Introduction: Surgical stress is a systemic response to surgical trauma and results from activation of the sympathetic nervous system, endocrine and immunological responses, and metabolic and haematological changes. By identifying and assessing surgical stress, appropriate measures can be planned to mitigate the magnitude of the stress and metabolic response. The measurement of surgical stress is of paramount importance in anaesthesia, physiology and surgery. By limiting surgical stress, we can influence the course of treatment and the prognosis of the disease. Purpose: The purpose of this thesis is to present the patient's metabolic changes after surgery and to present the active role of the nurse in identifying and reducing the excessive metabolic stress response to surgical trauma. Methods. The literature search was conducted in Science Direct, PubMed, Google Scholar and COBISS.SI databases. The literature was also manually searched in the library of the Faculty of Medicine. The analysis included literature in English and Slovenian published between 2014 and 2024, with a focus on the last 5 years. Results. Preventing the overdevelopment of the stress response after surgery is considered an important element of accelerated recovery programmes and involves a multimodal and multidisciplinary approach to patient management. Nurse-led interventions contribute to lower rates of insulin resistance development, good glycaemic control after surgery, reduced negative nitrogen balance (reduced lean body mass loss), improved wound healing and improved clinical outcomes after surgery. Poor patient nutrition markedly impairs the metabolic response after surgery and is associated with an increased risk of post-operative complications. The nurse is committed to ensuring that the patient is well prepared preoperatively for the procedure, carefully planning and implementing measures to limit surgical stress, monitoring clinical status, alleviating postoperative pain levels and promoting comfort. Its important role focuses on early identification of risk factors and complications and appropriate action. She plays an important role in the multidisciplinary team. Discussion and Conclusion: Carefully planned nursing care helps to reduce and mitigate the stress response and improve the patient's recovery, which is associated with lower complication rates. The integration of pre- and post-operative interventions contributes significantly to this. The effective implementation of interventions contribute nurse to provide the more quality of pre- and post-operative nursing care, which is the cornerstone for improving patient recovery. To be successful in implementing these measures, the nurse must have the appropriate knowledge and experience, which must be acquired and renewed through further training and work in the clinical setting.
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