Potential for Complications from Surgical Procedures and Health Alterations (Nursing)

00:00 Hi, I am Joanna Jackson and this lesson is about the potential for complications from surgical procedures and health alterations. This portion of learning is dedicated to the nurses ability to lessen the effects of complications following surgical or other procedures. The focus for the nurse is on the reduction of risks. A quick overview of our contents. We'll review key terms, warning signs, specific complications, and review the nursing process. Some key terms include aspiration, dehiscence, evisceration, hematoma, seroma, and hypoxia. It is the nurses' responsibility to do the following things. Educate the clients on the reduction of post procedure complications. Give the medications as ordered. The nurse should know the signs and symptoms of complications. Perform nursing assessments to identify any risks and respond appropriately to any complications. Immediately following procedures, the nurse should conduct complete and frequent physical assessments and monitor the patient's vital signs.

01:17 Promote physical health and well-being by providing care and comfort to the patient, and manage pain and prevent risks through medication administration such as antibiotics. Now let's talk about what is normal? Following any surgical procedure, it's perfectly normal for patients to have altered mental status due to any sedating medications that may have been given. It is also normal and expected for a patient to be pain or discomfort.

01:44 You should expect the patient to have the gradual return to baseline behavior and mobility. The ability for the patient to follow simple commands.

01:54 Urinary retention affected by the medication or the procedures is also possible. Initial inability to move bowels is expected and impaired gas exchanges including the respirations is also expected.

02:07 Nausea and vomiting can also be a side effect of medication, and changes in color, amount, and consistency of drainage is expected depending on the procedure given. Many complications following procedures are related to medications given before and after the procedures.

02:26 Think about common side effects of opioids, sedatives, IV fluids, and antibiotics. The signs and symptoms related to those medications may appear as complications. But they could resolve depending on the medication given.

02:41 Common side effects of opioids include drowsiness, slowed bowel function, sedation, respiratory depression and urinary retention.

02:50 Side effects of sedatives include drowsiness, slowed bowel function and sedation. IV fluids can come with fluid overload or electrolyte imbalances. And finally, antibiotics come with nausea, vomiting and frequently diarrhea. Some post procedure complications include aspirations, infections, hemorrhage, hypoxia, pain, shock, and falls and injury due to sedatives. This is not an inclusive list. The nurse should always consider the procedure received and possible specific risks. Aspirations. This is when food, liquid or other secretions are breathed into the airway. Ensure the patient remains NPO for the required time that means nothing by mouth. Review the patient's positioning. Elevate the head or put them in the side-lying position. Use sedatives sparingly. Assess feeding tubes for proper placement, and assess swallowing function before advancing their diet back to regular.

03:55 Another potential complication is an infection. Anytime a procedure is performed from blood collection to major surgery, there is a potential risk for an infection.

04:06 Use standard precautions or sterile procedure. Monitor vital signs and report an elevated temperatures immediately. Assess wound drainage regularly, monitor pain, swelling, and condition of any wounds or surgical sites, and administer medications like antibiotics as ordered.

04:27 Clinical signs of infections include elevated patient's temperature, excessive or unusual bleeding or drainage, wound breakdown, an unusual smell, and increased pain.

04:40 Some common wound complications following surgical procedures include dehiscence.

04:45 This is a partial or total disruption of the layers causing surgical wounds to rupture along the sutures. Evisceration, this is a very serious complication when a wound opens known as dehiscence and internal organs protrude through opening.

05:01 This is the emergency situation and the provider needs to be notified immediately. Hematomas are collection of blood that can cause the incision to separate and increase the risk of infection. And finally seroma. This is the collection of serous fluid that can cause the incision to separate and also increase risk of infection. Now let's put it all together. This section requires you to apply all of the nursing information you have learned. Take it slow. Reread the question, and pull out any important information.

05:37 Break the question down. What was the procedure? What are the vital signs? What is normal? Think about any medications that may have been administered and the side effects of those medications. Always consider what you should do first, that is what is the most immediate need. Immediately eliminate answers that are inappropriate in any situation. Let's practice putting in all together.

06:05 A nurse is caring for a patient who recently had an abdominal surgery. The patient's temperature is 102.2 F. Which of the following is an appropriate action by the nurse? 1. Prepare the client for his scheduled discharge. 2. Educate the patient on signs and symptoms to monitor following discharge. 3. Inform the provider of the elevated temperature and 4. Encourage the patient to increase fluid intake.

06:33 What are the normal findings following an abdominal surgery? Eliminate answers that are inappropriate responses and always consider what you should do first. We can immediately eliminate number 1, preparing the client for his scheduled discharge. It is always inappropriate to ignore any abnormal findings. We can also eliminate number 2, educating the patient on signs and symptoms to monitor. While education is an important response, I don't think you can do this first. Number 3, informing the provider of the elevated temperature is always inappropriate. We do not ignore abnormal findings. We can eliminate number 4, encouraging the patient to increase the fluid intake. This is not appropriate because it is not the most immediate need and the patient may need to be NPO for any corrective procedure. Tips for Success. Always assess, diagnosis, plan, and then implement. Always assess before taking any action. If two answers feel correct, do your very best to pick the one that is most correct. And opposites attract, if two answers are complete opposites, one is usually the correct answer.