Medical Surgical Nursing

(Tina Sui) #1

  • Fluid and electrolyte disturbances

  • Infection

  • Seizures


Planning



  • Major goals may include:

  • Improved tissue perfusion

  • Adequate thermoregulation

  • Normal ventilation and gas exchange

  • Ability to cope with sensory deprivation

  • Adaptation to changes in body image

  • Absence of complications


Maintaining Cerebral Perfusion



  • Monitor respiratory status; even slight hypoxia or hypercapnia can effect cerebral
    perfusion

  • Assess VS and neurologic status every 15 minutes to every hour

  • Strategies to reduce cerebral edema; cerebral edema peaks 24–36 hours

  • Strategies to control factors that increase ICP

  • Avoid extreme head rotation

  • Head of bed may be flat or elevated 30° according to needs related to the surgery and


surgeon preference


Interventions



  1. Regulating temperature



  • Cover patient appropriately.

  • Treat high temperature elevations vigorously; apply ice bags, use hypothermia


blanket, administer prescribed acetaminophen.



  1. Improving gas exchange



  • Turn and reposition every 2 hours.

  • Encourage deep breathing and incentive spirometry.

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