Anesthesia
Due to alteration that obesos patients have in the respiratory system, are important the rise of the thorax, in order to improve the oxygenation, in the immediate postoperative period. After the surgery the patient is kept with the headboard of the stream bed at least in 45, in order to reduce the pressure of abdome, in the diaphragm and in this manner to have high circulating volume. The patients must be encouraged by a nursing to tossir and to breathe deeply, with incentive of espirmetro, to help the mensurao of efforts as soon as to wake up. The preparation daily pay-operatrio in obesos patients includes the training in techniques of deep breath and technique of cough. Obesidade by itself already is a deep factor of risk for trombose venosa (TVP) and pulmonary tromboembolismo (TEP).
The esteem incidence of TVP and TEP in postoperative period of baritrica surgery is of 2,6% and 0,95%, respectively. Measures of Prophylaxis for tromboembolismo must be indicated before the induction of the anesthesia and use of heparina of low weight molecular. The nurse possesss a paper of utmost relevance in the control of the possible hemorrhages in postoperative the immediate one. Emphasizing that the postoperative patient o requires an assistance more effective of the nurse, whom had to the risk of effective complications, then the use of writs of prevention becomes important, as precocious deambulation – that it is presented as efficient in the prevention of estase venosa – use of elastic stockings of compression, use of devices of intermittent pneumatic compression and corporal positioning. Complications of the immobility of the patients are aspects of great importance of attention and include pneumonia, atelectasis, TVP, TEP and pressure ulcer, all these can be minimized by the details of the given care of nursing the surgical patient. The prevention of the fragility and integrity of the skin is of great importance, the nursing and health professionals are responsible for the course of the assistance and evolution of the skin.