I. Pre-operative guidance
1.Diet
(1) Enter high-calorie, high-protein, high-crude fiber, vitamin-rich food, drink more water, and keep the bowel movement smooth.
(2) Generally fast 12 hours before surgery, and drink 4 hours before surgery to prevent vomiting and aspiration during anesthesia surgery, which can cause aspiration pneumonia and asphyxia.
2.Activities and rest
(1) Lie in a suitable bed to prevent the fracture end from puncturing the blood vessels and nerve muscles after the fracture and aggravate the injury.
(2) Absolute bed rest for patients with spinal tuberculosis to prevent paralysis or aggravation of the disease.
3.Special examination guidance
Metal objects such as necklaces and watches should be removed from the body before the MRI examination.
4.Gastrointestinal preparation
(1) Train bedtime defecation for 3 days before the operation to prevent constipation or urinary retention due to unaccustomed bedtime defecation after the operation.
(2) If there is no stool for 3 consecutive days, tell the nurse so that medication can be used for laxation.
(3) It is necessary to eliminate the accumulated stool in the intestine one day before surgery to reduce postoperative abdominal distension and also to prevent contamination caused by defecation after anesthesia.
(5) Perform post-operative adaptive exercises, such as deep breathing, coughing and coughing up sputum.
6.Personal hygiene instruction
(1) Skin preparation: skin preparation for orthopedic surgery needs to exceed the joint range, cut the hair in the surgical area and remove the skin in and around the incision area before surgery.
(2) Bathing, hair washing, dressing and finger (toe) nail cutting.
(3) If there is hand or foot moss or skin ulceration, report to the medical staff as soon as possible.
II. Postoperative guidance
1.Eating and drinking
(1) Epidural or combined intrathecal anesthesia (lumbar anesthesia) is usually followed by liquid food or general food 6 hours after surgery, while general anesthesia or brachial plexus anesthesia (neck anesthesia) is usually followed by food without obvious nausea and vomiting.
(2) Diet should be high protein, high sugar, rich in collagen, trace elements (copper, zinc, calcium, iron) and foods rich in vitamin A and C, such as lean meat, pig skin, liver, egg yolk, soy products, carrots, fresh vegetables and fruits, etc.
2.Body position
(1) After general anesthesia, the patient should lie down before waking up, with the head tilted to the side to prevent accidental aspiration caused by vomiting.
(2) After limb surgery, elevate the affected limb with pillows and braces so that it is higher than the heart level and the distal end is higher than the proximal end to facilitate blood reflux and eliminate edema.
(3) Patients after external plaster fixation should also elevate the affected limb to facilitate venous blood return.
(4) After major surgery and for patients whose lower limbs cannot move, lie on an air mattress and start turning and massaging 4 hours after surgery, and repeat every 2~3 hours afterwards to prevent pressure sores.
3.Care
(1) If the following conditions occur indicating pressure on the limb and blood disorders, tell the medical staff to deal with them in time: severe pain in the limb, change from pain to no pain, pallor, loss of consciousness, chill, swelling, numbness, etc.
(2) For those who have wound drainage devices, prevent distortion, loosening and dislodgement, keep the wound drainage unobstructed and keep the skin around the wound dressing clean.
4.Treatment of complications
(1) Orthopedic surgical incisions all have different degrees of blood leakage. If there is hemorrhage, do not panic, immediately press the bleeding site with your hand to stop the bleeding, and then tell the medical staff for further treatment.
(2) Pain: generally the most intense within 24 hours after surgery, and then slowly relieved, tell the medical staff to apply painkillers as appropriate.
(3) Urinary retention: If you cannot urinate 6~8 hours after surgery, it is mostly related to anesthesia and intraoperative pulling of nerve tissue. If the inability to urinate is due to postural discomfort, ask permission from the health care provider to sit up or stand up to urinate, and for children, ask the parents to pick up and urinate. If the child is still unable to urinate, he/she can be catheterized by the health care provider.