Final answer:
The nurse's first action post-op for a total vaginal hysterectomy is to ensure patient safety and recovery by confirming identity and procedure, and ensuring all surgical safety checks were completed. The nurse should then monitor vital signs, control pain, check for bleeding, ensure all surgical items are accounted for, and review immediate postoperative care instructions.
Step-by-step explanation:
When caring for a patient immediately post-op following a total vaginal hysterectomy, the first action a nurse should take is to ensure patient safety and proper recovery. This involves confirming patients identity, the surgical procedure performed, and that all safety checks were completed before surgery, such as the administration of prophylactic antibiotics within 60 minutes before incision, as well as ensuring that all essential imaging results were properly referenced.
Following the procedure, the nurse must focus on vital signs monitoring, pain control, checking for vaginal bleeding, assessing the effects of anesthesia, and verifying that all sponges, needles, and instruments are accounted for. It is imperative for the nurse to undertake a "time out" to reassess the patient's condition, consider potential critical events that were discussed during the preoperative phase by the surgeon, anesthesia staff, and nursing staff, and to review any immediate postoperative care instructions.
The nurse plays a crucial role in the immediate recovery period, and attention to these priorities fosters a safe and effective recovery environment for the patient.