Preoperative Care<br />Paulette Hamner RN, MSN<br />NUR 1213<br />
Surgery<br />Art and science of treating diseases, injuries, and deformities by operation and instrumentation <br />
Surgery<br />Performed for<br />Diagnosis<br />Cure<br />Palliation<br />Prevention<br />Exploration<br />Cosmetic improve...
Surgical Settings<br />Inpatient <br />Same day admission<br />Ambulatory (outpatient)<br />Usually less than 3 to 4 hours...
Patient Interview<br />Check documented information prior to interview<br />Avoids repetition<br />Occurs in advance or on...
Patient Interview<br />Purpose<br />Obtain health information<br />Determine expectations<br />Provide and clarify informa...
Nursing Assessment<br />Overall goal<br />Identify risk factors<br />Plan care to ensure patient safety<br />
Nursing Assessment Goals<br />Determine psychological status to reinforce coping strategies<br />Determine psychological f...
Nursing Assessment Goals<br />Establish baseline data<br />Identify medications and herbs taken that may affect surgical o...
Nursing Assessment Goals<br />Identify cultural and ethnic factors that may affect surgical experience<br />Determine rece...
Nursing Assessment<br />Psychosocial assessment<br />Excessive stress response can be magnified and recovery affected<br />
Nursing Assessment<br />Influencing factors<br />Age<br />Past experience<br />Current health<br />Socioeconomic status<br />
Nursing Assessment<br />Use common language<br />Use translators if needed<br />Decreases level of anxiety<br />Communicat...
Nursing Assessment<br />Anxiety can impair cognition, decision making, and coping abilities<br />Lack of knowledge<br />Un...
Nursing Assessment<br />Anxiety may arise from conflict with interventions (i.e., blood transfusions) and religious/cultur...
Nursing Assessment<br />Fears<br />Death or disability<br />May prompt postponement<br />Influence outcome<br />Pain<br />...
Nursing Assessment<br />Fears <br />Mutilation/alteration in body image<br />Assess concerns nonjudgmentally<br />Anesthes...
Nursing Assessment<br />Fears<br />Disruption of life functioning<br />Range from fear of permanent disability to temporar...
Nursing Assessment<br />Hope<br />May be strongest positive coping mechanism<br />Never deny or minimize<br />Assess and s...
Nursing Assessment<br />Health history<br />Diagnosed medical conditions<br />Previous surgeries and problems<br />Menstru...
Nursing Assessment<br />Health history <br />Familial diseases<br />Conditions<br />Reactions/problems to anesthesia (pati...
Nursing Assessment<br />Current medications<br />Prescription and OTC<br />Herbs<br />Vitamins<br />Recreational<br />Drug...
Nursing Assessment<br />Allergies (drug and nondrug)<br />Screen areas:<br />Risk factors<br />Contact  urticaria<br />Aer...
Nursing Assessment<br />Cardiovascular system<br />Report<br />Problems for effective monitoring<br />Use of cardiac drugs...
Nursing Assessment<br />Cardiovascular system<br />Vitals recorded preoperatively for baseline<br />Bleeding/clotting time...
Nursing Assessment<br />Respiratory system<br />Inquire about recent airway infections<br />Procedure could be cancelled b...
Nursing Assessment<br />Respiratory system<br />History of dyspnea, coughing, or hemoptysis reported to operative team<br ...
Nursing Assessment<br />Respiratory system<br />Smokers should be encouraged to quit 6 weeks before procedure<br />Decreas...
Nursing Assessment<br />Nervous system<br />Evaluation of neurologic functioning<br />Vision or hearing loss can influence...
Nursing Assessment<br />Nervous system<br />Cognitive function<br />Assess or correct any deficits before surgery<br />Dur...
Nursing Assessment<br />Nervous system<br />Cognitive function<br />Postoperative delirium (falsely labeled senility or de...
Nursing Assessment<br />Urinary system<br />History of urinary or renal diseases<br />Renal dysfunction contributes to<br ...
