c. Make sure that the patient is warm and comfortable, and allow family members
to visit after you have completed the initial assessment.
8-17. THE EFFECTS OF ANESTHESIA
a. The effects of anesthesia tend to last well into the postoperative period.
Anesthetic agents may depress respiratory function, cardiac output, peristalsis and normal
functioning of the gastrointestinal tract, and may temporarily depress bladder tone and
(1) Effects on the respiratory system. Pulmonary efficiency is reduced,
increasing the possibility of postoperative pneumonia. Pneumonia is an inflammation of
the alveoli resulting from an infectious process or the presence of foreign material.
Pneumonia can occur postoperatively because of aspiration, infection, depressed cough
reflex, immobilization, dehydration, or increased secretions from anesthesia. Signs and
symptoms common to pneumonia are an elevated temperature, chills, cough producing
purulent or rusty sputum, dyspnea, and chest pain. The purposes of medical intervention
is to treat the underlying infection, maintain respiratory status, and prevent the spread of
(2) Effects on the cardiovascular system. Anesthesia may affect cardiac
output, thus increasing the possibility of unstable blood pressure. Shock is the reaction to
acute peripheral circulatory failure because of an alteration in circulatory control or to a
loss of circulating fluid.
(3) Effects on the urinary system. Anesthesia can cause urinary retention.
Decreased fluid intake can lead to dehydration. Assess urinary elimination status by
measuring intake and output. Offer the bedpan or urinal at regular intervals to promote
voiding. If catheter is present, monitor drainage.
(4) Effects on gastrointestinal system. Anesthesia slows or stops the
peristaltic action of the intestines resulting in constipation, abdominal distention, and
flatulence. Anesthesia may also cause nausea and vomiting resulting in a fluid imbalance.
Ordinarily, intravenous infusions are used while the patient takes nothing by mouth until
bowel sounds are heard upon auscultation. Observe the patient for abdominal distention.
Have the patient move about in bed and walk to help promote the movement and
expulsion of the flatus.
b. A wide variety of factors increase the risk of postoperative complications.
Comfort is often the priority for the patient following surgery. Nausea, vomiting, and other
effects of anesthesia cause alterations in comfort. The nursing care plan should include
activities to meet the patient's needs while helping him cope with these alterations.