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Operating room
Operating room
Operating room
Operating room
Operating room
Operating room
Operating room
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Operating room

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Credits to Ma'am Evangeline Teruel

Credits to Ma'am Evangeline Teruel

Published in: Health & Medicine
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  • 1. ARE YOUREADY FOR YOUROPERATION?
  • 2. Patient Safety:Provide safe patient careProvide a safe environment ERMTERUEL 2011
  • 3. PROVIDE SAFE PATIENT CARE  Knowledge of procedure  Ensure the correct patient, correct site, and correct level.  Knowledge of positioning  Adhere to safe medication administration guidelinesERMTERUEL 2011  Surgical counts
  • 4. WHO Safe Surgery Checklist JCAHO3 phases1.Sign in2. Time out3.Sign out
  • 5. PROVIDE A SAFE ENVIRONMENT Adhere to asepsis Promote coordinated and effectiveERMTERUEL 2011 communication
  • 6. ERMTERUEL 2011
  • 7.  Advocate  Protector  Teacher  Change agent  Manager of patient careERMTERUEL 2011
  • 8. Probability of morbidity or death from surgery
  • 9. Severity:  benign or malignantLocation:  location of the disease and the organ requiring surgeryDuration:  length of the time the patient has been exposed to the illness dictates the degree of risk involved.
  • 10. Operative risk is proportional with themagnitude ofthe operation
  • 11. Based on health status and person’s mental attitude toward surgeryERMTERUEL 2011
  • 12. a. Age  infants and elderly have the lowest tolerance to the stressful effects of surgery.b. Nutritional status  a well-nourished pre-op client is better prepared for surgical stress and return to optimal health after surgery. A. Obesity ERMTERUEL 2011 B. Malnutrition
  • 13. c. Fluid and electrolyte problems  fluid volume deficit leads to possible intra and post-op complications.d. Presence of diseases  increases the operative risk
  • 14. a. Pulmonary b. Cardiovascular
  • 15. c.Hematologicd.Neurological
  • 16. e. Liverf. Renal
  • 17. h. Gastrointestinali. Integumentaryj. Disabilitiesk. endocrine
  • 18. e. Use of medications 1. Tranquilizers 2. Insulin 3. Adrenal corticosteroids
  • 19. e. Use of medications 4. Diuretics 5. Phenothiazines and antidepressants (MAO) 6. Antibiotics
  • 20. FEAR1. Fear of the unknown2. Fear of anesthesia3. Fear of pain4. Fear of death5. Fear of disturbance of body image6. Worries
  • 21. 1. Anxiousness2. Bewilderment3. Anger4. Tendency to exaggerate5. Sad, evasive, tearful, clingy ERMTERUEL 2011
  • 22. 6. Inabilityto concentrate7. Short attention span8. Failure to carry out simple instructions9. Dazed ERMTERUEL 2011
  • 23. 1. Regression  behaves in a childlike manner. 2. Denial  appears unalarmed 3. Intellectualization  would discuss operationERMTERUEL and illness rationally 2011 but without emotion
  • 24. Caliber of theprofessional staff andhealth care facilities
  • 25. 1. Surgeon2. Assistant to the surgeon3. Anesthesiologist4. Nurse anesthetist (CRNA)5. Circulating nurse6. Scrub nurse
  • 26. works under the directsupervision of ananesthesiologist;most are nurses with required training
  • 27. Organfunctions aredisturbed
  • 28. Lifestyles may change
  • 29. NursingResponsibility:Preoperative Phase
  • 30. physiological andpsychological response
  • 31. To stimulate blood circulation in the extremities to prevent thrombophlebitisLeg exercises To facilitate lung aeration and secretionDeep breathing and mobilization to prevent atelectasis andCoughing hypostatic pneumoniaExercises Done every two to four hours For circulation, stimulate respiration,Positioning and decrease stasis of gasAmbulation
  • 32. Correct anydietarydeficiencies
  • 33. ERMTERUEL 2011
  • 34. Check forspecial orders Enema IV line
  • 35. Check NPO
  • 36. Check NPO
  • 37. Have client void beforepre-op meds
  • 38. Continue to supportemotionally
  • 39. Accomplish “pre- op checklist.”
  • 40.  Client has ID band and allergy bracelet Informed consent is signed and witnessed Diagnostic and laboratory test results Client voided Document height and weight Vital signs before exiting the ward
  • 41. Purpose: allay anxiety produce amnesia reduce n&v dec resp secretions dec vagal nerve stimulations inc pain threshold inc effects of anesthetic agents
  • 42. Peak effect is desired at thetime of inductionUsually given 45 min before induction
  • 43. Pre-op Drugs Example PurposeAnti-anxiety Diazepam To decrease nervousness Promote relaxationAnti-cholinergic Atropine Decreases secretions Prevent bradycardiaMuscle relaxant Succinylcholine To promote muscle relaxationAnti-emetic Promethazine To prevent nausea and vomitingAntibiotic Cephalosporin To prevent infection
  • 44. Pre-op Drugs Example PurposeAnalgesics Meperidine To decrease pain and decrease anesthetic doseAnti-histamine Diphenhydramine To decrease occurrence of allergyH-2 antagonist Cimetidine To decrease gastric fluid and acidity
  • 45. Send entire medical recordor chart to the Operating roomwith patient
  • 46.  Direct proper waiting room. Doctor informs family immediately after surgery. Explain reason for long interval of waiting. Explain what to expect.
  • 47. LEGAL document required for certain diagnostic procedures or therapeutic measures including surgery
  • 48. PURPOSE: ProtectionERMTERUEL 2011
  • 49. 1. Given voluntarily 2. Given to individual who have the capacity to understand. 3. Given information toERMTERUEL be the ultimate decision maker. 2011
  • 50.  Written consent made by the client. No signs of pressure No Sedation 24 hours before elective surgery emancipated minor Legal age and mentally capable 2 surgeon signed the consent in emergency. Authorized representative-minor, unconscious, psychologically ERMTERUEL 2011 incapacitated.
  • 51. Exemptions:ERMTERUEL 2011
  • 52.  No sedation The surgeon explains the consent The nurse: ADVOCATOR
  • 53. Assisting the surgeonas scrub nurse and circulating nurse
  • 54. METHOD by which contamination w/ microorganism is prevented to maintain sterility throughoutthe operative procedure.
  • 55. SCRUBOUT !!!

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