Postoperative Nursing Considerations And Interventions Discussion

Nursing Concerns For The Postoperative Patient

The following are the specific nursing considerations for the patient:

  • Type 2 diabetes had previously been diagnosed in the patient, hence post-operative care could be complicated.
  • Previously, the patient had been diagnosed with Atrial Fibrillation, hence patient must require extra care for that.
  • The patient had also suffered from a myocardial infraction six months prior, which was followed by acute pulmonary odema (APO), hence at the time of providing postoperative care extra care will be required to avoid stress.
  • It is possible that a postoperative complication arose as a result of a fluid imbalance. Postoperative Nursing Considerations And Interventions Discussion
  • Because the patient has diabetes, nurses must pay special attention to any wound formation or wound treatment that may have happened as a result of a recent accident.
  • When creating a fluid management plan, the types of fluids to be used, the volume of fluid to be administered, and the time of fluid administration are all critical factors to consider.
  • As a result of the rapid change in breath and effort that may have resulted in an imbalance in the patient’s homeostasis, the patient’s cardiac condition may have deteriorated.

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Provide a rationale/reason for each of these nursing concerns

Surgical anesthesiologists and general anesthesiologists are frequently in charge of postoperative care units, and multidisciplinary teams that comprise members from each of these specialties are also prevalent. When delivering postoperative fluid therapy, it is important to consider both the patient’s current health as well as the conditions that occurred during the procedure. Several elements must be considered while developing a fluid management strategy, including the types of fluids to be utilised, the volume of fluid to be supplied, and the timing of fluid administration. In fluid resuscitation, one of the most important goals is to maintain adequate tissue perfusion while minimising the risk of harm to the patient. A delicate balance must be struck between the dangers of endothelial glycocalyx malfunction and the advantages of fluid transfer to the extracellular compartment. (Mosimann et al., 2018). Patients’ body fluid state must be considered while executing fluid management operations, and this must be taken into consideration. It is possible that fluid resuscitation will be useful for persons who are receptive to fluids, but those who are not responsive to fluids are more likely to suffer the effects of overhydration and should not be administered this treatment (Kayilioglu et al., 2015).

The factors that may contribute to the incidence of unfavourable clinical outcomes in diabetes patients during the postoperative phase are not fully understood at this time. Diabetic patients may also be at greater risk of experiencing adverse outcomes during surgical procedures. Since more than half of both the diabetic population is expected to require at least one surgical surgery over their lifespan, this is a significant source of concern. It is more difficult to recover from postoperative complications since they prolong hospitalisation, increase the financial load, and increase mortality (Wang et al., 2019).

List a minimum of 4 interventions that need to be instigated for the remainder of your shift

Monitoring of blood glucose should be maintained postoperatively in order to detect hypoglycemia; otherwise, the treatment plan should remain the same as it was during the perioperative period. Sampling should be carried out not only in the event of any symptoms or signs of hypoglycaemia, but also on a frequent basis in the event of hypoglycaemia being ignorant of its presence (Cosson et al., 2018)Postoperative Nursing Considerations And Interventions Discussion.

In order to reduce the development of potentially life-threatening complications such as surgical site infections and wound dehiscence, which can be deadly if left untreated, it is critical to optimise post-operative wound management in the community. For general practitioners who have a significant impact on post-operative wound healing and subacute therapy, it is essential that they have a thorough understanding of both wound healing physiology and the principles of post-operative wound care (Gillespie et al., 2020).

In the postoperative surgery patient, it is possible to have a straightforward or a complex fluid management scenario, depending on the circumstances. Patients going through careful activities that don’t significantly adjust their hemodynamic climate could profit from intravenous upkeep liquid treatment to give suitable organ perfusion, keep away from catabolism, and keep up with electrolyte and pH balance. In specific cases, this might be all that is important to guarantee that patients get suitable treatment. Most of postoperative patients who have experienced broad horrendous or careful tissue injury, consumes, basic sickness, or sepsis will require more intricate resuscitative liquid treatment notwithstanding upkeep treatment to compensate for preoperative and intraoperative misfortunes, the pressure reaction to medical procedure, the hidden illness state, progressing gastrointestinal liquid misfortune, blood misfortune, and other organic liquid misfortunes, among different elements (Makaryus et al., 2018).

