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Pre and Post Operation Nursing Car
Per by ahmad shaker samim nurse trainer

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Pre-operative nursing care
•:physical examination
•:emotional assessment
•previous anesthetic history:
•
allergies or genetic problems
•
ensure that Necessary tests performed
•
Arranging appropriate consultative services

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1.1.Diagnostic ( biopsyDiagnostic ( biopsy((
2.2.Curative ( excision of tumorCurative ( excision of tumor((
3.3.ReparativeReparative
4.4.ReconstructiveReconstructive
5.5.PalliativePalliative

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• EmergentEmergent: require immediate attention without delay.: require immediate attention without delay.
• UrgentUrgent: require prompt attention within 24-30 hours.: require prompt attention within 24-30 hours.
• RequiredRequired: requires operation, plan hospital admission: requires operation, plan hospital admission
within a few wks or months.within a few wks or months.
• ElectiveElective: should be operated on, failure to have surgery: should be operated on, failure to have surgery
isn’t catastrophic.isn’t catastrophic.
• OptionalOptional: the decision rests with the pt, depend on: the decision rests with the pt, depend on
personal preferencepersonal preference

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The major nursing goals are to:
:
•
•
•
•
•

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Preparation for surgery
Informed Consent

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Criteria for valid Informed consent:
• Voluntary consentVoluntary consent (())
• Incompetent pt ( mentally retarded, mentally ill, orIncompetent pt ( mentally retarded, mentally ill, or
comatose)comatose) (())
• Informed subjectInformed subject (())
• ExplanationExplanation (())
• Description of risks and benefitsDescription of risks and benefits
(())
• Answer questions about procedureAnswer questions about procedure
(())
• InstructionsInstructions (())
• Pt able to comprehend. (Information written inPt able to comprehend. (Information written in
understandable language.understandable language.
()

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Preoperative Nursing Interventions
::
To present the pt in the best possible physicalTo present the pt in the best possible physical
and psychosocial conditions for his operationand psychosocial conditions for his operation

To initiate every effort that will eliminate orTo initiate every effort that will eliminate or
reduce post operative discomforts andreduce post operative discomforts and
complications.complications.
 ..

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Preoperative Teaching
::
• Facilitation of recuperative period.Facilitation of recuperative period.
(( ))
• Attainment of a sense of well-being with minimalAttainment of a sense of well-being with minimal
fear of the unknown.fear of the unknown.
(( ))
• Decreased need for analgesicsDecreased need for analgesics
(( ))
• Absence of complicationsAbsence of complications
(( ))
• Decrease time for hospitalizationDecrease time for hospitalization
(( ))

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When and What to teach:
:
•
•
•

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Deep breathing and coughing
( )
Pain Control and Management
( )
Cognitive Coping Strategies
( )
Reducing preoperative anxiety
( )
Decreasing Fears
( )
Reflecting Cultural, Spiritual, and Religious
Beliefs
( )

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The pt remains in recovery room until he has
full recovery from the anesthetic agents, stable
blood pressure, good air passage, and
reasonable degree of consciousness.

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Miss Iman ShaweeshMiss Iman Shaweesh 1313
Goals of post operative nursing care
11
PositioningPositioning
Cleaning the airwayCleaning the airway
Promoting lung expansion, Deep breathing andPromoting lung expansion, Deep breathing and
coughingcoughing
22

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Goals of post operative nursing care
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Restlessness and discomfortRestlessness and discomfort
PainPain
44
55

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Goals of post operative nursing care
66))ambulationambulation((
Ambulation increase respiratory exchangeAmbulation increase respiratory exchange
Prevent stasis of bronchial secretionsPrevent stasis of bronchial secretions
Reduce distensionReduce distension
Prevent thrombophlebitisPrevent thrombophlebitis
Increase rate of wound healingIncrease rate of wound healing
Ambulation done graduallyAmbulation done gradually

