Lesson 1Ileus prevention and recognition: bowel function monitoring, return of bowel sounds, criteria for NG tube or bowel rest, prokinetic considerationsCovers early recognition and prevention of postoperative ileus, including bowel sound monitoring, passage of flatus and stool, criteria for nasogastric tube insertion or bowel rest, and safe use of prokinetic medications in digestive surgery patients.
Baseline and ongoing bowel function assessmentExpected timeline for bowel sounds and flatusIndications for NG tube insertion or suctionNonpharmacologic ileus prevention measuresNursing role in prokinetic drug safetyLesson 2Pressure injury and mobility care: turning schedules, early mobilization milestones first and second postop dayDetails nursing care to prevent pressure injuries and promote mobility, including risk assessment tools, turning schedules, skin inspection, early mobilization goals for each postoperative day, and safe use of aids and support surfaces.
Initial and repeated pressure injury risk scoringTurning frequency and positioning techniquesSkin inspection and early lesion detectionDay 0–2 mobilization milestones and aidsUse of mattresses, cushions, and heel protectorsLesson 3Vital sign and clinical monitoring schedule: frequency for first 48 hours, parameters indicating deterioration (HR, BP, RR, O2 sats, temperature), early warning scoresDefines structured vital sign and clinical observation schedules for the first 48 hours, including frequency, acceptable ranges, parameters signaling deterioration, use of early warning scores, and clear escalation and documentation responsibilities for ward nurses.
Standard frequency first and second postop dayKey thresholds for HR, BP, RR, O2, temperatureUse of early warning and sepsis screening toolsFocused abdominal and respiratory assessmentsEscalation algorithms and rapid response callsLesson 4Wound, drain, and stoma assessment: signs of infection, anastomotic leak indicators, drain output thresholds and documentationFocuses on systematic assessment of abdominal wounds, drains, and stomas in digestive surgery patients, highlighting early signs of infection, anastomotic leak indicators, safe drain output thresholds, and accurate documentation requirements.
Standard wound inspection steps and timingLocal and systemic signs of wound infectionDrain types, expected character and volumeRed flag features for anastomotic leakDocumentation and escalation pathwaysLesson 5Venous thromboembolism prevention: mechanical prophylaxis, pharmacologic prophylaxis timing post-op, ambulation scheduleExplores venous thromboembolism prevention strategies, including mechanical prophylaxis devices, timing and monitoring of pharmacologic prophylaxis, early and progressive ambulation schedules, and nursing surveillance for deep vein thrombosis or PE signs.
VTE risk factors in digestive surgery patientsApplication and monitoring of mechanical devicesTiming and checks for anticoagulant dosesStructured ambulation plan for first 48 hoursRecognition of DVT and pulmonary embolismLesson 6Patient and family education in immediate postop period: analgesia expectations, stoma basics if present, signs of complications and when to seek helpFocuses on structured education for patients and families in the immediate postoperative period, addressing analgesia expectations, stoma basics when present, wound care, warning signs of complications, and when and how to seek urgent help after discharge.
Setting realistic pain and recovery expectationsTeaching basic wound and dressing careIntroductory stoma care and appliance checksExplaining signs of common complicationsWritten instructions and contact pathwaysLesson 7Fluid balance and nutrition: urine output targets, daily fluid charts, progression from clear fluids to oral diet per ERAS, indications for IV fluid continuationReviews fluid balance and early nutrition management, including urine output targets, daily fluid charts, IV fluid adjustments, progression from clear fluids to oral diet following ERAS principles, and indications to delay or modify advancement.
Urine output targets and oliguria responseAccurate intake and output charting methodsIV fluid review and adjustment each shiftStepwise diet advancement per ERASRed flags requiring diet regression or NPOLesson 8Nursing-led discharge readiness elements for 48-hour window: pain control, oral intake, mobilization, wound/stoma basicsOutlines nursing-led criteria for assessing discharge readiness around 48 hours, including pain control, oral intake tolerance, mobilization milestones, wound and stoma self-care basics, and coordination with the multidisciplinary team for safe discharge.
Pain control targets and oral regimen stabilityMinimum oral intake and hydration criteriaMobility milestones and functional statusPatient ability with wound and stoma basicsDischarge teaching, checklists, and referralsLesson 9Prevention of pulmonary complications: incentive spirometry, deep breathing and coughing techniques, chest physiotherapy frequency, oxygen therapy targetsAddresses prevention of postoperative pulmonary complications through incentive spirometry, deep breathing and coughing techniques, chest physiotherapy scheduling, positioning, and oxygen therapy targets tailored to digestive surgery patients on the ward.
Risk factors for postoperative pulmonary issuesTeaching incentive spirometry step by stepSupported coughing and splinting techniquesPositioning, ambulation, and chest therapyOxygen targets and weaning on the wardLesson 10Pain management plan on the ward: epidural management protocols, transition to oral analgesia, dosing, breakthrough pain assessment and documentationCovers multimodal pain management on the ward, including epidural and regional techniques, transition to oral analgesia, dosing schedules, breakthrough pain assessment, side effect monitoring, and documentation to support recovery and mobilization.
Pain assessment tools and target scoresEpidural and regional analgesia monitoringTransition from IV or epidural to oral drugsManaging breakthrough and incident painMonitoring adverse effects and documentation
