Post operative care.
Post operative complications: Day1:
Primary haemorrhage: continuous bleeding.
Sometimes starting during surgery.
Replace blood loss,return to the theater for adequate haemostasis. Treat shock.
Reactive haemorrhage: haemostasis appear secure until BP raises. Then the bleeding starts.
Basal atelectasis: mimic lung collapse, cough, pyrexia and basal changes in CXR.
Physiotherapy and pain control.
Shock: suggests blood loss: MI, PE, septicaemia.
Pain: HTN is often a sign of pain.
Low urine output.
Next few days: paralytic ileus, secondary haemorrhage, pneumonia, wound dehiscence, wound infection, pyrexia, UTI, urinary retention, DVT and confusion.
Q: A 35y ? patient with post-op distention of the abdomen. Pulse: 100, BP: 90/70. Talk to the registrar about the cause and management.
Answer: State of the patient after the operation.
Findings: TPR, BP.
Abdomen: distention, tenderness and shifting dullness.
Management: secure airway, give O2, insert two large bore IV cannula, take blood for investigations, infuse plasma expanders.
Send bloods for FBC, U and E, ESR, Grouping, cross matching and culture.
Monitor the patient: I/o charts, TPR, BP.
Send urine for urinalysis and arrange for abdomen USG and CXR.