Pulmonary problems.

Prevention of pulmonary complications continues to be a major goal of therapy in the care of patients in the postoperative period. Numerous factors, including anesthesia and surgery-induced diaphragmatic dysfunction, reductions in lung volumes and capacities, and release of mediators that damage the endothelium, set the stage for the development of complications such as atelectasis, pneumonia, and ARDS. Nursing assessment focuses on the early identification and evaluation of respiratory distress and degree of oxygen supply/demand imbalance. Intervention focuses on restoration of appropriate ventilation/perfusion matching and provision of adequate oxygen to meet tissue metabolic demands.