SECTION III. RECOVERY ROOM CARE8-10. THE RECOVERY ROOM Show
a. The recovery room is defined as a specific nursing unit, which accommodates patients who have undergone major or minor surgery. Following the operation, the patient is carefully moved from the operating table to a wheeled stretcher or bed and transferred to the recovery room. The patient usually remains in the recovery room until he begins to respond to stimuli. General nursing goals of care for a patient in the recovery room are:
b. The difference between the recovery room and surgical intensive care are:
8-11. RESPIRATORY DISTRESS a. Respiratory distress is the most common recovery room emergency. It may be caused by laryngospasm, aspiration of vomitus, or depressed respirations resulting from medications.
b. After removal of the endotracheal tube by the anesthesiologist or anesthetist, an oropharyngeal airway is inserted to prevent the tongue from obstructing the passage of air during recovery from anesthesia. The airway is left in place until the patient is conscious. 8-12. PREVENTION OF RESPIRATORY DISTRESS a. Monitor respiratory status as frequently as prescribed. Respiratory function is assessed by monitoring the patient's respiratory rate, rhythm, and depth, and by observing skin color. The following observations indicate ineffective ventilation:
b. Report labored respirations to supervisor. c. Report shallow, rapid respirations to the supervisor. d. Maintain a patent airway with or without an oropharyngeal tube. e. Maintain the patient in a position to facilitate lung expansion, usually in Fowler's position. f. Administer oxygen as ordered. g. Prevent aspiration of vomitus.
h. Suction the patient either through the nose or mouth as ordered. 8-13. HYPOVOLEMIC SHOCK a. When there is an alteration in circulatory control or a loss of circulating fluid, the body's reaction is shock. The most common type of shock seen in the postoperative patient is hypovolemic shock, which occurs with a decrease in blood volume. Common signs and symptoms are hypotension; cold, clammy skin; a weak, thready, and rapid pulse; deep, rapid respirations; decreased urine output; thirst; apprehension; and restlessness. b. Hemorrhage, which is an excessive blood loss, may lead to hypovolemic shock. Postoperative hemorrhage may occur from a slipped suture, a dislodged clot in a wound, or stress on the operative site. It also may result from the pathological disorder for which the patient is being treated, or be caused by certain medications. c. The primary nursing care goal is to maintain tissue perfusion by eliminating the cause of the shock.
d. The primary purposes of care for the patient having a hemorrhage include stopping the bleeding and replacing blood volume. 8-14. DETECTION OF PENDING HYPOVOLEMIC SHOCK a. Inspect the surgical dressing frequently and report any bleeding to the supervisor. Also inspect the bedding beneath the patient because blood may drain down the sides of a large dressing and pool under the patient. When reporting bleeding, note the color of the blood. Bright red blood signifies fresh bleeding. Dark, brownish blood indicates that the bleeding is not fresh. b. Outline the perimeter of the blood stain on the original dressing. Reinforce the original dressing, and make note on the dressing of the date and time the outline was made. c. Document your observations and the action taken in the nurse's notes. d. Monitor the patient's vital signs as ordered and report any of the following abnormalities to the supervisor.
e. Administer narcotics only after checking doctor's orders and consulting with supervisor. If shock is imminent, it may be precipitated by administration of narcotics. f. Administer fluids to replace volume in accordance with the doctor's orders. The doctor may order that blood volume be replaced by intravenous (IV) fluids, plasma expanders, or whole blood products. 8-15. GENERAL NURSING CARE OF A PATIENT IN THE RECOVERY ROOM a. When the patient is moved to the recovery room, every effort should be made to avoid unnecessary strain, exposure, or possible injury. The anesthesiologist or anesthetist goes to the recovery room with the patient, reports his condition, leaves postoperative orders and any special instructions, and monitors his condition until that responsibility is transferred to the recovery room nurses. The recovery room nurse should check the doctor's orders and carry them out immediately. b. Patients are concentrated in a limited area to make it possible for one nurse to give close attention to two or three patients at the same time. Each patient unit has a recovery bed equipped with side rails, poles for IV medications, and a chart rack. The bed is easily moved and adjusted. Each unit has outlets for piped-in oxygen, suction, and blood pressure apparatus. The following are nursing implications for the general care of a patient in the recovery room:
Continue to Section IV. Postoperative Care What is the greatest potential problem associated with low Fowler's position?an increased potential for airway loss. an increased risk for nerve damage and facial edema.
What is a common trouble area for a patient in the supine position?One such risk involves the patient's respiratory functions. When a patient is placed from an upright to a supine position, the intra-abdominal organs shift cephalad, compressing the adjacent lung tissue and potentially leading to decreased functional residual capacity (FRC).
Which complications can occur as a result of improper mobility of the patient?The hazards or complications of immobility, such as skin breakdown, pressure ulcers, contractures, muscular weakness, muscular atrophy, disuse osteoporosis, renal calculi, urinary stasis, urinary retention, urinary incontinence, urinary tract infections, atelectasis, pneumonia, decreased respiratory vital capacity, ...
Which complication is most likely to occur in a client who is unable to perform range of motion exercises due to impaired mobility quizlet?While assessing a patient with impaired mobility, the nurse observes that the patient is unable to perform range of motion exercises. Which complications are most likely to occur in the patient? Lack of movement and exercise places patients at risk for respiratory complications.
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