POSTOPERATIVE NURSING CARE& PROCEDURES Goal: prevent complications such as infection, to promote healing of the surgical incision, and

to return the patient to a state of health. Standard Nursing Management for Postoperative Patient: Assess breathing & apply supplemental oxygen, if prescribed. Monitor vital signs & note skin warmth, moisture& color. Assess level of consciousness, orientation &ability to move extremities. Connect all drainage tubes to gravity or suctions ordered & monitor closed drainage systems. Assess the dressing and the amount and character of any drainage that is present. Assess level of pain, pain characteristics(location & quality) & timing, type & route of administration of last pain medication. Position patient to enhance comfort, safety &lung expansion. Assess IV site for patency & infusion for correct rate & solution. Assess urine output or patients urge to void &bladder distension. Reinforce need to begin deep breathing & leg exercises. Provide information to patient & family. Types of Drainage: 1 . Hemorrhagic/Sanguineous Bright red or bloody Small amounts are expected after surgery or trauma Large amounts may indicate hemorrhage; sudden large amounts of dark-red blood may indicate draininghematoma2. Serosanguineous Blood-tinged yellow or pink Expected for48-72 hrs. After injury or trauma Sudden increase may indicate wounddehiscence3. Serous Thin, clear, yellow Expected for up to

1 week after trauma or injury Sudden increase may indicate drainingseroma4. Purulent Thin, cloudy, foul-smelling; may be thick if filled with dead cells Usually indicates infection; ay drain suddenly from abscess5. Catarrhal Thin, clear mucus Seen with upper respiratory infections Perinea Carecleansing of the perineum. Purpose: 1 . Remove perinea secretions and odors.2. Prevent infection.3. Render the perineum clean before and after childbirth as well as any treatment, surgery or procedure involving the perinea area. Equipments: . Sterile pitcher with sterile water 2. Sterile forceps3. Sterile sponges soaked in disinfecting solution4. Bedpan5. Rubber sheet lined with cotton drawn sheet6. Bath blanket or bed sheet7. Waste receptacle8. Disposable gloves Procedure: 1 . Check to see specific physicians orders to befollowed2. Explain Procedure to patient3. Prepare all necessary equipments4. Provide privacy5. Place client in a dorsal recumbent position with knees flexed and separated. Drape the client.6. Place rubber sheet lined with cotton draw sheet under the patients buttocks.7. Position patient on a bedpan.8. Clean the perineum Pour warm sterile water gently over the vulva Clean the perinea area gently &thoroughly using a sponge soaked in disinfectant solution held by a pair of forceps. Use a top down direction or the9-cottonball technique. Rinse with sterile water Dry the perinea area with a dry sponge. Apply a clean perinea pad as needed. Return client to a comfortable & safe position. Evaluation & Documentation: 1 . Any complaints or irrtitation or discomfortand their location2. Any inflammation or swelling observed3. Presence of unusual odor.4. Other significant findings especially onclients with indwelling catheter Range of Motiondegree of movement possible for each joint.

Passive ROM - the nurse or another personmoves each of the clients joints through their complete ROM.

Active ROM - the client moves each joint in the body through its complete ROM. ActiveAssistive ROM - carried out with the client and the nurse participating. Purpose: 1 . Improve or maintain joint function.2. Restore joint function that has been lost due to disease, injury or lack of use.3. Improve or maintain muscle tone & strength4. Prevent contractures5. Prepare client for ambulation6. Help maintain cardio respiratory function in an immobilized client. Assessment: 1 . Assess clients joint mobility & activity status to determine the need for ROM exercises2. Assess clients general health status to determine whether any contraindications to ROM exercises are present3. Assess clients ability & willingness to cooperate Planning: 1 . Plan when ROM exercises should be done.2. Plan what type of ROM exercise as well as which joints are to be included. Basic Guidelines: Start gradually & work slowly Avoid overexertion and using exercises to the point that the client develops fatigue Support the part being exercised at the proximal part of the joints Move each joint until there is resistance but not pain. Keep friction to a minimum when moving to avoid injuring the skin Use ROM exercises regularly as prescribed to build up muscle and joint capabilities. Procedure: 1. Wash hands 2. Identify client 3. Explain the procedure to the client 4. Position the bed. Lower the head of the bed. Raise the entire bed to a comfortable working level for you. 5. Maintain own proper body mechanics as you carry The exercises for the client 6. Perform ROM exercises 7. Wash hands