List some (13) components of a postoperative order:
- Medications
- Diet
- Intake & Output
- IV fluids
- Vital Signs
- Urinary catheter
- Activity
- Positioning
- Wounds and Skin Treatment
- Suction
- Abdominal Drains
- Referrals to Multidisciplinary teams
- Discharge and follow-up
What is a “Sips - DAT” diet order?
This diet order allows the RN to slowly increase the patient diet as tolerated based on their assessments of the patient without requiring a further written diet order from the Surgeon.
Why might the Surgeon order specific positioning orders post-op?
To prevent bed sores or aspirating.
How long post-op are a patients I & O monitored and recorded for?
24-48hrs
What do vital signs consist of?
temperature, pulse, respiration rate and blood pressure
Why is suction ordered post-op?
To remove fluid and/or air from the body cavities and surgical wounds. It is usually ordered to remove post-op secretions or to impede vomiting.
What are the 2 most common types of incisional suctions?
Hemovac and Davol.
What are the 2 most common abdominal drains used?
penrose or JP (Jackson/Pratt) drain
What various Multidisciplinary team referrals might be ordered for a patient?
Physiotherapy, Occupational therapy, Dietician, Wound Care Nurse, Social Work etc.
What are the NUC’s responsibilities post-op (checklist)?
- Inform RN of patients arrival from PARR/PACU
- Remove addressograph and return to addressograph holder prn.
- File old thinned charts in the appropriate place on ward
- Organize chart and file all OR records behind the proper dividers in the correct order in the chart.
- Scan orders for Medications and fax to Pharmacy if not already done in PARR/PACU
- Transcribe the post-op orders informing RN of any STAT orders.
- Record date and type of surgery performed on the Kardex under “Operations” in INK
- Record catheters or drains that may still be in the patient.
- A new MAR is started post op.
Give 4 examples of post-op medication orders and why they are given.
- Narcotics - to relieve pain
- antiemetics - for nausea and vomiting
- hypnotics/sedatives - for rest/sleep
- antibiotics - to prevent post-op infections
