postoperative care is planned to ease the patient's recovery from surgery. The nursing
care plan includes promoting physical and psychological health, preventing complications,
and teaching self-care for the patient's return home. While the patient is in the operating
and recovery room, an unoccupied bed is prepared. The top linen is folded to the side or
bottom of the bed. Absorbent pads are placed over the drawsheet to protect bottom
linens. Equipment and supplies, such as blood pressure apparatus, tissues, an emesis
basin, and a pole for hanging the intravenous fluid containers, should be in place when the
patient returns. The unit nurse should be informed by the recovery room nurse if other
items, such as suction or oxygen equipment will be needed.
b. Postoperative patient care begins with the unit nurse assisting recovery room
personnel in transferring the patient to the bed in his room. Data from the preoperative
and intraoperative phases is used to make an initial assessment. The assessment is often
combined with implementation of the doctor's postoperative orders and should include the
(1) Position and safety. Place the patient in the position ordered by the
doctor. The patient who has had spinal anesthesia may have to remain lying flat for
several hours. If the patient is not fully conscious, place him in a side-lying position and
raise the side rails.
(2) Vital signs. Take vital signs and note alterations from postoperative and
recovery room data, as well as any symptoms of complications.
(3) Level of consciousness. Assess the patient's reaction to stimuli and ability
to move extremities. Help the patient become oriented by telling him that his surgery is
over and that he is back in his room.
(4) Intravenous fluids. Assess the type and amount of solution, the tubing,
and the infusion site. Count the rate at which the intravenous fluid is infusing.
(5) Wound. Check the patient's dressing for drainage. Note the color and
amount, if any. If there is a large amount of drainage or bright red bleeding, report this
immediately to the supervisor.
(6) Drains and tubes. Assess indwelling urinary catheter, gastrointestinal
suction, and other tubes for drainage, patency, and amount of output. Be sure drainage
bags are hanging properly and suction is functioning. If the patient is receiving oxygen, be
sure that the application and flow rate is as ordered.
(7) Color and temperature of skin. Feel the patient's skin for warmth and
perspiration. Observe the patient for paleness or cyanosis.
(8) Comfort. Assess the patient for pain, nausea, and vomiting. If the patient
has pain, note the location, duration and intensity. Determine from recovery room data if
analgesics were given and at what time.