Nursing Assessment<br />Urinary system <br />Renal function tests<br />Note problems voiding and inform operative team<br />
Nursing Assessment<br />Integumentary system<br />History of skin and musculoskeletal problems<br />History of pressure ul...
Nursing Assessment<br />Musculoskeletal system<br />Identify joints affected with arthritis<br />Mobility restrictions may...
Nursing Assessment<br />Musculoskeletal system <br />Report problems affecting neck or lumbar spine to ACP<br />Can affect...
Nursing Assessment<br />Endocrine system<br />Patients with diabetes mellitus especially at risk for:<br />Hypo/hyperglyce...
Nursing Assessment<br />Endocrine system<br />Patients with diabetes mellitus <br />Serum glucose tests morning of surgery...
Nursing Assessment<br />Endocrine system<br />Patients with thyroid dysfunction<br />Hyper/hypothyroidism are surgical ris...
Nursing Assessment<br />Endocrine system<br />Patients with Addison’s disease<br />Abruptly stopping replacement corticost...
Nursing Assessment<br />Immune system<br />Patients with history of compromised immune system or use of immunosuppressive ...
Nursing Assessment<br />Fluid and electrolyte status<br />Vomiting, diarrhea, or difficulty swallowing can cause imbalance...
Nursing Assessment<br />Fluid and electrolyte status <br />NPO status	<br />May require additional fluids and electrolytes...
Nursing Assessment<br />Nutritional status<br />Obesity<br />Stresses cardiac and pulmonary systems<br />Increased risk of...
Nursing Assessment<br />Nutritional status <br />Provide extra padding to underweight patients to prevent pressure ulcers<...
Nursing Assessment: Exam<br />Findings enable ACP to rate patient for anesthesia administration<br />Indicator of perioper...
Nursing Assessment: Exam<br />Document relevant findings and report to perioperative team<br />Obtain and evaluate results...
Nursing Management<br />Preoperative teaching<br />Patient has right to know what to expect and how to participate<br />In...
Nursing Management<br />Preoperative teaching <br />Limited time available<br />Address needs of highest priority<br />Inc...
Nursing Management<br />Preoperative teaching <br />Several days before surgery<br />Observe and listen to determine amoun...
Nursing Management<br />Preoperative teaching <br />Must be documented and reported to postoperative nurses<br />Avoid dup...
Nursing Management<br />Preoperative teaching<br />Teach deep breathing, coughing, and moving for postop<br />Inform if tu...
Nursing Management<br />Preoperative teaching<br />Basic information before arrival<br />Time and place<br />Fluid and foo...
Nursing Management<br />Legal preparation<br />All required forms are signed and in chart<br />Informed consent<br />Blood...
Nursing Management<br />Consent for surgery<br />Informed consent must include<br />Adequate disclosure<br />Understanding...
Nursing Management<br />Surgeon responsible for obtaining consent<br />Nurse may obtain and witness signature<br />Verify ...
Nursing Management<br />Consent for surgery<br />Medical emergency may override need for consent<br />
Nursing Management<br />Legally appointed representative of family may consent if patient is<br />Child<br />Unconscious<b...
Nursing Management<br />Day-of-surgery preparation<br />Final preoperative teaching <br />Assessment and report of pertine...
Nursing Management<br />Day-of-surgery preparation<br />Labs <br />History and physical examination<br />Baseline vitals<b...
Nursing Management<br />Day-of-surgery preparation <br />Patient should not wear any cosmetics<br />Observation of skin co...
Nursing Management<br />Day-of-surgery preparation<br />Valuables returned to family member or locked up<br />Dentures, co...
Nursing Management<br />Void before surgery<br />Prevents involuntary elimination under anesthesia or early postoperative ...
Nursing Management:Intraoperative Care<br />
Physical Environment<br />Department Layout<br />Holding Area<br />Operating Room<br />
Surgical Team<br />Registered Nurse<br />Licensed Practical Nurse and Surgical Technician<br />Surgeon and Assistant<br />...
