Assessing the postoperative patient: Philosophy, knowledge and theory

Abstract

The assessment of the postoperative patient is critical in identifying the patient's current condition and to monitor any complications that might occur. However, many nurses fail to realize the implications that philosophical paradigms, knowledge and theoretical concepts bring to the assessment practice and the manner in which assessment is conducted; in particular, within 24 h after surgery. This article seeks to explore the usefulness of philosophy, knowledge and theory as they relate to nursing assessment of the postoperative patient within the initial 24 h after surgery. It is the duty of nurses to select and effectively apply appropriate philosophical dimensions, knowledge and theories in practice and critically evaluate these areas with respect to assessment of the postoperative patient, thus aiming for a holistic assessment of the patient.

Circulação extracorpórea e complicações no período pós-operatório imediato de cirurgias cardíacas

“…Nurses' clinical skills and competences in this period are extremely important, as they are directly oriented towards the establishment of the hemodynamic balance, pain relief and complication prevention (13) . CBP is common and used in cardiac surgeries for most patients (14) .…”

“…CBP is common and used in cardiac surgeries for most patients (14) . It has been appointed one of the causes of postoperative pulmonary dysfunction, due to increased airway resistance and a possible diaphragm dysfunction increase (13) . Literature on the main possible complications after a cardiac surgery involving CBP use is still scarce (13)(14)(15)(16) , which made it difficult to compare the results in this study.…”

“…As for complication, pain was the most frequent in both groups under analysis, which can be explained by the extent of the tissue trauma patients were submitted to during cardiac surgeries. Acute pain, common after cardiac surgeries, is related to other complications, mainly respiratory problems (13,15) , and also with the triggering of arrhythmias (15) . Pain levels tend to be higher on the first and second postoperative day (16) .…”

Physical Assessment: A Continuing Need for Clarification

“…Even though these domains are defined separately, they should occur simultaneously while at the same time incorporating patient input. Watson‐Miller (2005) identifies that focusing on objective measurements without including the patient's perspective does not allow for a holistic approach to assessment practice.…”

Determining Factors Required for a Holistic Approach to Weight Management of Those With Obesity

“…8 Therefore, a need exists to consider how relationships can be identified, 9 what patterns may exist for those with obesity, and what influence these may exert on weight management. Knowledge and use of such patterns could assist practitioners to offer a more effective approach, 10 to obesity management and inform future development of holistic interventions. Although we would see the interrelationships as the key feature here, we identify physical factors as including functional abilities, symptoms, and activities, social as including support from family, friends, and colleagues and emotional as including feelings, body satisfaction, and anxiety and depression.…”