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- Surgical Procedures
- Preoperative care
- Parental presence
- Preoperative sedation
- Postoperative care
- Continuous monitoring
- Vital signs assessment
- Potential causes of Postoperative vital sign alterations in children
- Preoperative care
- Surgical Procedures
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Alteration | Potential Cause | Comments |
Heart rate | ||
Increase | Decreased perfusion (shock) | Heart rate may increase to maintain cardiac output. |
Elevated temperature | ||
Pain | ||
Respiratory distress (early) | ||
Medications (atropine, morphine, epinephrine) | ||
Decrease | Hypoxia | Bradycardia is of more concern in young child than tachycardia. |
Vagal stimulation | ||
Increased intracranial pressure | ||
Respiratory distress (late) | ||
Medications (neostigmine [Prostigmin Bromide]) | ||
Respiratory Rate | ||
Increase | Respiratory distress | Body responds to respiratory distress primarily by increasing rate. |
Fluid volume excess | ||
Hypothermia | ||
Elevated temperature | ||
Pain | ||
Decrease | Anesthetics, opioids | Decreased respiratory rate from opioids may be compensated for by increased depth of respiration. |
Pain | ||
Blood Pressure | ||
Increase | Excess intravascular volume | This is serious in premature infants because it increases risk for intraventricular hemorrhage. |
Increased intracranial pressure | ||
Carbon dioxide retention | ||
Pain | ||
Medication (ketamine, epinephrine) | ||
Decrease | Vasodilating anesthetic agents (halothane, isoflurane, enflurane) | Decreased blood pressure is late sign of shock because of elasticity and constriction of vessels to maintain cardiac output. |
Opioids (e.g., morphine) | ||
Temperature | ||
Increase | Shock (late sign) | Fever associated with infection usually occurs later than fever of noninfectious origin. Absence of fever does not rule out infection, especially in infants.
Malignant hyperthermia requires immediate treatment. |
Infection | ||
Environmental causes (warm room, excess coverings) | ||
Malignant hyperthermia | ||
Decrease | Vasodilating anesthetic agents (halothane, isoflurane, enflurane) | Neonates are especially susceptible to hypothermia, with serious or fatal consequences. |
Muscle relaxants | ||
Environmental causes (cool room) | ||
Infusion of cool fluids or blood |