The is notes are about the care given to a patient who has undergone surgery it also talks about the vital precautions to take when treating these patients

1. POST OPERATIVE CARE
BY YVONNE PHIRI RN ,SN BSC NURSING

2. INTRODUCTION
 Postoperative care begins immediately after surgery. It
lasts for the duration of the client’s hospital stay and may
continue after he or she has been discharged. Monitoring,
assessment and observation skills are essential in post-
operative care. Nurses can support patients recovering
from surgery and identify complications. The extent of
post-operative care required depends on the individual's
pre-surgical health status and type of surgery.

3. GENERAL OBJECTIVES
 At the end of the lecture/discussion, students should be
able to acquire knowledge on how to give post-operative
care to clients.

4. SPECIFIC OBJECTIVES
 At the end of the session, the students should be able to;
1. Define post-operative care
2. State the aim of post-operative care
3. Outline the care given to a client after an operation

5. DEFINITION
 POST operative care is the management
of a patient after Post surgery
(Lewis, et al. 2007).

6. AIMS /GOALS
• The goal of postoperative care is to ensure that patients
have good outcomes after surgical procedures.A good
outcome includes recovery without complications and
adequate pain management.
• Another objective of postoperative care is to assist
patients in taking responsibility for regaining optimum
health.

7. GENERAL POST OPERATIVE CARE
 Receiving the patient from theatre
 Counter check all preparations done in the pre-op. care
 Carry a post-operative tray when going to receive the patient
 When receiving the patient, ensure that he/she is conscious; counter
check post op. observation; Check patient’s identity

8. • Ensure that all IV infusions & drains are patent
• Check the wound site for proper closure and ensure that there is no
bleeding
• Enquire on the details of the operation & plan of management
• When satisfied, wheel the patient to the ward while providing
psychological care

9. Position
• Place patient in acute bay for close observations on a
post op. bed
• While still under the effect of anaesthesia, nurse him in
lateral position with the head turned to one side.
• Secure all tubings to prevent traction pressure
• After gaining consciousness, the patient is nursed in
prescribed position which will depend on site of operation

10.  Observations
meticulous observations in the immediate post op period are very crucial in detection
of post op complications.
• Any abnormality should immediately be managed or reported as it may indicate serious
complications.
• Vital signs should be taken every 15 minutes in the first hour and if stable, every 30
minutes in the next hour, then hourly and later 4 hourly
• Observe for colour of skin, breathing pattern, vital signs, pain, bleeding, etc

11. • Observe for restlessness which can indicate haemorrhage
• Observe wound site for haemorrhage, gapping & later
infection
• Strict intake and output; noting type of output
• Observe for pain and offer pain relieving measures
accordingly
• Assess for the psychological well being
• Assess the hydration status
• Assess for the return of bowel function

12.  Fluid and Electrolyte Balance
• Inadequate replacement of fluids or fluid losses
may result in dehydration and electrolyte
deficiency volume
• Keep a fluid & electrolyte balance chart

13. Care of Incision Site/Wound
• Wound care is cardinal to the prevention of infection
• Inspect the surgical site for approximation of wound
edges, integrity of sutures or staples, redness,
discoloration, warmth, swelling, unusual tenderness, or
drainage.
• The area around the wound should also be inspected for
a reaction to tape or trauma from tight bandages.
• The op. dressing may be removed on 1st post op day

14. • The op. dressing may be removed on 1st post op day
• The wound should be dressed as prescribed by
using aseptic techniques
• Keep wound site clean & dry at all times
• Closed wounds are usually cleaned with antiseptic
• The wound may be covered or left open
• A bed cradle may be used to protect the wound
• Advise the patient to support the wound with sterile
gauze or clean hands when coughing or turning to
prevent gapping

15. • Advise patient & relatives to avoid touching the
wound with hands
• Keep the environment clean & well ventilated
• Sutures may be removed between 5th & 7th day post
op.
• Alternative sutures may be removed by 5th day while
remaining sutures are removed on 7th-10th day

16. Rest, Comfort and Pain
• Adequate rest and comfort are important if the patient is to
withstand the stress of surgical procedure
• Rest facilitate recovery from anaesthesia
• Narcotics such as Pethidine and Morphine are administered in
the first 24 hours for pain relief
• Ensure that there is no undue tension from drains by securing
them
• Respiratory depression must be avoided and the patient must
not be too sedated.
• Carry out all other measures that promote rest and reduce pain

17.  Psychological Care
• Continue reassuring the patient to gain cooperation, instil trust
• Explain all procedures & the role of the patient
• Involve family members to promote a feeling of love &
belongingness
• Allow patient to express his feelings
 Carry out the nursing care promptly

18.  Hygiene
• Good hygiene is very important in the post op period to minimize the risk of infection
and for comfort of the client.
• On the day of operation, wipe the patient of any secretions or sweat
• Depending on the condition, a bed or big bath is given on 1st day post-operative
• Nails, hair and oral hygiene is attended to
• Frequent mouth washes help to stimulate appetite as well as to prevent halitosis
• General body cleanliness also improves morale

19. Post-Operative Ambulation/Exercises
Movements and ambulation post operatively are encouraged to prevent complications
related to circulatory stasis and weakness including respiratory complications such as
hypostatic pneumonia
• Patient is encouraged to move, turn, flex ankles and toes, cough and breathe deeply if able
• For patients who are not able, perform passive exercises by e.g. flexing and extending the
elbow & knee joints
• Depending on the type of surgery, patient is encouraged to sit up in bed by 1st day or hours
post-op, sit in a chair by 2nd day, move around the bed by end of day 2 and walk to the
toilet by day 3

20.  Post-Operative Nutrition
• During surgery, there is considerable blood & fluid lost.
• Therefore, the patient needs to be on a balanced diet.
• While still under general anaesthesia; & before bowel sounds
return, keep patient nil orally
• The patient may have fluid restricted from 24 to 48 hours after
surgery of the GIT

21. • While patient is nil orally, maintain nutrition through IV
fluids/electrolytes
• The patient who exhibit no nausea & vomiting is allowed to
drink fluid when he/ she has recovered from anaesthesia.
• Fluids such as tea, fruit juice, soups and gelatine are encouraged
because they are well tolerated by the patient.
• The nutritional status is closely monitored depending on the
type of surgical procedure.
• Patients should start with sips of water, fluid diet, semi-fluid &
then solid foods containing all the nutrients

22. Medication
• Administer prescribed drugs such as antibiotics for prophylaxis.
• Pain relieving drugs such as Pethidine 50-100mg are also given
when necessary(PRN).
Elimination
• Ambulate early to prevent constipation which is common after
surgery due to decreased mobility, decreased oral intake, and
opioid analgesics which contribute to

23. having difficulty bowel movement, and also advise patient
to eat high fiber diet and administer stool softener if
prescribed.
• Assess the abdomen for distention and the presence and
frequency of bowel sounds until patient report return of
bowel function.
• If the abdomen is not distended and bowel sounds are
present, and if the patient does not have a bowel movement
by the second or third postoperative day, the physician
should be notified so that a laxative can be administered.
• Catheterize the patient and monitor fluid intake and output.

24. conclusion
 Post-operative care involves management of pain, care of
catheters and drains, wound care, and positioning and
rehabilitation of patients. The main goal of post-operative
care is to ensure that patients have good outcomes after
surgical procedures.


25. ASSIGNMENT
Write in your note books the information,
education and communication (IEC) you would
give a client post-operatively.
Work to be checked in the next lecture.