Nursing Management: Patient Before Surgery<br />Psychosocial Assessment<br />Physical Assessment<br />Chart Review<br />Ad...
Nursing Management: Patient During Surgery<br />Room Preparation<br />Transferring the Patient<br />Scrubbing, Gowning, an...
Nursing Management: Patient During Surgery (cont.)<br />Positioning the Patient<br />Preparing the Surgical Site<br />Safe...
Classification of Anesthesia<br />General Anesthesia<br />Intravenous Induction Agents<br />Inhalation Agents<br />
Classification of Anesthesia<br />General Anesthesia (cont.)<br />Adjuncts to General Anesthesia<br />Opioids<br />Benzodi...
Classification of Anesthesia (cont.)<br />Local Anesthesia<br />Methods of Administration<br />Spinal and epidural anesthe...
Gerontologic Considerations: Patient During Surgery<br />
Catastrophic Eventsin the Operating Room<br />Anaphylactic Reactions<br />Malignant Hyperthermia<br />
Postoperative Care in the Postanesthesia Care Unit (cont.)<br />Potential Alterations in Cardiovascular Function<br />Etio...
Nursing Management:Cardiovascular Complications<br />Nursing Assessment<br />Nursing Diagnoses<br />Nursing Implementation...
Postoperative Care in the Postanesthesia Care Unit (cont.)<br />Potential Alterations in Neurologic Function<br />Etiology...
Nursing Management:Neurologic Complications<br />Nursing Assessment<br />Nursing Diagnoses<br />Nursing Implementation<br />
Postoperative Care in the Postanesthesia Care Unit (cont.)<br />Pain and Discomfort<br />Etiology<br />
Nursing Management: Pain<br />Nursing Assessment<br />Nursing Diagnoses<br />Nursing Implementation<br />
Postoperative Care in the Postanesthesia Care Unit (cont.)<br />Hypotherma<br />Etiology<br />
Nursing Management: Hypothermia<br />Nursing Assessment<br />Nursing Diagnoses<br />Nursing Implementation<br />
Postoperative Care in the Postanesthesia Care Unit (cont.)<br />Nausea and Vomiting<br />Etiology<br />
Nursing Management:Nausea and Vomiting<br />Nursing Assessment<br />Nursing Diagnoses<br />Nursing Implementation<br />
Postoperative Care in the Postanesthesia Care Unit (cont.)<br />Surgical-Specific Care of the Patient in the PACU<br />Dis...
Care of the Postoperative Patient on the Clinical Unit<br />Potential Alterations in Respiratory Function<br />Etiology<br />
Nursing Management:Respiratory Complications<br />Nursing Assessment<br />Etiology<br />Nursing Diagnoses<br />Nursing Imp...
Nursing Management:Cardiovascular Complications<br />Nursing Assessment<br />Etiology<br />Nursing Diagnoses<br />Nursing ...
Nursing Management:Urinary Complications<br />Nursing Assessment<br />Nursing Diagnoses<br />Nursing Implementation<br />
Nursing Management:Gastrointestinal Complications<br />Nursing Assessment<br />Etiology<br />Nursing Diagnoses<br />Nursin...
Nursing Management:Surgical Wounds<br />Nursing Assessment<br />Etiology<br />Nursing Diagnoses<br />Nursing Implementatio...
