護(hù)理學(xué)專業(yè)英語(yǔ)課件：Unit Five Postoperative Nursing2

1、Unit FivePostoperative Nursing Unit FiveText A: Postoperative Nursing I. Explanation of the text II. Study & Practice Reading Comprehension Words to Practice Audio Tasks Teaching Aims and Requirements:1. Have a good understanding of post-operative nursing. 2. Understand, know well and master relativ

2、e contents of post-operative nursing.3. Improve the ability of listening and speaking Language Points of the Text4. Nursing diagnoses for postoperative client focus on a wide variety of actual, potential, and collaborative problems, of which the most common are Impaired Skin Integrity and Risk for i

3、nfection. Nursing diagnosis for postoperative patient emphasize on a large number of actual, potential, and combined problems, the most common problems are impaired skin integrity and risk for infection.impaired skin integrity 皮膚完整性受損risk for infection 有感染的風(fēng)險(xiǎn) 4. Some major client outcomes after surg

4、ery include maintaining comfort, healing, achieving wellness and avoiding complications. Pain is usually greatest 12 to 36 hours after surgery, decreasing after the second or third postoperative day. maintaining comfort 保持心情舒暢 healing 傷口的愈合 achieving wellness 恢復(fù)健康 avoiding complications 避免并發(fā)癥 4. Nur

5、ses can provide non-pharmacologic measures in addition to prescribed analgesia, ensuring the client is warm and providing back rubs, position changes, and adjunctive measures. Nurses should encourage clients to do deep-breathing and coughing exercises hourly, or at least every 2 hours. During waking

6、 hours for the first few days, nurses should assist clients to a sitting position in bed. a sitting position in bed 半坐臥位4. Nurses can splint the incision for the client to reduce discomfort, encouraging the client to turn from side to side at least every 2 hours and the client should ambulate as soo

7、n as possible after surgery in accordance with the surgeons orders because early ambulation prevents respiratory, circulatory, urinary, and gastrointestinal complications.turn from side to side: 翻身ambulate: get off the bed and have a slow walk 4. When oral intake is permitted, nurses initially offer

8、 only small sips of water. Nurses should measure the clients fluid intake and output for at least 2 days or until fluid balance is stable without an intravenous infusion. Depending on the extent of surgery and the organs involved, the client may be allowed nothing by mouth (NPO) for several days or

9、may be able to resume oral intake when nausea is no longer present. nothing by mouth 禁食 4. When “diet as tolerated ” is ordered, the nurse should offer clear liquids first. If the client tolerates these with no nausea, the diet can often progress to full liquids and then to a regular diet. Bowel sou

10、nds should be carefully assessed every 4 to 6 hours and nurses must observe the clients tolerance of the food and fluids ingested, noting and reporting the passage of flatus or abdominal distention. diet as tolerated 患者可進(jìn)食 full liquids 濃稠的流質(zhì)食物 bowel sounds 腸鳴音 abdominal distention 腹脹 4. Last but not

11、 least, nurses should provide measures that promote urinary elimination, ensuring that fluid intake is adequate and reporting to surgeons if a client does not vomit within 8 hours following surgery. The most important is that nurses should offer methods to promote urinary elimination, make sure that

12、 fluid intake is enough and telling surgeons if a patient doesnt vomit in 8 hours after surgery. 5. Some clients return from surgery with a gastric or intestinal tube in place and orders to connect the tube to suction. The suction ordered can be continuous or intermittent. Intermittent suction is ap

13、plied when a single-lumen gastric tube is used to reduce the risk of damaging the mucous membrane near the distal port of the tube. Continuous suction may be applied if a double-lumen tube is in place. with a gastric or intestinal tube in place: 身上留置了胃腸減壓管orders to connect the tube to suction: 要求連接在

14、負(fù)壓吸引裝置上a single-lumen gastric tube: 單腔胃管mucous membrane: 黏膜double-lumen tube: 雙腔胃管 5. Fluids and electrolytes must be replaced intravenously when gastric suction or continuous drainage is ordered. Nasogastric tubes may be irrigated if the lumen becomes clogged. They are generally irrigated before an

15、d after tube feedings or the instillation of medications. Nasogastric irritation may require a physicians order, particularly following gastrointestinal surgery. fluids and electrolytes: 液體和電解質(zhì) nasogastric tubes: 鼻胃管 irrigate: to wash out a wound or part of the body with a flow water or liquid 沖洗 cl

16、og：to block sth or to become blocked 阻塞；堵塞 tube feedings: 管喂養(yǎng)；管喂食 physicians order: 醫(yī)囑6. Most clients return from surgery with a sutured wound covered with a dressing, although in some cases, the wound may be left unsutured. Dressings are inspected regularly to ensure they are clean, dry, and intact

