Postoperative Care at the Hospital

By Stine Thestrup Hansen, RN, PhD, Postdoc in Nursing

When the patient returns to the ward after surgery, the plastic nurse should follow standard postoperative procedures (2,8):

1. Check that the patients’ airway/throat is open and that the patient is breathing adequately
2. Usually the patient is conscious when leaving the surgical department, but if the patient is heavily sedated, e.g. the tongue falls back and blocks the airway, check this
3. Check oxygen saturation
4. Measure temperature, pulse and bloodpressure, respiration, respiratory rate and compare with preoperative measurements
5. Observe the surgical wound and drain(s) if any
6. Check that any intravenous infusion is running  properly
7. Check whether there is information from the operating room or the intensive care unit about special conditions that needs to be followed up
8. Ensure that the patient is in a comfortable position and that the extremities are supported so that nerve or muscle damage does not occur
9. Provide pain relievers as needed and prescribed to ease pain and anxiety

Ongoing postoperative assessment includes the following (8):

1. Measure vital values ​​(blood pressure, heart rate, saturation, temperature and respiratory rate)
2. Help the patient with personal care, this includes washing, change clothes if necessary and support oral care
3. Continue prevention of thromboembolic complications by administration of low molecular weight heparin product (if prescribed) and anti-embolic stockings
4. If not contraindicated, the patient can consume increasing amounts of liquid and solid food
5. Anti-nausea drugs should be prescribed if relevant for nausea
6. Observe the wound regularly for leakage, bleeding or hematoma
7. Aseptic techniques must be used to avoid infection
8. Register amount and time of urination and time of defecation (there is a risk of constipation due to immobility, dehydration and the use of pain medication)
9. If the patient has not had defecation after three days, the nurse should consider prescribing laxative products
10. Make sure the patient is getting rest
11. Stimulus for breathing exercises
12. Ensure that the patient is mobilized quickly, preferably on the day of surgery (individual mobilization/restrictions should be described by the surgeon)
13. Observe nutritional status for rapid nutritional intervention
14. Ensure that the patient is pain-relieved so that pain does not delay convalescence. Complete assessment of pain if necessary using a pain scale
15. Observe the patient’s mental state (risk of delirium is a frequent complication of surgical procedures)