Principles of post-operative patient care

Abstract

Surgery causes physiological stress on the body and carries inherent risks such as shock and haemorrhage. This article discusses cardiogenic and hypovolaemic shock and outlines the principles of safe and effective post-operative care, including recognising hypovolaemia, maintaining fluid balance and administering pain control.

Nursing diagnosis of delayed surgical recovery

“…Despite its high incidence, the report of pain in the postoperative was not considered a defining characteristic. For having commonly been associated to a contributing factor for the development of delayed surgical recovery, it can be considered as a related factor (23)(24)(25)(26)(27)(28)(29) to the concerned diagnosis.…”

“…So, the associated factor pain should be highlighted, once the surgical stress activates the hypothalamic-pituitary-adrenal via, which causes liberation of catecholamine such as adrenaline and nor-adrenaline. This can lead to the increase of cortisol, and the protein and muscle exhaustion causing a delay in the heading of the surgical site (18)(19)28,(30)(31)(32) .…”

“…The report of the evidence of the defining characteristics was found, such as the loss of appetite with nausea and loss of appetite without nausea with diagnosis (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33) . However, the items separately, loss of appetite and nausea were mainly identified in specific surgeries, such as the gastro-intestinal ones.…”

The immediate post-operative period following lung transplantation: mapping of nursing interventions

“…Nursing care in the postoperative period must be individualized, but can follow the same clinical reasoning, based on signs and symptoms, for providing safe care ( 24 ) . For this, hemodynamic monitoring, recognition of hypovolemia, control of the ventilatory strategy, aspiration of secretions and pain management must be taken into consideration.…”

“…The management of the pain was underestimated in many prescriptions, in spite of being frequently mentioned in many studies as the principal postoperative care measure following major surgery. Pain is considered the fifth vital sign to be evaluated, and lung transplantation is major surgery, with combined anesthesia and maintenance of the peridural catheter in the Immediate Postoperative Period (IPP) ( 15 , 22 , 24 ) . However, in the present study only 16 prescriptions were undertaken in relation to pain, representing 14% of the care measures prescribed.…”