17、. Excessive drainage may indicate hemorrhage, infection, or an open wound. many patients go back form operating room with a suture wound covered with a dressing, although in some conditions, the wound may not be sutured. Nurses inspect dressings regularly to make sure that the dressings are clean, d

18、ry, and intact. More than drainage may show hemorrhage, infection, or an open wound. open wound 開(kāi)放性創(chuàng)傷；裸露的傷口；撕裂傷口6. When dressings are changed, nurses assess the wound for appearance, size, drainage, swelling, pain and the status of a drain or tubes. Not all surgical dressings require changing. Somet

19、imes surgeons in the operating room apply a dressing that remains in place until sutures are removed, and no further dressings are required. In many situations, however, surgical dressings are changed regularly to prevent the growth of microorganisms. appearance 傷口的外表 size 傷口的大小 drainage 傷口的出血量 swel

20、ling 傷口的腫脹 pain 傷口的疼痛 the status of a drain or tubes 引流管的狀態(tài)6. In some instances, a client may have a Penrose drain inserted directly into the incision. In this situation, the main surgical incision is considered cleaner than the surgical stab wound made for the drain insertion, because there is usua

21、lly considerable drainage. The main incision is therefore cleaned first. In some cases, a patient may have a Penrose drain which is inserted directly into the incision. In the case, the major surgical incision is regarded cleaner than the surgical stab wound implemented for the drainage, as there is

22、 often a large amount of drainage. So first the surgical incision should be cleaned . Study & Practice : I. Reading Comprehension Choose the best answer for each of the following questions. 1. Postoperative assessments are usually made every 15 minutes until vital signs stabilize. Of the following,

23、which client would require qh(every hour) vital signs? A. Client with stable vital signs on the day of discharge. B. Client with stable vital signs 3 hours postoperative. C. Client with hypotension and depressed respirations 2 hours postoperative. D. Client with high fever second day postoperative.

24、Answer : B 2. When a postoperative client is complaining of pain, which of the following is the most accurate way to assess the severity of pain? A. Asking the client to rate the pain using a scale of 0 to 10. B. Assessing the clients vital signs. C. Asking the clients if the pain is mild, moderate,

25、 or severe. D. Observing physiologic signs such as grimace(痛苦的表情) or sweating. Answer: A 3. What are the 3 phases of recovery that occur in the PACU EXCEPT _ ? A. immediate recovery phase: intensive nursing care provided B. less intensive care: patient prepared for self care in PACU or transferred t

26、o an inpatient unit or outpatient unit C. vital signs stabilized D. extended care/observation unit: patient prepared for discharge Answer: C 4. The overall goals of nursing care during the postoperative period are to promote comfort and healing, restore the highest possible level of wellness, and pr

27、event associated risks such as _ . A. loss of blood B. abnormalities of consciousness C. infection or respiratory and cardiovascular complications D. anesthesia effects Answer: C 5. What are the goals of general postoperative care? A. To promote comfort B. To determine non pharmacological pain relie

28、f C. To administer analgesic (止痛劑、鎮(zhèn)痛劑) D. All of the above Answer: D II. Word to Practice Fill in the blanks with the words or expressions given below. Change the form where necessary.sequence perspiration hemorrhage stimuli anesthesiain accordance with respire complain assess elimination 1. Arthrit

29、is is a common _ among the elderly, including rheumatic(風(fēng)濕病), rheumatoid(類風(fēng)濕關(guān)節(jié)炎), traumatic, osteoarthritis(骨關(guān)節(jié)炎) and septic(敗血癥的) ones. Answer: complaint 2. The _ dengue broke out in the southeast of Asia last year, causing thousands of deaths. Answer: hemorragic 3. The _ system comprises the nose,

30、 pharynx(咽), larynx(喉), trachea(氣管), bronchi, lungs, etc. Answer: respiratory 4. If you feel any pain, please let me know, and I will ask the _ to give you some more local anesthetic. Answer: anesthesiologist 5. Please keep the numbered cards in _: dont mix them up. Answer: sequence 6. A specific an

31、tigen will _ the body to produce only a specific antibody in response to it. . Answer: stimulate 7. As soon as he got into the operating room to have the common prostatectomy(前列腺切除術(shù)), the elderly client _ so much. Answer: perspired 8. What is your _ of this state of affairs(事態(tài))? Answer: assessment 9. It is suggested that wed better drink more boiled water every day whether we are thirsty or not to _ waste materials from our bodies. Answer: eliminate 10. _ the regulations,