the patient who is under the effects of anaesthesia
Patient needs close and diligent observation until the
patient fully recover from anaesthesia. This will help to detect the early
signs of complications after surgery and the nurse will be
able to respond immediately.
A noisy breathing is indicative of airway obstruction that
can occur, due to the tongue falling back and obstructing the pharynx, or fluid
collected in the airway passages or fluids aspirated into the lungs. Apply
suction immediately, send & call the surgeon and the anaesthetist.
Keep the patient in a suitable position that will be helpful
to drain out the vomitus, blood and secretions collected in the mouth and will
prevent them aspirating into the lungs. This position is maintained until
protective reflexes are returned.
The oro-pharyngeal airway left in the mouth of the patient
should be removed as soon as the patient has regained the cough and swallowing
Excessive secretions in the mouth or anywhere in the
respiratory passage can lead to airway obstruction. It should be sucked out. If
intra-tracheal auctioning is necessary, always use sterile technique.
If the patient is cyanosed, administer oxygen inhalation. At
the same time, find out the cause and remove the cause. Prolonged oxygen
therapy should be guided • by arterial blood gas determinations.
A weak thready pulse with a significant fall in blood
pressure may indicate circulatory failure. It may also indicate blood loss from
the body. The surgeon and the anaesthetist should be informed.
In order to prevent injury from falls from bed, put on the
side rails on the bed. Till the patient recover from the effects of
anaesthesia, the nurse should not leave the patient alone. Even, when the
patient has recovered from the effects of anaesthesia, entrust the patient to
someone responsible for the care.
While awakening from anaesthesia, patients need frequent
orientation as to where they are, what has been done to them, and reassurance
that they are safe in the hands of the medical team. They also need to know
that the operation is over and they are recovering from anaesthesia.
Although these patients, while they are under the effects of
anaesthesia, appear to be unconscious, the nurses should be careful, not to
make any statement about the patient or his disease conditions that may create
anxiety in the patient.
When the patients under the effects of anaesthesia complain
pain in the operation site, the narcotics/sedatives may be ordered by the
surgeon and it should be given with caution.
The first post operative dose of a narcotic is usually
reduced to half the dose the patient will be receiving after fully recovered
from anaesthesia. This is because it can cause pronounced depression of the
respiratory/circulatory/central nervous systems that may follow.
Patient recovering from anaesthesia may ask for drinking
Unless die patient has fully regained the swallowing reflex,
drinking water may choke the patient; it should not be given.
As the patient is recovering from the effects of
anaesthesia, the patient may become restless due to the discomfort caused by
the presence of those devices attached to the patient, such as IV sets, urinary
catheters, drainage tubes etc.
nurse should help the patient by giving adequate explanations.
Keep the family informed of the successful completion of
surgery, transfer of the patient from the operating room to recovery room etc.
These informations will reduce their anxiety.
If possible, allow the relatives to meet surgeon to clear