Potential Nursing Concerns

Infection of the wound following surgery is a typical concern. The process of wound infection is complicated, including the interaction of multiple biological processes at the molecular level, and it is difficult to understand. Wound infections are associated with a high rate of morbidity and death. This activity discusses the aetiology, epidemiology, pathophysiology, and common presentations of postoperative wound infections, as well as the evaluation and management of patients with this condition. It also emphasises the importance of the interprofessional team in the evaluation and management of patients with postoperative wound infections (Gunter et al., 2018).

Individuals suffering from diabetes have a more harder time recovering after surgery than the average population does. Diabetes is a potential side effect of surgery that has been recognised as insulin resistance, and the degree of this resistance may have an impact on the amount of time it takes for a patient to recover following surgery. It is possible that the increased chance of infection and the inability to fully treat wounds would result in further health issues and higher medical costs in the future. Readmission to the hospital is a possibility for patients who have these issues, which will result in further charges being applied to their accounts. More recent research has concentrated on patient-centered outcomes, such as the absence of symptoms, the capacity to do daily activities, the return to work, and general quality of life, to mention a few aspects (Sánchez-Pernaute and colleagues, 2015; Sanchez-Pernaute and colleagues, 2015). A number of traditional recovery criteria, such as the length of hospitalisation, have been investigated in the previous. Despite the fact that efforts have been made to characterise the postoperative healing process, a wide range of perspectives on the subject have been expressed by a number of stakeholders and are discussed here. In the aftermath of surgery, individuals with diabetes commonly face a prolonged recovery period, which can be caused by a variety of reasons, including their condition. The increased insulin resistance that has developed as a result of the surgery is a substantial contribution to the issue. If wound infections occur, diabetes patients are typically the first to develop them, which can result in a number of additional health concerns. Before surgery, patients with diabetes or a history of blood glucose fluctuations should have a thorough initial screening and should seek professional assistance during the recovery period Postoperative Nursing Considerations And Interventions Discussion.

Immediately following surgery, it is critical to keep a careful eye on the wound healing process to verify that everything is progressing as expected. Before applying any dressings in the postanesthesia care unit for the second time, make sure they have been thoroughly evaluated for drainage and closure to ensure that they are securely attached. As a bandage changer, there are no words that sufficiently explain how critical it is to keep your hands clean and to practise good asepsis at all times. Bedard and colleagues (2017) examine the patient’s body temperature and offer warming therapies if necessary, as directed by a doctor or other qualified healthcare professional. Immediately after a patient is discharged from the hospital following surgery, he or she should be given a thorough explanation of the postoperative care recommendations. Acute care hospital fundamental practises are divided into two categories: (1) fundamental practises that should be implemented by all acute care hospitals, and (2) special approaches that should be considered for use in specific locations and/or populations within hospitals when HAIs are not controlled by the implementation of fundamental practises. Fundamental practises should be implemented by all acute care hospitals (Macones et al., 2020). Maintaining adequate hand hygiene, infection control, and infection prevention and control are all considered to be fundamental practises in the medical field. When the promise of decreasing HAI risk surpasses the danger of negative consequences, there are recommendations contained in the key procedural principles for infection control. When the likelihood of an intervention reducing HAI risk is high, but there is concern about the risks of undesirable outcomes as a result of the intervention, when the quality of evidence is low, or when there is evidence to support the impact of the intervention in specific settings, the use of special approaches to address HAI risk reduction concerns are all possibilities. The following are examples of such strategies: In some situations (for example, during epidemics or for certain patient populations) (Macones et al., 2020). When hospitals employ the preventative techniques, which are mentioned as fundamental practises in this section, they may be able to better prioritise their efforts by concentrating their first efforts on these strategies first. If hospital HAI monitoring or other risk assessments indicate that there is a continuous opportunity for improvement in the hospital environment, the implementation of any or all of the preventative techniques described above as special approaches, or a combination of these approaches, should be considered. In accordance with the findings of outcome studies, risk assessments, and/or local constraints, it may be necessary to restrict the deployment of these treatments to specific locations or patient groups, or it may be necessary to apply them across the entire hospital. In some cases, however, it may be necessary to apply them across the entire hospital.

