A patient may develop a distended abdomen as a result of decreased GI motility postoperatively. A distended abdomen can cause a patient to be unable to take deep breaths. Vomiting may have profound effects on hemodynamics as well as pain in the surgical patient.
• Distention
• Bowel Sounds
• Nausea & Vomiting
Urine output is an excellent indicator of cardiac output and perfusion. Periods of hypotension can cause a patient to develop acute renal failure. Urine output as well as serum creatinine must be monitored postoperatively. This should be correlated with fluid balance and daily weights.
• Urine output & appearance
• how much is enough?
• 0.5ml/kg/hr
• Foley patency
• Daily weights
Pulse quality indicates perfusion/adequate cardiac output. The distal circulation must be checked hourly in the extremity with an arterial line.
• Temp
• Capillary refill
• Pulse quality
• Color of extremities
Hemoglobin and Hematocrit are indicators of bleeding, but also oxygenation. Abnormal blood gases should be corrected. Alterations in homeostasis can lead to decreased cardiac output as well as dysrhythmias. Cardiac surgery patients are sensitive to disturbances in electrolytes. These should be monitored and corrected. Electrolyte imbalances can lead to cardiac dysrhythmias.
Use caution with administration on NSAID's. Monitor renal function tests and urine output.
• Hgb & Hct
• Electrolytes
• Arterial blood gases
• respiratory acidosis/alkalosis
• metabolic acidosis/alkalosis
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Date last modified: January 7, 2013.
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