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1001224_perioperative nursing care 1.ppt

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Perioperative Nursing Care
1
Perianesthesia and
Perioperative Nursing
is the field of nursing that addresses the nursing
roles associated with the three phases of
surgical experiences : pre operative
postoperative and intraoperative
2
Preoperative Nursing Care:
• begins when the decision to proceed with
surgical intervention is made and end with the
transfer of patient to the operation table
3
Examples of nursing activities in the preoperative
phase include :
Pre admission testing
• Initial preoperative assessment
• Initiate teaching appropriate to patients needs
• Involve family in interview
• Verify completion of preoperative testing
4
Admission to surgical unite or center
• Complete the preoperative assessment
• Assess for risk of complications
• Report upnormal findings
• Verify that informed consent obtained
• Answers family questions
• Develop a plan of care
5
Others also in the holding area prior to the surgery
• Review patient chart
• Identify patient
• Verify surgical site
• Establish intravenous line eg canula
• Administer prescribed medications
• Provide support
6
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1001224_perioperative nursing care 1.ppt

  • 2. Perianesthesia and Perioperative Nursing is the field of nursing that addresses the nursing roles associated with the three phases of surgical experiences : pre operative postoperative and intraoperative 2
  • 3. Preoperative Nursing Care: • begins when the decision to proceed with surgical intervention is made and end with the transfer of patient to the operation table 3
  • 4. Examples of nursing activities in the preoperative phase include : Pre admission testing • Initial preoperative assessment • Initiate teaching appropriate to patients needs • Involve family in interview • Verify completion of preoperative testing 4
  • 5. Admission to surgical unite or center • Complete the preoperative assessment • Assess for risk of complications • Report upnormal findings • Verify that informed consent obtained • Answers family questions • Develop a plan of care 5
  • 6. Others also in the holding area prior to the surgery • Review patient chart • Identify patient • Verify surgical site • Establish intravenous line eg canula • Administer prescribed medications • Provide support 6
  • 7. Intraoperative Nursing Care • Begins when patient is transferred to onto the operation table and ends with admission to the post anesthesia care unite Main nursing activities include • Maintain safety • Maintain aseptic environment • Transfer patient to operation room or table • Position the patient in correct alignment • Ensure that instruments count are correct • Complete documentation 7
  • 8. Physiologic monitoring • Calculate fluid loss or gain • Distinguish normal and abnormal data • Report changes in vital sign Physiologic support • Provide emotional support 8
  • 9. Postoperative Nursing Care • Begins when patient is admitted to the post anesthesia care unite and end with follow up evaluation in home or clinical setting Activities include • Maintain airway • Monitor vital sign • Assess the effect of anesthetic agents • Assess complications assess pain • Promote recovery and initiate teaching • Initiate discharge plan 9
  • 10. Surgical classification ( according to urgency) • Emergent : immediately with no delay eg sever bleeding • Urgent: patient needs prompt attention must be done within 24 hrs eg gall bladder infection and kidney stone • Required : patient must have surgery within few weeks or months eg cataract, Thyroid disorder • Elective : failure to have surgery has some impact on patient life but not very dangerous eg repair of scare and simple hernia • Optional : personal preference eg cosmetics 10
  • 11. Preparation for Surgery Informed Consent • process for getting permission before conducting a healthcare intervention on a person. A health care provider may ask a patient Which procedures need informed consent ? • Invasive procedure such as need anesthesia • Non surgical procedure that carry considerable risk such as arteriography • Procedures that involve radiation 11
  • 12. Criteria for valid informed consent • Voluntary • Must be written • Patient must be competent and able to comprehend • In case of incompetent patient family member or law representatives may give consent • Should contain explanation of procedure • Instruction that patient can withdraw consent • Explanation that all patients questions would be answered and if there is any significant notes such as change in customary procedure 12
  • 13. Assessment of health factor that affect patient preoperatively • Nutritional and fluid status • Drug and alcohol abuse • Respiratory status • Cardiovascular status • Hepatic and renal function • Endocrine function • Immune function • Previous medication use • Psychosocial factors • Spiritual and cultural beliefs 13
  • 14. Special situations • Ambulatory surgery : patient discharge the same day of surgery • Obese patient • Emergency surgery 14
  • 15. Preoperative nursing intervention • Preoperative teaching • Deep breathing coughing exercise • Teach patient how to promote mobility and active body movement by frequent position • Leg exercise • Getting out of bed • Pain management • Coping strategies • Reduce anxiety and fear 15
  • 16. • Maintain patient safety • Manage fluid status • Prepare the bowel • Prepare the skin 16
  • 17. Immediate preoperative nursing interventions • Administer pre anesthetic medications • Maintain preoperative records • Transport patient to the operation room 17