Nursing Management:Psychologic Function<br />Nursing Diagnoses<br />Etiology<br />Nursing Implementation<br />
Care of the Postoperative Patienton the Clinical Unit (cont.)<br />Planning for Discharge and Follow-Up Care<br />
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Periop 2010

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Periop 2010

  1. 1. Preoperative Care<br />Paulette Hamner RN, MSN<br />NUR 1213<br />
  2. 2. Surgery<br />Art and science of treating diseases, injuries, and deformities by operation and instrumentation <br />
  3. 3. Surgery<br />Performed for<br />Diagnosis<br />Cure<br />Palliation<br />Prevention<br />Exploration<br />Cosmetic improvement<br />
  4. 4. Surgical Settings<br />Inpatient <br />Same day admission<br />Ambulatory (outpatient)<br />Usually less than 3 to 4 hours in PACU<br />
  5. 5. Patient Interview<br />Check documented information prior to interview<br />Avoids repetition<br />Occurs in advance or on day of surgery<br />
  6. 6. Patient Interview<br />Purpose<br />Obtain health information<br />Determine expectations<br />Provide and clarify information on procedure<br />Assess emotional state and readiness<br />
  7. 7. Nursing Assessment<br />Overall goal<br />Identify risk factors<br />Plan care to ensure patient safety<br />
  8. 8. Nursing Assessment Goals<br />Determine psychological status to reinforce coping strategies<br />Determine psychological factors of procedure contributing to risks<br />
  9. 9. Nursing Assessment Goals<br />Establish baseline data<br />Identify medications and herbs taken that may affect surgical outcome<br />Identify, document, and communicate results of laboratory/diagnostic tests<br />
  10. 10. Nursing Assessment Goals<br />Identify cultural and ethnic factors that may affect surgical experience<br />Determine receipt of adequate information from surgeon in order to sign informed consent<br />
  11. 11. Nursing Assessment<br />Psychosocial assessment<br />Excessive stress response can be magnified and recovery affected<br />
  12. 12. Nursing Assessment<br />Influencing factors<br />Age<br />Past experience<br />Current health<br />Socioeconomic status<br />
  13. 13. Nursing Assessment<br />Use common language<br />Use translators if needed<br />Decreases level of anxiety<br />Communicate all concerns to surgical team<br />
  14. 14. Nursing Assessment<br />Anxiety can impair cognition, decision making, and coping abilities<br />Lack of knowledge<br />Unrealistic expectations<br />Information lessens anxiety<br />
  15. 15. Nursing Assessment<br />Anxiety may arise from conflict with interventions (i.e., blood transfusions) and religious/cultural beliefs <br />Identify beliefs and discuss with surgeon and operative staff<br />
  16. 16. Nursing Assessment<br />Fears<br />Death or disability<br />May prompt postponement<br />Influence outcome<br />Pain<br />Consult with ACP<br />Reassure drugs will be available<br />
  17. 17. Nursing Assessment<br />Fears <br />Mutilation/alteration in body image<br />Assess concerns nonjudgmentally<br />Anesthesia<br />ACP for consult<br />Assess malignant hyperthermia risk<br />
  18. 18. Nursing Assessment<br />Fears<br />Disruption of life functioning<br />Range from fear of permanent disability to temporary loss<br />Include family and financial concerns<br />Consultations PRN<br />
  19. 19. Nursing Assessment<br />Hope<br />May be strongest positive coping mechanism<br />Never deny or minimize<br />Assess and support<br />
  20. 20. Nursing Assessment<br />Health history<br />Diagnosed medical conditions<br />Previous surgeries and problems<br />Menstrual/obstetric history<br />
  21. 21. Nursing Assessment<br />Health history <br />Familial diseases<br />Conditions<br />Reactions/problems to anesthesia (patient or family)<br />
  22. 22. Nursing Assessment<br />Current medications<br />Prescription and OTC<br />Herbs<br />Vitamins<br />Recreational<br />Drugs<br />Alcohol<br />Tobacco<br />
  23. 23. Nursing Assessment<br />Allergies (drug and nondrug)<br />Screen areas:<br />Risk factors<br />Contact urticaria<br />Aerosol reactions<br />History of reactions suggesting latex allergy<br />
