Post-Operative Assessment

A postoperative finding only makes sense when it is compared with the patient's preoperative status and the effects of the operation and anaesthetic. Before accepting handoff, identify the procedure performed, the operative site, estimated blood loss, fluids or blood products given, anaesthetic and regional techniques used, drains or catheters inserted, allergies, baseline vital signs, usual mental status, and the current analgesia plan. General anaesthesia can reduce pharyngeal muscle tone, blunt respiratory drive, and leave residual neuromuscular weakness. Opioids may add sedation, hypoventilation, nausea, and urinary retention. Spinal or epidural anaesthesia may explain temporary sensory or motor loss and hypotension, but the block should still be assessed against the expected distribution and documented trend. A new deficit outside that pattern is not assumed to be an anaesthetic effect. The operation itself creates additional risks. Abdominal and thoracic procedures can make deep breathing painful; orthopaedic procedures can threaten distal circulation or nerve function; pelvic procedures and neuraxial anaesthesia can interfere with bladder emptying. Blood loss, third spacing, fluid administration, inflammation, immobility, and medication effects all alter the patient's physiology. The nurse's task...