NLE Perioperative & Pain Nursing — Postoperative Care and Surgical Wound ManagementConcept Map

Concept

Immediate Postoperative Care in PACU

Sub Concepts

• ABCs Priority Assessment (Airway, Breathing, Circulation)
• Level of Consciousness Monitoring
• Vital Signs Monitoring
• Temperature Assessment
• Pain Assessment and Management
• Intake and Output Monitoring
• Protective Reflexes Return
• Aldrete Score Recovery Assessment

Relationship To Central

First critical phase of postoperative management following surgery completion

Concept

Postoperative Complications Prevention and Management

Sub Concepts

• Respiratory Complications (Atelectasis, Pneumonia)
• Circulatory Complications (DVT, Pulmonary Embolism)
• Gastrointestinal Complications (Paralytic Ileus)
• Wound Complications (Dehiscence, Evisceration)
• Hemorrhage and Hypovolemic Shock
• Postoperative Infection
• Urinary Retention
• Postoperative Nausea and Vomiting

Relationship To Central

Critical nursing interventions to recognize and prevent life-threatening complications

Concept

Wound Healing Process

Sub Concepts

• Primary Intention Healing
• Secondary Intention Healing
• Tertiary (Delayed Primary) Intention Healing
• Hemostasis Phase
• Inflammatory Phase (Days 1-4)
• Proliferative Phase (Granulation and Epithelialization)
• Maturation/Remodeling Phase
• Factors Supporting Healing (Protein, Vitamin C, Zinc, Glycemic Control)

Relationship To Central

Physiological progression essential for restoring tissue integrity after surgery

Concept

Surgical Drain Management

Sub Concepts

• Penrose Drain (Passive Open Drain)
• Jackson-Pratt Drain (Closed Suction System)
• Hemovac Drain (Closed Suction System)
• Maintaining Patency and Suction
• Empty and Re-compress Bulb
• Recording Drain Output
• Assessing Color and Amount of Drainage
• Securing Drain to Prevent Accidental Removal
• Aseptic Technique Application

Relationship To Central

Essential nursing care to prevent complications from fluid accumulation at surgical site

Concept

Postoperative Fever Timeline

Sub Concepts

• First 24 Hours (Wind) - Atelectasis
• Days 2-3 (Water) - Urinary Tract Infection
• Days 3-5 (Walking/Veins) - Deep Vein Thrombosis
• Days 4-6 (Wound) - Surgical Site Infection
• Any Time (Wonder Drugs) - Drug Reactions or IV-line Infection
• Fever above 38°C after Day 3 indicates infection

Relationship To Central

Memory aid for identifying likely causes of fever based on postoperative day (5 Ws)

Concept

Transfer from PACU and Discharge Planning

Sub Concepts

• PACU Discharge Criteria
• SBAR Hand-off Report
• Same-day Surgery Discharge Requirements
• Written Discharge Instructions
• Wound and Dressing Care Instructions
• Activity and Lifting Restrictions
• Medication Instructions
• Diet Advancement Guidelines
• Warning Signs to Report
• Follow-up Appointment Scheduling

Relationship To Central

Essential safety protocols ensuring patient safety and continuity of care

Concept

Nursing Diagnoses and Care Planning

Sub Concepts

• Risk for Ineffective Airway Clearance
• Ineffective Breathing Pattern
• Risk for Hemorrhage
• Acute Pain
• Risk for Infection
• Risk for Venous Thromboembolism
• Delayed Surgical Recovery
• Impaired Physical Mobility
• Constipation Risk
• Knowledge Deficit regarding Self-care

Relationship To Central

Application of NANDA-I framework for postoperative patient care using Maslow's hierarchy

Concept

Philippine Healthcare Context and Legal Framework

Sub Concepts

• Republic Act 9173 (Nursing Law)
• Scope of Practice - Licensed Nurses
• Standards of Care in Philippine Hospitals
• Documentation Requirements
• Patient Safety and Risk Management
• Infection Control Protocols

Relationship To Central

Professional practice standards and regulatory requirements for perioperative nursing

To

ABCs Priority Assessment

From

Immediate PACU Care

Strength

strong

Relationship

Core foundation of postoperative assessment; ABCs guide all other interventions

To

Immediate PACU Care

From

Postoperative Complications Prevention and Management

Strength

strong

Relationship

Prevention begins in PACU with proper positioning, mobility, and monitoring

To

Deep breathing, Incentive spirometry, Ambulation

From

Atelectasis

Strength

strong

Relationship

Prevention measures directly address the pathophysiology of alveolar collapse

To

Postoperative Complications Prevention and Management

From

Wound Healing Process

Strength

strong

Relationship

Proper wound care and healing management prevent infection and dehiscence

To

Wound Healing Process

From

Surgical Drain Management

Strength

strong

Relationship

Drains prevent fluid accumulation that would delay healing and increase infection risk

To

Postoperative Complications Prevention and Management

From

Postoperative Fever Timeline

Strength

moderate

Relationship

Fever timeline helps nurses systematically identify which complication is likely present

To

Early Ambulation

From

DVT Prevention

Strength

strong

Relationship

Early ambulation is the primary intervention to prevent venous stasis and DVT

To

Early Ambulation

From

Paralytic Ileus

Strength

strong

Relationship

Mobility is key intervention that promotes return of peristalsis

To

Surgical Emergency Management

From

Wound Dehiscence and Evisceration

Strength

strong

Relationship

Evisceration is a surgical emergency requiring immediate intervention and surgical consultation

To

SBAR Hand-off Report

From

Transfer from PACU and Discharge Planning

Strength

strong

Relationship

Structured communication ensures continuity of care and patient safety during transitions

To

Patient Safety and Recovery

From

Discharge Teaching

Strength

strong

Relationship

Clear instructions prevent complications at home and promote optimal healing

To

NANDA-I Framework

From

Nursing Diagnoses and Care Planning

Strength

moderate

Relationship

Uses standardized nursing diagnosis language for professional communication and planning

To

RA 9173 Nursing Law

From

Philippine Healthcare Context

Strength

moderate

Relationship

Legal framework defines scope of nursing practice and accountability in perioperative care

To

Supporting Factors (Protein, Vitamin C, Zinc)

From

Wound Healing Phases

Strength

strong

Relationship

Nutritional factors are essential to support each phase of healing

To

Wound Healing

From

Glycemic Control

Strength

strong

Relationship

High glucose impairs healing and immunity; critical in diabetic patients

To

Circulation Assessment in PACU

From

Hemorrhage and Hypovolemic Shock

Strength

strong

Relationship

Primary concern in immediate postoperative period; first sign often hypotension

To

Postoperative Monitoring

From

Urinary Retention

Strength

moderate

Relationship

Common complication requiring assessment of bladder distention and appropriate intervention

To

Pain Management

From

Postoperative Nausea and Vomiting

Strength

moderate

Relationship

Often related; both require assessment and targeted pharmacological management

To

Nursing Care Procedures

From

Drain Types

Strength

strong

Relationship

Different drain types require specific care techniques to maintain function

To

Maintaining Suction

From

JP Drain and Hemovac

Strength

strong

Relationship

Must be compressed regularly to maintain negative pressure for drainage