POSTOPERATIVE COMPLICATIONS  Ligation of bleeders

 Pressure dressings
 SHOCK   Blood transfusion ; IV fluids
 Response of the body to a decrease  in the
circulating blood volume, which results to poor tissue perfusion
& inadequate tissue oxygenation

Impaired Tissue Metabolism  FEMORAL PHLEBITIS / DEEP THROMBOPHLEBITIS 

  Often occurs after operations on the lower abdomen or during
Cell / Organ Death the course of septic conditions as rupturered ulcer or peritonitis.
 CLINICAL
 CAUSES 
MANIFESTATION 
 Injury – damage to vein  Pain
 HEMORRHAGE   Hemorrhage  Redness
 COPIOUS ESCAPE OF BLOOD FROM THE BLOOD  Prolonged Immobility  Swelling
VESSEL  Heat /
 Obesity / Debilitation
 Capillary  slow, generalize oozing warmth
 Venous  dark in color & bubble out  +
 Arterial  spurts & bright red in color Homan’s Sign

 CLINICAL MANIFESTATION NURSING INTERVENTIONS 

 Apprehension; restlessness;  Prevention Active Intervention
thirst; cold, moist, pale skin  Hydrate adequately  Bed rest; elevate
 Deep rapid RR; low body to prevent the affected leg with pillow
temperature hemoconcentration. support.
 Low CO (cardiac output)  Wear antieembolilic
 Encourage leg
 Low BP, low Hgb support hose from the toes
exercise
 Circumoral pallor, spots to the groin.
before the eyes, ringing in the ears  Avoid any
 Avoid massage on
 Progressive weakness, then restricting devices that can
the calf of the leg.
death ensues constrict & impair circulation.
 Prevent use of bed
 Initiate
rolls, knee gatches, dangling
 MANAGEMENT anticoagulant therapy as
over the side of the bed with
 Vit. K ordered.
pressure on popliteal area.

 PULMONARY COMPLICATIONS 
 Atelectasis
 Bronchitis
 Bronchopneumonia
 Lobar Pneumonia
 Hypostatic pulmonary
congestion
 Pleurisy
 INTESTINAL OBSTRUCTION (3RD TO 5TH
 Loop of intestine may kink due to inflammatory adhesions
 CLINICAL
MANIFESTATION
 Intermittent sharp,
colicky abdominal pains
 Nausea & vomiting
( fecaloid)
 Abdominal
distention, hiccups
 Diarrhea
(incomplete obstruction), no
bowel movement
(complete)
 Return flow of
 NURSING
INTERVENTIONS 
 Reinforce deep
breathing, coughing, turning
exercise (DBCT)
 Encourage early
ambulation
 Incentive
spirometry
POSTOP DAY) 
 NURSING
INTERVENTIONS 
 NGT insertion
 Administer
Electrolyte/IV as ordered
 Prepare for possible
surgical intervention
enema is clear
 Shock, then death
occurs
 HICCUPS 
 Intermittent spasms of the diaphragm causing a sound
(”hic’”) that result from the vibration of closed vocal cords as air
rushes suddenly into the lungs.
 CAUSES 
 Irritation phrenic nerve between the
sp9inal cord & terminal ramifications on ubdersurface of the
diaphragm.
 NURSING INTERVENTIONS 
 Remove the cause
 E.q. abdominal distention – NGT insertion
 Hold breath while taking a large swallow of water
 Pressing on the eyeball through closed lids for several
minutes
 Breath in & out paper bag (CO2)
 Plasil (Methochlorpramide) as ordered
 URINARY DIFFICULTIES 
 Retention  Incontenence
 Occurs most  30 -60 ml. q°15 – 30
frequently after operation mins.- over distended
of the rectum, anus vagina, bladder – overflow
& lower abdomen. incontenence.
  Cause by spasm of
the bladder sphincter.
NURSING INTERVENTIONS 
 Implement measures to induce voiding
 WOUND INFECTION 
 CLINICAL
 CAUSES 
MANIFESTATION
MANIFESTATION
 Staphylococcus aureus
 Escherichia coli
 Proteus vulgaris
 Pseudomonas aeruginosa
 Anaerobic bacteria
 Rule of Thumb
 Fever 1st 24°
- disruption in the coaptation
of the wound edges (wound
breakdown)
 Within 48° -
UTI
 Within 72° -
wound infection
 Loss tone of the bladder
sphincter.
 Redness, swelling,
pain, warmth
 Pus or other
discharge on the wound
 Foul smell from the
wound
 Elevated
temperature; chills
 Tender lymph
nodes on the axilla or groin
closest to wound
 Preventive
Interventions:
 Housekeepin
g cleanliness in the surgical
environment
 STRICT
ASEPTIC TECHNIQUE
 Wound care
 Antibiotic
therapy.
 WOUND COMPLICATIONS 
 KINDS 
 Hemorrhage / Hematoma
 Wound Dehiscence – disruption in the coaptation of wound
edges (wound breakdown)
 Wound Evisceration – dehiscense + outpouching of
abdominal organ
 NURSING INTERVENTIONS 
 Apply abdominal binders
 Encourage proper nutrition – high CHON, Vit. C
 Stay with patient, have someone call for doctor
 Keep in bed rest
 Supine or semis – Fowler’s position, bend knees to
relieve tension on abdominal muscles.
 Cover exposed intestine with sterile, moist saline
dressing.
 Reassure, keep patient quiet & relaxed.
 Prepare for surgery & repair of wound.
 POSTOP PSYCHOLOGICAL DISTURBANCES 
 Delirium
 ACS ( Acute Confusional State )
 CAUSES   MANIFESTATION 
  Dehydrated
 Insufficient
Oxygenation
 Anemia
 Hypotension
 Hormonal
Imbalances
 Infection
 Trauma
 Poor memory
 Restlessness
 Inattentiveness
 Inappropriate behavior
 Wild excitement,
hallucinations, delusions,
depression
 Disoriented
 Sleep disturbances

 NURSING INTERVENTIONS 
 Sedatives to keep patient quiet & comfortable.
 Explain reasons for interventions
 Listen & talk to patient & significant others
 Provide physical comfort
 Treat the underlying cause