Postoperative Assessment

Postoperative Assessment

Postoperative operative assessment is always referred to as how a patient is examined regards to his or her perception on the operation. On the other hand, the nurses also observe the behavior and the psychological responses. During this period, it is recommended that the vital signs and the observation of the behavior of the patient is not to be used unless the patient is not in a position to communicate. The patient may encounter some problems after the operation so it usually required that the pain management be done during the postoperative care. This can be done through non-analgesic and analgesic strategies to manage the patient’s pain. For example in the case of 44 year old Sophie who is a postoperative on arthritis. As a nurse, it is recommended that the patient is taken care-off in a manner that will make her feel comfortable during this period.

The first thing will be to access the perception of the patient, which will include physiological and behavioral responses. This should never be used when assessing the patient unless she is in a condition that makes it impossible for her to speak. Secondly, reassessing and assessing of the pain should be done immediately during the period of postoperative. In this case, the frequency of the assessment of the pain is determined by the performance of the operation and the severity of the pain, example in the case of Sophie who has pain in the wound, which oozes thick yellow substance. For her, the assessment should take place after every two hours after the main operation (Donahue, 2010). For this reason, she should be attended to with a lot of aggression so that this situation can ease off or else the situation might worsen. On the other hand, the pain should be recorded as it intensifies or cools down and this will be in relation to the intervention, which will be easily identified on places that are accessible, and visible which may include the bedside sheet flow. In cases where the pain has not been properly controlled, it is required that the management plan is observed thoroughly. Finally, it is very essential that the patient is reviewed properly before the discharge process takes place (D’Antonio, 2010). This means that one should use the patient’s efficacy in regards to the pain and the management process.

During this period, the nurse is usually important even before the operation. Therefore, it is good to understand the importance of the nurses during the postoperative care of the patient. One of these is the preparation of the patient several hours before the operation takes place. This can be done physically and psychologically. The nurse should also be responsible for administering the IV fluids incase the patient gets dehydrated before the operation. The vital signs of the patient are very imperative and should be recorded (Donahue, 2010). This is usually the work of the nurses. In some cases, there can be wrong diagnosis for the patient and it is required that the nurse gives accurate information so that the correct diagnosis is done for the patient. Some patients sometimes get anxious before the operation; therefore, the nurse is required to be in place to answer any question that may be put across by the patient. The nurse is also obligated to wash and shave the area to be operated before the surgery takes place (Dorschner, 2010).

After the operation, the nurse is also needed to be in position where she will be required to asses the pain of the patient using the pain scale. After this, the nurse will recommend the best pain reliever for the patient. The nurse is also required in the monitoring process of the vital signs as the patient is recovering from the operation in the hospital. The patient should be recommended to eat or drink after the nurse has reviewed her (D’Antonio, 2010). Moreover, the nurse is also responsible for monitoring the wound aseptically and this may include washing and dressing of the wound after every two days and removal of stitches and clips after ten days.

On the other hand, during the preoperative period, the data on the vital signs is usually taken. This data will also be useful during the postoperative period. This data will be used in the assessment period. The combination of both the preoperative and postoperative data will be used by the implementation of the next orders by the doctor (Buchan, 2002). Therefore, the data is very important in knowing any symptoms of complications so that the doctor may know how to deal with the situation. The patient is always assessed further immediately after the operation and by the help of the data of the vital signs will be made to use. These vital signs should include the body temperature of the patient, respiration and the heartbeat’s pulse rate. One should not forget about the blood pressure for it may tell a lot about the patient’s response to the drugs. These are always important because they show the presence of life.

 During the assessment of the vital signs, the height and the weight of the patient are always put into consideration. These are mandatory because of several reasons, one of them being for diet management. This will enable the health team to determine whether the patient is gaining or loosing weight from the food that she is eating (Judd, 2009). On the other hand, they will also be able to observe and determine the medical status of the patient. This will be made possible, as they will be in a position to know if the patient is over or under weight, and if she is able to retain fluids in her body. The changes in the weight of the patient will enable the health care team to know the process at which the disease is progressing in the body. On the other hand, they will also be in a position to know the effectiveness of the supplement of nutrition that the patient is being given. The measuring of the weight and height will also make the health team know and calculate the dosage of medicine that the patient will be given. This is because the blood concentration and the weight of the always determines the how the dosage of drug is to be prescribed to the patient. Larger dosage is always given to the heavier people.

After the operation, the wound needs to be assessed and one needs to know the healing process of the wound. It is believed that the healing process is a systematic process that starts with the injury before it ends up with the physiological process of healing. There is only one systematic factor, which helps, in the healing process of the wound (Judd, 2009). This process requires continual assessment of the wound, which is holistic in nature. This is one factor, which will help in the fastening of the wound to heal. If the wound is assessed accurately, one will be able to know an occurrence of the problem whenever it takes place. These problems can be a hindrance to the healing process. Therefore, this problem will be noticed early and proper care will be taken for the wound to enable it to heal (Buchan, 2002).