  24. 24. Nursing Assessment<br />Cardiovascular system<br />Report<br />Problems for effective monitoring<br />Use of cardiac drugs<br />Presence of pacemaker/MI<br />
  25. 25. Nursing Assessment<br />Cardiovascular system<br />Vitals recorded preoperatively for baseline<br />Bleeding/clotting times<br />Laboratory reports<br />Possible prophylactic antibiotics<br />
  26. 26. Nursing Assessment<br />Respiratory system<br />Inquire about recent airway infections<br />Procedure could be cancelled because of increased risk of laryngo/bronchospasm or decreased SaO2 <br />
  27. 27. Nursing Assessment<br />Respiratory system<br />History of dyspnea, coughing, or hemoptysis reported to operative team<br />COPD or asthma<br />High risk for atelectasis and hypoxemia <br />
  28. 28. Nursing Assessment<br />Respiratory system<br />Smokers should be encouraged to quit 6 weeks before procedure<br />Decreases risk of complications<br />Greater years and number of packs = greater risk<br />
  29. 29. Nursing Assessment<br />Nervous system<br />Evaluation of neurologic functioning<br />Vision or hearing loss can influence results<br />
  30. 30. Nursing Assessment<br />Nervous system<br />Cognitive function<br />Assess or correct any deficits before surgery<br />Durable power of attorney for health care should be obtained if deficits cannot be corrected<br />
  31. 31. Nursing Assessment<br />Nervous system<br />Cognitive function<br />Postoperative delirium (falsely labeled senility or dementia) can occur with dehydration, hypothermia, and adjunctive medications<br />
  32. 32. Nursing Assessment<br />Urinary system<br />History of urinary or renal diseases<br />Renal dysfunction contributes to<br />F and E imbalances<br />Increased risk of infection<br />Impaired wound healing<br />Altered response to drugs and their elimination<br />
  33. 33. Nursing Assessment<br />Urinary system <br />Renal function tests<br />Note problems voiding and inform operative team<br />
  34. 34. Nursing Assessment<br />Integumentary system<br />History of skin and musculoskeletal problems<br />History of pressure ulcers<br />Extra padding during procedure<br />Affect postoperative healing<br />
  35. 35. Nursing Assessment<br />Musculoskeletal system<br />Identify joints affected with arthritis<br />Mobility restrictions may affect positioning and ambulation<br />Bring mobility aids to surgery<br />
  36. 36. Nursing Assessment<br />Musculoskeletal system <br />Report problems affecting neck or lumbar spine to ACP<br />Can affect airway management and anesthesia delivery<br />
  37. 37. Nursing Assessment<br />Endocrine system<br />Patients with diabetes mellitus especially at risk for:<br />Hypo/hyperglycemia<br />Ketosis<br />Cardiovascular alterations<br />Delayed wound healing<br />Infection<br />
  38. 38. Nursing Assessment<br />Endocrine system<br />Patients with diabetes mellitus <br />Serum glucose tests morning of surgery (baseline)<br />Clarify with physician or ACP if usual dose of insulin is taken<br />
  39. 39. Nursing Assessment<br />Endocrine system<br />Patients with thyroid dysfunction<br />Hyper/hypothyroidism are surgical risk due to altered metabolic rate<br />Verify with ACP about giving medications<br />
  40. 40. Nursing Assessment<br />Endocrine system<br />Patients with Addison’s disease<br />Abruptly stopping replacement corticosteroids could cause addisonian crisis<br />Stress of surgery may require increased dose of corticosteroids <br />
  41. 41. Nursing Assessment<br />Immune system<br />Patients with history of compromised immune system or use of immunosuppressive drugs can have<br />Delayed wound healing<br />Increased risk for infection<br />
  42. 42. Nursing Assessment<br />Fluid and electrolyte status<br />Vomiting, diarrhea, or difficulty swallowing can cause imbalance<br />Identify drugs that alter status<br />Diuretics <br />Evaluate serum electrolyte levels<br />
  43. 43. Nursing Assessment<br />Fluid and electrolyte status <br />NPO status <br />May require additional fluids and electrolytes prior to surgery if dehydration occurs<br />