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Fluid Management Considerations

In addition to re-establishing and maintaining tissue fluid and electrolyte balance, intravenous fluids are intended to keep the central euvolemia stable and avoid excessive salt and water consumption. As a result, the amount of oxygen delivered to the tissues will be raised without causing any damage to the tissues. It is stressed in many perioperative guidelines and procedures that adequate IV fluid administration must be obtained in order to get the greatest potential perioperative results. IV fluids must be administered in strict compliance with established procedures and in response to particular patient requirements, just as they are with other types of drugs (Allegranzi et al., 2016)Postoperative Nursing Considerations And Interventions Discussion. During the past two decades, a large number of studies on fluid and hemodynamic optimization have been conducted. The fact that the majority of these investigations were extremely modest single-center studies with outcomes that were occasionally conflicting should be mentioned should not be overlooked. Despite the fact that several large multicenter randomised controlled trials and observational studies, including those including electronic medical records, have been published on these themes in major medical publications in recent years, more research is being conducted. All of these efforts have resulted in a significant increase in the evidence base, which is a credit to the calibre of our profession and its members.

References

Allegranzi, B., Zayed, B., Bischoff, P., Kubilay, N. Z., de Jonge, S., de Vries, F., Gomes, S. M., Gans, S., Wallert, E. D., Wu, X., Abbas, M., Boermeester, M. A., Dellinger, E. P., Egger, M., Gastmeier, P., Guirao, X., Ren, J., Pittet, D., & Solomkin, J. S. (2016). New WHO recommendations on intraoperative and postoperative measures for surgical site infection prevention: an evidence-based global perspective. The Lancet Infectious Diseases, 16(12), e288–e303. https://doi.org/10.1016/s1473-3099(16)30402-9

Anderson, D. J., Podgorny, K., Berríos-Torres, S. I., Bratzler, D. W., Dellinger, E. P., Greene, L., Nyquist, A.-C., Saiman, L., Yokoe, D. S., Maragakis, L. L., & Kaye, K. S. (2014). Strategies to Prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update. Infection Control & Hospital Epidemiology, 35(S2), S66–S88. https://doi.org/10.1017/s0899823x00193869

Bedard, N. A., Pugely, A. J., Elkins, J. M., Duchman, K. R., Westermann, R. W., Liu, S. S., Gao, Y., & Callaghan, J. J. (2017). The John N. Insall Award: Do Intraarticular Injections Increase the Risk of Infection After TKA? Clinical Orthopaedics & Related Research, 475(1), 45–52. https://doi.org/10.1007/s11999-016-4757-8

Cosson, E., Catargi, B., Cheisson, G., Jacqueminet, S., Ichai, C., Leguerrier, A.-M. ., Ouattara, A., Tauveron, I., Bismuth, E., Benhamou, D., & Valensi, P. (2018). Practical management of diabetes patients before, during and after surgery: A joint French diabetology and anaesthesiology position statement. Diabetes & Metabolism, 44(3), 200–216. https://doi.org/10.1016/j.diabet.2018.01.014

Gillespie, B. M., Walker, R. M., McInnes, E., Moore, Z., Eskes, A. M., O’Connor, T., Harbeck, E., White, C., Scott, I. A., Vermeulen, H., & Chaboyer, W. (2020). Preoperative and postoperative recommendations to surgical wound care interventions: A systematic meta-review of Cochrane reviews. International Journal of Nursing Studies, 102, 103486. https://doi.org/10.1016/j.ijnurstu.2019.103486 Postoperative Nursing Considerations And Interventions Discussion