SICU, postoperative care

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3. a. To enable a successful and faster recovery of the patient post operatively.
b. To reduce post operative mortality rate.
c. To reduce the length of hospital stay of the patient.
d. To provide quality care service.
e. To reduce hospital and patient cost during post operative period.
Aims of postoperative care & follow up
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5. PHASES OF POST OP UNIT
Two phases:
1. Phase I
2. Phase II
AIM OF PHASE I & II
Homeostasis
Treatment of pain
Prevention & early detection of complications
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6.  It is the immediate recovery phase and requires intensive nursing
care to detect early signs of complication.
 Receive a complete patient record from the operating room which to
plan post operative care.
 It is designated for care of surgical patient immediately after surgery
and patient requiring close monitoring
Phase I
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7. o Care of the surgical patient who has been transferred from the Phase I
post op unit.
o Patient requiring less observation and less nursing care than Phase I
o This phase is also known as Step down or progressive care unit.
Phase II
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8. Pain
IV nutrition
Nausea & vomiting
Bleeding
Deep vein thrombosis
Hypothermia / shivering
Fever
Prophylaxis against infection
GENERAL POST-OPERATIVE PROBLEMS
Pressure sores
Confusional states
Drains
Wound care
Wound dehiscence
Enhanced recovery
Discharge of patients
Follow-up in clinic

9. To provide care until the patient has recovered from the effect of anesthesia.
Assessing the patient :
• Monitor vitals-pulse volume and regularity, depth and nature of
respiration.
• Assessment of patient’s O2 saturation.
• Skin colour.
• Check the level of consciousness. Ability to respond to commands.
• Maintain input & output fluid state.
NURSING MANAGEMENT IN POST OP UNIT
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10. Airway care
o By proper positioning of patient’s head.
o By clearing airway.
o Oxygen therapy.
Pharyngeal obstruction:
Can occur when the patient lies on the back as there are chances
for tongue to fall back.
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Jaw thrust Chin lift

11. PACU charting
Time PR SPO2 RR Bp Conscious UOP IVF Note drugs
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12. Maintaining IV Stability
Hypovolemic shock: can be avoided by:
1) Administration of IV Fluids, blood and blood products and
medication.Replacement of fluids.[colloids and crystalloids]
2) Keep the patient warm.
3) Monitor intake and output balance.
4) Monitor the vitals continuously with the patient condition.
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13. Keep the patient in shock position, flat on back, legs elevated at 20
degree+knee kept straight.
Shock Position
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14. ASSESSMENT OF THE SURGICAL SITE
Hemorrhage
o It is a serious complication of surgery that resulting death.
o It can occur in immediate post operatively or up to several
days after surgery.
o If left untreated, cardiac output decreases and blood pressure
and Hb level will fall rapidly.
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15. • Blood transfusion if necessary, what are the indication of blood
transfusion ?
• The surgical site & incision should always be inspected.
• If bleeding: pressure dressing are placed.
• If the bleeding is concealed, the patient is taken in OR for
emergency exploration of concealed haemorrhage in body cavity.
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16. Administer opioid analgesia as per Doctor’s order.
Epidural analgesia.
NSAIDS.
Psychological support to relieve fear.
Relieving pain +Anxiety
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17. These are common problem in post operative period.(causes)?
Controlling Nausea+Vomitting
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 Adequate treatment of pain, anxiety, hypotension and dehydration will minimize the risk
of the patient developing PONV.
 Medication can be administered as per doctor’s order.

26. A patient remains in the post op unit, untill the patient has fully recoverd
from anesthesia.
Following measures are used to determine the patient ready for disharge
from post operative unit.
Stable vital signs
Orientation to Person Place , Time or events
Adequate oxygen saturation level.
Urine out put at least 30ml/hour
Minimal pain.
Adequate respiratory function.
Aldrete score more than ‘ 9 ‘ before shifting from Post Operative Anaesthesia Care
Unit
Discharge from the Post Operative Unit
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