  44. 44. Nursing Assessment<br />Nutritional status<br />Obesity<br />Stresses cardiac and pulmonary systems<br />Increased risk of wound dehiscence and infection<br />Slower recovery from anesthesia<br />Slower wound healing<br />
  45. 45. Nursing Assessment<br />Nutritional status <br />Provide extra padding to underweight patients to prevent pressure ulcers<br />Identify dietary habits that may affect recovery (i.e., caffeine)<br />
  46. 46. Nursing Assessment: Exam<br />Findings enable ACP to rate patient for anesthesia administration<br />Indicator of perioperative risk and overall outcome<br />
  47. 47. Nursing Assessment: Exam<br />Document relevant findings and report to perioperative team<br />Obtain and evaluate results of laboratory tests<br />Monitor blood glucose for diabetics<br />
  48. 48. Nursing Management<br />Preoperative teaching<br />Patient has right to know what to expect and how to participate<br />Increases patient satisfaction<br />Reduces fear, anxiety, stress, pain, and vomiting<br />
  49. 49. Nursing Management<br />Preoperative teaching <br />Limited time available<br />Address needs of highest priority<br />Include information focused on safety<br />Provide written material<br />
  50. 50. Nursing Management<br />Preoperative teaching <br />Several days before surgery<br />Observe and listen to determine amount of teaching for each session<br />Anxiety and fear can hinder learning<br />Give priority to patient’s concerns<br />
  51. 51. Nursing Management<br />Preoperative teaching <br />Must be documented and reported to postoperative nurses<br />Avoid duplication of information<br />Assess learning<br />
  52. 52. Nursing Management<br />Preoperative teaching<br />Teach deep breathing, coughing, and moving for postop<br />Inform if tubes, drains, monitoring devices, or special equipment will be used postop<br />
  53. 53. Nursing Management<br />Preoperative teaching<br />Basic information before arrival<br />Time and place<br />Fluid and food restrictions<br />Need for enema<br />Need for shower<br />
  54. 54. Nursing Management<br />Legal preparation<br />All required forms are signed and in chart<br />Informed consent<br />Blood transfusions<br />Advance directives<br />Power of attorney<br />
  55. 55. Nursing Management<br />Consent for surgery<br />Informed consent must include<br />Adequate disclosure<br />Understanding and comprehension <br />Voluntarily given consent<br />
  56. 56. Nursing Management<br />Surgeon responsible for obtaining consent<br />Nurse may obtain and witness signature<br />Verify patient has understanding<br />Permission may be withdrawn at any time<br />
  57. 57. Nursing Management<br />Consent for surgery<br />Medical emergency may override need for consent<br />
  58. 58. Nursing Management<br />Legally appointed representative of family may consent if patient is<br />Child<br />Unconscious<br />Mentally incompetent<br />
  59. 59. Nursing Management<br />Day-of-surgery preparation<br />Final preoperative teaching <br />Assessment and report of pertinent findings<br />Verify signed consent<br />
  60. 60. Nursing Management<br />Day-of-surgery preparation<br />Labs <br />History and physical examination<br />Baseline vitals<br />Consultation records<br />Nurse’s notes<br />
  61. 61. Nursing Management<br />Day-of-surgery preparation <br />Patient should not wear any cosmetics<br />Observation of skin color is important<br />Remove nail polish for pulse oximeter<br />
  62. 62. Nursing Management<br />Day-of-surgery preparation<br />Valuables returned to family member or locked up<br />Dentures, contacts, prostheses are removed<br />Identification and allergy bands on wrist<br />
  63. 63. Nursing Management<br />Void before surgery<br />Prevents involuntary elimination under anesthesia or early postoperative recovery<br />Before medication administration<br />
  64. 64. Nursing Management:Intraoperative Care<br />
  65. 65. Physical Environment<br />Department Layout<br />Holding Area<br />Operating Room<br />
