Need some info on post-op patients

[RNLola035]

Hello, I'm a new grad on a surgical unit and I would like information on different surgeries and procedures, like a frontal lobe resection, CABG, post cardiac cath, ortho surgeries, etc. Does anyone know of any good books or online resources I can look at? I'd like to have information on what to expect post-op, what's normal, typical nursing assessments/interventions for these patients and things like that. I have lots of information in my Med/Surg book about medical diagnoses, but the surgical part is very limited. Thanks!! :redbeathe

[diane227, LPN, RN]

Well, that is a lot of area to cover because every surgery is different. You have to know some history on your patient to start with. Know if they have HTN, pacer, depression etc to make sure they are getting their meds. If they use CPAP or BiPap you really need to know that. You start with a post op by doing your regular head to toe assessment, especially noting mental status, circulatory status, and the neuro status of all extremities especially if they have had an epidural or an intrathecal injection. Note their dressings and any drains. Make sure that that they have on any special post op equipment that is required such as ice bags, SCD's, TED hose, traction, PCA pump etc and for the first few hours you will need to monitor them closely, especially for changes in vitals, mental status, circulation, and pain. Make sure you check your surgical sites and dressings. I usually start my patients out on clears unless they are really hungry. Some of my ortho patients want to eat full meals right away so as long as they are not having nausea that's OK. If they have had GYN surgery you might need to keep up with a pad count. Your post op orders should guide you for your general post op care. Make sure they have an IS and know how to use it and that they DO use it. Get these people us as soon as they can get up. The longer they stay in bed the more apt they are to get a DVT or a pneumonia. Some ortho cases such as knees have collection devices that collects blood that can be reinfused. You have to keep up with it because it has to be reinfused within a certain amount of time. Caring for a post op also get much more complicated depending on where you work. If you work in a surgical, NEURO, CV or trauma ICU your patients are going to be much more complicated. You have to be on your game with these post op's because you never know how they will be affected by anesthesia. And again, take special care with these big people who use CPAP OR BIPAP. They can really desat when off O2.