The wound needs to be taken care-off after the operation. That is why in the case of Sophie’s wound, there are some things that need to be done. Sophie’s wound is classified under the secondary healing intention. Therefore, one should be able to consider the location of the wound. This will make one understand the reason why the wound has is not yet healed and the reason why it has yellow substance oozing from it. The second consideration should be dimension and the depth of the wound (Delucia et al, 2009). There are big wound that sometimes take time heal, maybe Sophie’s wound is bigger than expected. Moreover, the other thing that should be considered is the location and the depth in which the wound is tunneling. There are some wounds that are tunneled more to the inside than the other parts. These types of wound takes time to heal. Moreover, the stage of the wound should always be put into consideration whenever it is being assessed. There are some wounds that are on stages that are difficult to heal without being catalyzed to heal. Therefore, the case of Sophie needs to be analyzed and understand the reason why it is oozing yellow substances; perhaps it is not on a proper stage of healing (Delucia et al, 2009).

There are some wounds that require aseptic techniques, which is also known as the non-touch technique. This technique is all about maintenance of the asepsis and no touching of the wound. There are people that say that it is important as it is about the sterile technique. There are some standardized practices, which are always involved in the maintenance of the asepsis. The first component is that the hands should always be washed effectively. This will be to ensure that the dirt acquired from the air does not reach the wound of the patient. The second component is that the key parts should never be contaminated. This is essential for the patient not to incur any other complications that might be as a result from germs and dirt. The other consideration should be that the non-key parts should be touched with a lot of confidence. This will ensure that the non-key parts will be assessed fully which will enable the key parts to heal properly without interference. Finally, the precautions that are to be taken should be effective. This effectiveness will ensure that there are no complications that the patient will experience due to carelessness (Delucia et al, 2009).

The aseptic is very effective and it has been known for ages to be time saving and the cost is effective. This is because it requires minimum resources and staff to deliver the services. The technique is also easy to apply since it can be taught easily and its awareness is easy to put into place. Moreover, it will be applicable in Sophie’s case since her wound has already been contaminated. This form of technique will really work for her (Davies, 2002). By looking at the effectiveness of the technique one will be able to understand how to take care of her. The first reason is due to poor practice. In areas such as the intensive locations and the theatres, do not allow the technique practice to be implemented easily. This will allow her the chance of being in the position of receiving care in regards to application of the technique; this is because she is taken care-off from home. The second section is on false sense of security, this is in the sense that the wound will not be given false alarm that may have resulted from contamination (Davies, 2002).

The case study has put everything down that one of the caustic issues that might have weakened her wound to heal is the massive infection. The infection might be due to the contaminated environment that she is in. It is for this reason that the aseptic technique is qualified for her situation. If the technique could have been applied earlier, then the situation would have been different. Perhaps her wound would have been healed by now. The second reason might be due to over-weight. The problem that is caused by over weight is that the situation always deepens the wound. This can be a problem to make the wound be in a position to heal (Grammaticos, 2008).

Conclusion

Sophie had undergone an appendectomy that meant that she had an infection on her appendix and so an inflammation had to take place. By looking at her condition, it is discovered that she is allergic to penicillin. This calls for a postoperative care for her. However, it was noticed that she had complications on the healing process of the wound that made her have yellow ooze on the wound. This was due to some infection. For this reason, she was recommended to have an aseptic technique. This technique has been seen to be prospective when it is a question of po0stoperative care since it is clean and safe for the patients.  

References

Buchan, J. (2002). “Global nursing shortages“. BMJ 324 (7340): 751.

D’Antonio, P (2010). American Nursing: A History of Knowledge, Authority, and the Meaning of Work

Davies, A. (2002). Nursing. Hong Kong: Oxfor University Press.

Delucia, Patricia R.; Ott, Tammy E.; Palmieri, Patrick A. (2009). “Chapter 1
Performance in Nursing”. Reviews of Human Factors and Ergonomics

Donahue, M. (2010),  Nursing, The Finest Art: An Illustrated History

Dorschner, John. (2010 )“Healthcare advocacy experts aid workers.” Miami Herald 31 August

Grammaticos, PC; Diamantis, A (2008). “Useful known and unknown views of the father of modern medicine, Hippocrates and his teacher Democritus”. Hellenic journal of nuclear medicine 

Judd, Deborah. A History of American Nursing: Trends and Eras (2009) 272pp

Reverby, M. (1987)  Ordered to Care: The Dilemma of American Nursing, 1850-1945

Snodgrass, Mary Ellen. Historical Encyclopedia of Nursing (2004), 354pp; from ancient times to the present

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