs: muscle cramps, weakness, arrhythmias.

IV magnesium sulfate is indicated for ****.

Hypomagnesemia (low serum magnesium).

Critical assessment when administering IV magnesium.

Monitor deep tendon reflexes and respiratory rate to detect toxicity.

What does the Honan sign assess?

Pain on dorsiflexion of the foot indicating possible DVT (now largely replaced by other assessments).

Purpose of dangling a patient’s legs at bedside before standing.

To prevent orthostatic hypotension and assess balance prior to ambulation.

Normal daily drainage from a T-tube after cholecystectomy.

About 500 mL of bright yellow bile, decreasing over several days.

Significance of serosanguineous drainage turning suddenly sanguineous.

Possible hemorrhage; requires immediate provider notification.

Why is early ambulation encouraged post-operatively?

Reduces risk of constipation, paralytic ileus, DVT, and promotes lung expansion.

Minimum assessment data included in a pre-operative health history.

Reason for surgery, procedure name, medical diagnosis, allergies, medications, disabilities/prostheses.

Which lab test guides oxygen therapy in a hypoxic postoperative patient?

Arterial blood gas (ABG) analysis.

Define ‘open drain’ and give one example.

A passive drainage system without suction, e.g., Penrose drain.

Expected characteristic of nasogastric (NG) drainage immediately after gastric surgery.

Bloody then progressing to pale yellow or serosanguineous fluid.

First nursing action when hypovolemia is suspected post-op.

Notify the provider and anticipate rapid IV fluid administration.

What PPE and practice are vital to prevent surgical site infection?

Strict hand hygiene and aseptic wound care techniques.

Priority safety measure when transferring a sedated patient to the OR table.

Apply safety straps and maintain warmth while the patient is still awake.

Purpose of the pre-operative bowel prep for lower abdominal surgery.

To reduce fecal content and minimize risk of contamination during surgery.

Functional assessment data important for peri-operative planning.

Usual activity level, support system, coping methods, and use of assistive devices.