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Goals of post operative nursing care
Bed exercisesBed exercises.. (())
 Deep- breathing exercisesDeep- breathing exercises (())
 Arm exercisesArm exercises (())
 Hand and finger exercisesHand and finger exercises (())
 Foot exercisesFoot exercises (())
 Exercises to prepare pt for ambulatoryExercises to prepare pt for ambulatory
activitiesactivities (( ))
 Abdominal and gluteal contraction exercisesAbdominal and gluteal contraction exercises
(( ))

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Post operative Problems
• Vomiting- Aspiration
• ShockShock
• Abdominal distension
• Thirst. (atropine).
• Hiccups
• Constipation
• Fecal Impaction
• Diarrhea
• HemorrhageHemorrhage

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Post operative Problems
• ThrombosisThrombosis
Preventive:Preventive:
 Adequate administration of fluids after operation toAdequate administration of fluids after operation to
prevent blood concentrationprevent blood concentration
 Leg exercisesLeg exercises
 Elastic stockingsElastic stockings
 Early ambulation to prevent stagnation of the blood inEarly ambulation to prevent stagnation of the blood in
the veins of the lower extremity.the veins of the lower extremity.
 Low-dose of heparin prophylactically to prevent deepLow-dose of heparin prophylactically to prevent deep
vein thrombosis and major pulmonary embolismvein thrombosis and major pulmonary embolism
 Avoid blanket-roll, pillow –rolls or any form of elevationAvoid blanket-roll, pillow –rolls or any form of elevation
that can constrict vessels under the kneesthat can constrict vessels under the knees

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Post operative Problems
Respiratory ComplicationsRespiratory Complications
• Pulmonary EmbolismPulmonary Embolism
The signs are:The signs are:
Sharp, stabbing pains in the chest.Sharp, stabbing pains in the chest.
Breathless, cyanotic, and anxious.Breathless, cyanotic, and anxious.
Pupils dilated, cold perspiration appears.Pupils dilated, cold perspiration appears.
Rapid, irregular pulse.Rapid, irregular pulse.
• AtelectasisAtelectasis
• BronchitisBronchitis
• PneumoniaPneumonia

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Nursing Management of Pulmonary Complications
• Ask the pt to have at least 10 deep breaths every hourAsk the pt to have at least 10 deep breaths every hour
1010
• Use incentive Spiro meter to expand the lungs fullyUse incentive Spiro meter to expand the lungs fully
• Turning the pt from side to sideTurning the pt from side to side
• Suction when needed.Suction when needed.
• Early ambulationEarly ambulation

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Post operative Problems
• Urinary ProblemsUrinary Problems
1-1- Urinary RetentionUrinary Retention (())
Nursing management:Nursing management:
• Allow the pt to sit beside the bed or stand behind the bedAllow the pt to sit beside the bed or stand behind the bed
to voidto void (())
• Sound of running water this relax the spasm of theSound of running water this relax the spasm of the
bladder sphincterbladder sphincter (())
• Using a warm bedpan to irrigate the perineumUsing a warm bedpan to irrigate the perineum
• A small warm enemaA small warm enema (())
• Catheterization: this procedure can be delayed after 12-Catheterization: this procedure can be delayed after 12-
18 hours.18 hours. (())
2- Urinary incontinence2- Urinary incontinence (())
3- Urinary Infection3- Urinary Infection (())

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Post operative Problems
• Wound ComplicationsWound Complications
1- Hematoma (Hemorrhage)1- Hematoma (Hemorrhage) (())
• The nurse should know the location of the pt’s incision toThe nurse should know the location of the pt’s incision to
inspect the site of operation for bleeding at intervals forinspect the site of operation for bleeding at intervals for
the first 24 hours.the first 24 hours.
• Any undue amount of bleeding should be reported.Any undue amount of bleeding should be reported.
2- Infection (Wound Sepsis)2- Infection (Wound Sepsis) (())
• The temperature and pulse increase, wound becomeThe temperature and pulse increase, wound become
tender, swollen, and warmtender, swollen, and warm
• (( ))
• Aseptic techniques in wound careAseptic techniques in wound care (())
• Cleanliness and environmental disinfection areCleanliness and environmental disinfection are
important.important. (())
• The symptoms appear within 36-48 hours.The symptoms appear within 36-48 hours.

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