  66. 66. Surgical Team<br />Registered Nurse<br />Licensed Practical Nurse and Surgical Technician<br />Surgeon and Assistant<br />Registered Nurse First Assistant<br />Anesthesia Care Provider<br />
  67. 67. Nursing Management: Patient Before Surgery<br />Psychosocial Assessment<br />Physical Assessment<br />Chart Review<br />Admitting the Patient<br />
  68. 68. Nursing Management: Patient During Surgery<br />Room Preparation<br />Transferring the Patient<br />Scrubbing, Gowning, and Gloving<br />Basic Aseptic Technique<br />Assisting the Anesthesia Care Provider<br />
  69. 69. Nursing Management: Patient During Surgery (cont.)<br />Positioning the Patient<br />Preparing the Surgical Site<br />Safety Considerations<br />Patient After Surgery<br />
  70. 70. Classification of Anesthesia<br />General Anesthesia<br />Intravenous Induction Agents<br />Inhalation Agents<br />
  71. 71. Classification of Anesthesia<br />General Anesthesia (cont.)<br />Adjuncts to General Anesthesia<br />Opioids<br />Benzodiazepines<br />Neuromuscular blocking agents<br />Antiemetics<br />Dissociative Anesthesia<br />
  72. 72. Classification of Anesthesia (cont.)<br />Local Anesthesia<br />Methods of Administration<br />Spinal and epidural anesthesia<br />Additional Anesthesia Considerations<br />
  73. 73. Gerontologic Considerations: Patient During Surgery<br />
  74. 74. Catastrophic Eventsin the Operating Room<br />Anaphylactic Reactions<br />Malignant Hyperthermia<br />
  75. 75. Postoperative Care in the Postanesthesia Care Unit (cont.)<br />Potential Alterations in Cardiovascular Function<br />Etiology<br />
  76. 76. Nursing Management:Cardiovascular Complications<br />Nursing Assessment<br />Nursing Diagnoses<br />Nursing Implementation<br />
  77. 77. Postoperative Care in the Postanesthesia Care Unit (cont.)<br />Potential Alterations in Neurologic Function<br />Etiology<br />
  78. 78. Nursing Management:Neurologic Complications<br />Nursing Assessment<br />Nursing Diagnoses<br />Nursing Implementation<br />
  79. 79. Postoperative Care in the Postanesthesia Care Unit (cont.)<br />Pain and Discomfort<br />Etiology<br />
  80. 80. Nursing Management: Pain<br />Nursing Assessment<br />Nursing Diagnoses<br />Nursing Implementation<br />
  81. 81. Postoperative Care in the Postanesthesia Care Unit (cont.)<br />Hypotherma<br />Etiology<br />
  82. 82. Nursing Management: Hypothermia<br />Nursing Assessment<br />Nursing Diagnoses<br />Nursing Implementation<br />
  83. 83. Postoperative Care in the Postanesthesia Care Unit (cont.)<br />Nausea and Vomiting<br />Etiology<br />
  84. 84. Nursing Management:Nausea and Vomiting<br />Nursing Assessment<br />Nursing Diagnoses<br />Nursing Implementation<br />
  85. 85. Postoperative Care in the Postanesthesia Care Unit (cont.)<br />Surgical-Specific Care of the Patient in the PACU<br />Discharge from the PACU<br />Ambulatory Surgery Discharge<br />
  86. 86. Care of the Postoperative Patient on the Clinical Unit<br />Potential Alterations in Respiratory Function<br />Etiology<br />
  87. 87. Nursing Management:Respiratory Complications<br />Nursing Assessment<br />Etiology<br />Nursing Diagnoses<br />Nursing Implementation<br />
  88. 88. Nursing Management:Cardiovascular Complications<br />Nursing Assessment<br />Etiology<br />Nursing Diagnoses<br />Nursing Implementation<br />
  89. 89. Nursing Management:Urinary Complications<br />Nursing Assessment<br />Nursing Diagnoses<br />Nursing Implementation<br />
  90. 90. Nursing Management:Gastrointestinal Complications<br />Nursing Assessment<br />Etiology<br />Nursing Diagnoses<br />Nursing Implementation<br />
  91. 91. Nursing Management:Surgical Wounds<br />Nursing Assessment<br />Etiology<br />Nursing Diagnoses<br />Nursing Implementation<br />
  92. 92. Nursing Management:Psychologic Function<br />Nursing Diagnoses<br />Etiology<br />Nursing Implementation<br />
  93. 93. Care of the Postoperative Patienton the Clinical Unit (cont.)<br />Planning for Discharge and Follow-Up Care<br />

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