The postoperative period of the surgical experience extends from the time the client is transferred to the recovery room or past-anesthesia care unit (PACU) to the moment he or she is transported back to the surgical unit, discharged from the hospital until the follow-up care.
Goals during the Postoperative Period
During the postoperative period, reestablishing the patient’s physiologic balance, pain management and prevention of complications should be the focus of the nursing care. To do these it is crucial that the nurse perform careful assessment and immediate intervention in assisting the patient to optimal function quickly, safely and comfortably as possible.
- Maintaining adequate body system functions.
- Restoring body homeostasis.
- Pain and discomfort alleviation.
- Preventing postoperative complications.
- Promoting adequate discharge planning and health teaching.
Patient Care during Immediate Postoperative Phase: Transferring the Patient to RR or PACU
Special consideration to the patient’s incision site, vascular status and exposure should be implemented by the nurse when transferring the patient from the operating room to the postanethesia care unit (PACU) or postanesthesia recovery room (PARR). Every time the patient is moved, the nurse should first consider the location of the surgical incision to prevent further strain on the sutures. If the patient comes out of the operating room with drainage tubes, position should be adjusted in order to prevent obstruction on the drains.
- Assess air exchange status and note patient’s skin color
- Verify patient identity. The nurse must also know the type of operative procedure performed and the name of the surgeon responsible for the operation.
- Neurologic status assessment. Level of consciousness (LOC) assessment and Glasgow Coma Scale (GCS) are helpful in determining the neurologic status of the patient.
- Cardiovascular status assessment. This is done by determining the patient’s vital signs in the immediate postoperative period and skin temperature.
- Operative site examination. Dressings should be checked.
Moving a patient from one position to another may result to serious arterial hypotension. This occurs when a patient is moved from a lithotomy to a horizontal position, from a lateral to a supine position, prone to supine position and even when a patient is transferred to the stretcher. Hence, it is very important that patients are moved slowly and carefully during the immediate postoperative phase.