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Potential Post-Op Alterations (Respiratory (potential complications…
Potential Post-Op Alterations
Respiratory
Ineffective airway clearance
ineffective breathing pattern
impaired gas exchange
potential complications
pneumonia
**atelectasis
bronchial obstruction
decreased respiratory excursion
pulmonary edema
aspiration of gastric contents
pre-medicate with histamine-H2 receptor antagonist before anasthesia - prevents HCl secretions
bronchospasm:
small airway closes --> edema --> secretions --> increase bronchial smooth muscle tone
wheezing, dyspnea, use of acc muscles, hypoxemia, tachypnea
Causes of Post-Op Airway Compromise
A: obstruction
B: hypoxemia (PaO2 <55-60 mmHg)
hypoventilation
Greater risk: general anestheisa, older, heavy smoker, lung disease, obesity; thoracic, airway, abdominal sx
NURSING CARE
(
A
) Airway patency - chest symmetry, respirations - depth, rate, character
(
B
) temperature, oximetry, respiratory rate, patterns, breath sounds
notify anaesthesiologist of crackles or wheezes
hypoxemia present?
regularly monitor VS with pulse ox
sputum characteristics
(
B
) deep breathing and coughing techniques:
10 times each hour while awake. prevent alveolar collapse, aid movent of resp secrns to larger airways to expel. Incentive spirometer for visuals
pre-medicate for pain; splint abdominal incision
Cardiovascular
common complications
(
C
) hypotension
(
C
) hypertension
(
C
) dysrhythmias:
cause often identifiable
(
C & D
) syncope
hypokalemia
stress response
Neurological Function
emergency delirium
delayed awakening
NURSING CARE
(
D
) AVPU, GCS
(
D
) Orientatoin
(
D
)ability to follow commands
(
D
)size, reactivity, and equality of pupils
(
D
) sensory and motor status - risk of injury