Before reading the text and doing exercises
Look through Text Вand name
1) the sources of information the nurse can use to increase her knowledge about surgical disease and procedures;
2) the vital signs that are monitored in the postoperative period.
NURSING CARE OF THE POST OPERATIVE PATIENT
After surgery, patients are in need of excellent nursing care. Well-planned care will prevent or minimize complications in the patient’s recovery. Immediately after a surgical procedure is completed, the patient is transferred to the recovery room where the patent is closely observed by the nursing staff. As the patient emerges from the effects of anesthesiaA the nurse must monitor the airway, neurological and circulatory response, and level of consciousness. It is also important to keep the patient warm and comfortable until he is able and ready to betransferred to the patient care unit. When the patient arrives in the patient care unit, the nurse responsible for the care of the patient will help transfer him from the stretcher to the bed. She must take particular care to protect the patient and his intravenous tubing, dressings, wound drains and traction devices.
It is the nurse’s responsibility to understand the medical diagnosis and the surgical procedure. If the nurse is not familiar with the diagnosis or surgical procedure, she needs to increase her knowledge by using available resources including speaking with more experienced staff nurses, referring to nursing and medical text books, and speaking with the surgeon.
The patient should be paced in a position of comfort and safety. The patient needs to have his or her position changed every 2 hours, unless otherwise orderedBto promote improved respiratory status, prevent pneumonia and decrease the chance of skin breakdown. The patient must be encouraged and supported in coughing and breathing deeply. Since pain may discourage the patient from doing so, the nurse may plan to give him his pain medication prior to beginning this exercise. The nurse administers pain medications after she has made an assessment of the patient. Assessment of pain should include heart rate, respiratory rate, blood pressure, patient’s verbalizations of painc, irritability, and body language, such as facial expressions and decreased mobility.
Activity levels for each patient vary based on their unique problems and the type of procedure. The goal is to get the patient out of bed and walking as soon as possible, since this has many beneficial effects, including the maintenance of normal respiratory function. Patients should be on bed rest until they are fully awake, then they may be up and walking that night or the next morning, depending upon the surgery.
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Post-operative care needs include monitoring of vital signs, and fluid intake and output. Vital signs may be ordered® as frequently as every 30 minutes for the first few hours, then reduced to every 4 to 8 hours once vital signs have remained stable. Simply documenting temperature, pulse, respiration, and blood pressure without comparing the present vital signs with previous ones is not a useful technique. Vital signs can be an important indicator of side effects of anesthesia, respiratory compromise and impending shock.
Assessment and interventions related to intake and output are also important in postoperative care. The patient should take nothing bymouth (NPO) until nausea resolves or until bowel activity is regained as determined by bowel sounds, passing flatus or having a bowel movement. Diet then may begin with clear liquids and be advanced as tolerated. The nurse must record all intake and output to assess fluid and electrolyte balance. This assessment should be performed every eight hours or more frequently if the patient’s condition is unstable. Intake includes oral fluid, foods, intravenous fluids, intravenous blood products, and nasogastric tube feedings. Output includes emesis, urine, stool, and any output from wound drains, catheters, and nasogastric tubes. Urine output should be 1 cc/kg/hour (1 куб. см/кг/час)at a minimum, with the adult standard of 30 cc/hour. As part of this data collection, the nurse will inspect the operative site and examine the dressing, outlining any bleeding area on the dressing or cast with a pen.
Notes:
A as the patient emerges from the effects of anesthesia— померетогокакбольнойприходитвсебяпослеанестезии
Bunlessotherwiseordered— еслинетдругихпредписаний/назначений
Cpatient’sverbalizationsofpain— какбольнойописываетболь
Dvitalsignsmaybeordered— может быть предписана оценка жизненных показателей.
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I. Vocabulary Exercises
1. Practice the pronunciation of the following words:
consciousness
immediately
promote
regain
awake
verbalization
breakdown
resolve
advance
traction
previous
transfer
depend(on)
tolerated
2. Pronounce the following words and guess their Russian meanings. Consult the dictionary to check your answers.
Minimize, anesthesia, circulatory, position, respiratory, pneumonia, mobility, unique, catheter, nasogastric.
3. Find in the text English equivalents of the following Russian words and expressions.
Уменьшить число осложнений до минимума; выздоровление пациента; послеоперационная палата; медсестринский персонал; степень нахождения в сознании; переместить пациента с каталки на кровать; особенно позаботиться о..; обезболивающие препараты; частота сердечных сокращений; частота дыхания; речевые (звуковые) сигналы пациента о боли; выражение лица; сниженная подвижность; быть на постельном режиме; потребление и выделение жидкости; важный показатель; побочные эффекты; осложнённое дыхание; угроза шока; пока не прекратится тошнота и не восстановится работа кишечника; кишечный шум; электролитический баланс; операционное поле.
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