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Medical-Surgical Nursing, 9th Ed., Ignatavicius & Workman, 2018 | Nursing (RN) School Study Aid


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16 - Care of Postoperative Patients
22 Picmonics to Learn | 35 mins

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Postoperative Care
Head to Toe Assessment
Complications
Hemorrhage
Clotting
Pain
Dehiscence or Evisceration
Respiratory Complications
Paralytic Ileus
Infection
2 mins
Postoperative Fever
5 W's
Wind (Days 1-3)
Atelectasis
Pneumonia
Water (Days 3-5)
Urinary Tract Infection from Catheter
Walking (Days 4-6)
Deep Vein Thrombosis (DVT)
Pulmonary Embolism
Wound (Days 5-7)
Infection
Wonder Drugs (Days 7+)
Drugs
2 mins
Vital Signs - Adult
Temperature (96.8-100.4 Degrees F) (36-38 Degrees C)
Rectal - Remove 1 Degree
Axillary - Add 1 Degree
Respiration (12-20)
Oxygen Saturation (94%-100%)
Pulse (60-100)
Blood Pressure (<120/80)
Pain
2 mins
Venous Thromboembolism (DVT) Interventions
Anticoagulants
Prevention Education
Frequent Ambulation
Leg Exercises
Compression Stockings or SCD's
Avoid Nicotine and Oral Contraceptives
Surgery
1 min
Level of Consciousness: Descriptive guide for Glasgow Coma Scale
Conscious
Confused
Delirious
Somnolent
Obtunded
Stuporous
Comatose
3 mins
IV Solutions
Hypotonic (< 280 mOsm/L)
1/4 Normal Saline (0.225% NaCl)
1/2 Normal Saline (0.45% NaCl)
Isotonic (280-300 mOsm)
Normal Saline (0.9% NaCl)
Lactated Ringer's (LR)
Dextrose 5% in Water (D5W)
Hypertonic (> 300 mOsm)
3% or 5% NaCl
Dextrose 5% in 0.45% NaCl
Dextrose 10% in Water (D10W)
3 mins
Ondansetron
Indications
Postoperative Vomiting
Chemotherapy-induced Nausea and Vomiting
Mechanism
5-HT3 Serotonergic Antagonist
Centrally-acting Antiemetic
Side Effects
Headache
Constipation
QT Prolongation
1 min
Interventions for Impaired Skin Integrity
Assessment
Signs of Skin Breakdown
Pain
Redness
Decreased Skin Turgor
Bleeding
Bony Prominences
Intervention
Reposition Q2H
Pressure Relief
Maintain Clean and Dry Skin
Adequate Nutrition and Hydration
2 mins
Wound Drainage Types and Devices
Drainage Types
Serous
Serosanguineous
Sanguineous
Purulent
Drainage Devices
T-tube
Penrose
Jackson-Pratt (JP)
Hemovac
Considerations
Record Drainage Amounts
Check Device Function
2 mins
Anxiety Assessment
Mild
Increased Alertness
Heightened Perception
Moderate
Perception Narrowed
Short Attention Span
Shaking
Severe
Ineffective Problem Solving
Automatic Behavior
Hyperventilation
Panic
Hallucinations
Inability to Function or Communicate
2 mins
Oxygen Delivery Methods
Nasal Cannula
Simple Face Mask
Non-Rebreather Mask
Venturi-Mask
Safety Precautions
Oxygen In Use Sign
No Electrical Sparks
Six Feet Away from Open Flames
Nursing Considerations
Dry Nasal and Upper Airway Mucosa
Skin Irritation
Home Education
1 min
Morphine
Mechanism
Opioid Receptor Agonist
Indications
Pain
Myocardial Infarction
Side Effects
Nausea and Vomiting
CNS Depression
Biliary Colic
Constipation
Increased Intracranial Pressure (ICP)
Pupillary Constriction
Hypotension
2 mins
Butorphanol
Indications
Migraine
Severe Pain
Labor
Mechanism of Action
Partial Agonist at Mu and Full Agonist at Kappa Receptors
Less Respiratory Depression
Side Effects
Withdrawal Symptoms
1 min
Codeine
Mechanism
Opioid Receptor Agonist
Indications
Mild to Moderate Pain
Cough Suppressant
Side Effects
Sedation
Constipation
Miosis
Considerations
Close Monitoring When Breast Feeding
Often Combined with Non-Opioids
2 mins
Ibuprofen (Advil, Motrin)
Mechanisms
NSAID
COX Inhibitor
Indications
General Pain
Fever
Inflammatory Conditions
Side Effects
GI Ulcers
Nephrotoxicity
Rash
Considerations
Avoid with Alcohol
Risk of Thrombotic Event
2 mins
Opioid Abuse and Withdrawal Assessment
Abuse Assessment
Euphoria
Miosis
CNS Depression
Abuse Withdrawal
Yawning
Gooseflesh
Sweating
Rhinorrhea
Kicking Movements
Consideration
Naloxone
1 min
Opioid Antidote
Antidote
Naloxone
28 secs
Naloxone (Narcan)
Mechanism
Competitive Opioid Receptor Antagonist
Indications
Opioid Induced CNS Depression
Side Effects
Severe Nausea and Vomiting
Excitable State
Opioid Withdrawal Symptoms
Considerations
Repeated Dosing Often Required
1 min
NSAIDs
Indications
Anti-inflammatory
Analgesic
Fever
Closure of PDA
Mechanism of Action
Reversible Inhibition of COX-1 and COX-2
Block Prostaglandin Synthesis
Side Effects
Interstitial Nephritis
Gastric Ulcer
Renal Ischemia
1 min
Diazepam (Valium)
Indications
Anxiety
Seizures and Status Epilepticus
Muscle Spasms
Alcohol Withdrawal
Side Effect/Assessment
Dizziness/Vision Changes
Confusion/Amnesia
Urinary Incontinence
Behavioral Changes
Respiratory Depression
Antidote
Flumazenil (Romazicon)
Nursing Considerations
Fall Precaution
Do Not Stop Abruptly
2 mins
Benzodiazepine Intoxication Assessment
Drowsiness
Confusion
Respiratory Depression
Hypotension
Coma
Treatment
Flumazenil (Romazicon)
2 mins
Benzodiazepine Antidote
Antidote
Flumazenil
39 secs

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