The Postoperative Phase

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-check the pt’s history to see whether there are any risk factors that predispose to hypoglycaemia.

-plaster checks (dressing): the wound site should be secure and dry

-Check for oozing of serous fluid and blood from the incision or drainsite.

-check pulses following arterial surgery (surgery involving the artery)

-check circulation of graft site (skin grafting)

-Positioning of pt: lateral position is commonly used for unconscious pt. This is because to prevent risk of inhalation of bloos, saliva or vomits. It also allows drainage of oral secretions and blood which may acuumulate in the oroharynx and lower cheek.

-provode comfort: pt should be kept warm by providing light heater and place a warm blankets over pt body.

-provide reassurance: if pt is conscious, xplain that the operation is finish and he is in recovery room for observation. Tell pt that he will be sent back to the ward if his condition is stable.

-read and carry out postoperarive orders. It is important for a recovery nurse to read and caryy out the posoperative orders.

-report or record any abnormalities. Eg. Excessive bleeding, unstable vital signs, excessive vomitting and nausea.

Cardinal room for postoperatrive care

- maintain an open ariway and adequate resp function

- Take the vital signs until the pt’s condition is stable

- Maintain fluid balance and record fluids taken

- Check the operative iste for excessive draingae and bleeding

- Povode for the pt’s saftey (eg. Siderails, positioning and prevent infection [wash hands before touching pt])

- Provide for the pt’s needs

Discharge from PACU

-most pt remain in the PACU for at least 1 hr or until they have sficiently recovered from anaesthesia sothat their vital sign have stabilized and capable of reasonalble self care

-the pt’s condition is scored using a postanaesthesia scoring sytem according to vital signs, activity lvl and consciousness. (alderett score)

-the anaesthesia provide

- Aldrete score: simple sum of numerical values assigned to ativity, rep, circulation, consciousness, and o2 saturation

- Postanaestahsia discharged scoring system: VS, activity, nausea and vomitting, pain and surgical bleeding

The lvl of consciousness

Unconscious - the pt does not respond to stimuli, and the reflex are absent; the pt is unable to swallow or blink. Genera anaestehsia prcedure unconsiousness

Semi conscious - the pt respond to painful stimuli, moves

Disoriented - the pt may be able ti respond to all stimuli but is confusd about reality with respect to persons, time, place, or events. Speech is often irrelevant and behaviour may be inappropriate.

Conscious - the pt is able to respond to all stimuli, is alert and is in command of intelectual skills.