DISCHARGE AND AFTERCARE

Postsurgery Checklist

September 03, 2017

Postsurgery Checklist 

Healthcare provider talking to man in exam room.After surgery, there are steps you can take to help with your recovery. You may have been admitted as an inpatient (staying in the hospital overnight) or an outpatient (going home the day of surgery). While in the hospital it is important to follow instructions from your surgeon, nurse, and other healthcare providers. This will help you be able to go home as soon as possible. Talk with the healthcare providers before leaving the hospital about help you may need at home. Once you are home, continue to rest, but also try to slowly get back to your normal activities. 

Call your surgeon if you have any questions about your recovery.

In the hospital

Managing pain

  • You’ll get medicine to control pain. You may be given medicine by mouth (oral), by injection, or into your vein (intravenous or IV). Or you may have PCA (patient-controlled analgesia). PCA allows you to control your own pain medicine. Follow your healthcare provider’s instructions on how to use the PCA.

  • Tell your nurse if the medicines don’t help control your pain or if the pain gets worse.

Preventing deep vein thrombosis (DVT)

This is a condition in which a blood clot forms in a deep vein, often in the leg. Part of the clot may break loose and travel to the lungs. This is called a pulmonary embolism. It is a serious condition and may cause death. People who have surgery have an increased chance of developing blood clots. So to prevent clots, your surgeon will prescribe one or more of the following:

  • Blood thinner (anticoagulant) medicine. This is a blood thinner that helps to prevent blood clots. It may be given to you before or right after surgery. 

  • Compression stockings. These are elastic stockings that fit tightly around your legs. This helps keep blood flowing toward the heart, so that it is less likely to pool in the legs and cause a blood clot.

  • Getting out of bed and walking (ambulation). As soon as you’re able, you’ll be helped out of bed by your nurse. Moving around improves blood flow and helps prevent blood clots.

  • Exercises. Simple exercises while in bed or sitting in a chair can help prevent blood clots. Move your feet in a circle or up and down 10 to 30 times an hour to improve blood flow.

  • Sequential compression device (SCD) or intermittent pneumatic compression (IPC). These are special sleeves that are placed around the legs. They are connected to an electric pump. The pump inflates and deflates the sleeves. As the sleeves inflate, they gently squeeze the leg or foot muscles. This helps with blood flow and helps prevent blood clots. Remove the sleeves so that you do not trip or fall when you are walking, like when you use the bathroom or shower. If you need help removing the cuffs, ask the nurse or aid.

Nausea and vomiting

This is common after surgery. If you are having problems with nausea and vomiting, be sure to tell your nurse or surgeon.

Preventing pneumonia

To help clear your lungs and prevent pneumonia, you may be taught deep-breathing and coughing exercises. Follow your healthcare provider’s instructions on how to do the exercises and how often to do them.

Incision care

The nurse will change the dressing over your incision. To help prevent germs from getting into the incision, avoid touching it. Before you go home, your nurse will teach you or a family member how to take care of your incision at home. Make sure you understand the instructions. Nurses may also help you with your incision care and other needs once you are home. The hospital nurses and other staff will help you set up care you may need after you leave the hospital.

Blood tests

After surgery, you’ll likely have blood drawn. This is to make sure you’re healing well and aren’t developing problems, like infection, anemia, or high blood sugar (hyperglycemia).

Urinary catheter

During surgery, a tube (catheter) may have been inserted into your bladder to drain urine. Your surgeon will determine when the catheter can be removed. If you go home with the catheter in place, the nurse will teach you how to take care of the catheter at home. Be sure to ask any questions about catheter care before you leave the hospital. You may also get help from family members or home health nurses.

At home

Here is what you can do at home:

  • Pain management. Take your pain medicines as directed, before the pain becomes severe. Don’t take medicine more often than prescribed. Overdose is dangerous. Also don’t take medicine less often than prescribed. This makes the medicine less effective. Taking pain medicine at night can help you sleep.

  • Preventing blood clots and pneumonia. DVT and pneumonia can still occur even after you go home. Follow the discharge instructions you were given in the hospital. Some things you can do to prevent DVT may include continuing to wear compression stockings, using a sequential compression device (SCD) or intermittent pneumatic compression (IPC), or taking medicine. Make sure you removed the sleeves when you are up and walking. Some things you can do to prevent pneumonia may include keeping up with the breathing and coughing exercises you learned in the hospital.

  • Incision care. Follow instructions you received in the hospital about when it’s safe to shower. Until then, keep the incision dry. Watch for signs of infection. Signs include increased redness, swelling, drainage from the incision, or a fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider. 

  • Activity. At your follow-up visit, ask your surgeon when it’s safe to return to your regular activities. Slowly get back to exercise and other activities.

  • Returning to work. Going back to work depends on your surgery and the type of job you do. You and your surgeon will decide when you can return to work. It’s often 4 to 6 weeks after major surgery, and a few days after minor surgery. 

  • Driving. Do not drive until your surgeon tells you that you can. 

  • Get good nutrition. Healthy eating helps your body heal. If you had a special diet before surgery, ask your surgeon if you should stay on the same diet.

Follow-up appointment                              

My follow-up appointment is scheduled for: 

 

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Call 911

Call 911 if you have the following symptoms that mean a blood clot in the lungs:

  • Chest pain

  • Trouble breathing

  • Fast heartbeat

  • Sweating

  • Coughing (may cough up blood)

  • Fainting

Also call 911 if you have heavy or uncontrolled bleeding.

When to call your healthcare provider

Call your surgeon right away if you have any of the following:

  • Pain, swelling, and redness in your leg or arm. These symptoms may mean a blood clot.

  • Increased pain or pain that is not relieved with medicines

  • Drainage, redness, or swelling around the incision

  • Incision opens up (cover it with a clean dressing or cloth)

  • Severe nausea and vomiting

  • Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

Updated:  

September 03, 2017

Sources:  

Overview of Complications Occurring in the Post-Anesthesia Care Unit. UpToDate, Prevention of Venous Thromboembolic Disease in Surgical Patients. UpToDate

Reviewed By:  

Image reviewed by StayWell art team.,Sudheendra, Deepak, MD,Taylor, Wanda L, RN, Ph.D.