Peri operative nursing is a nursing specialty that works with patients who are having injuries, invasive procedures. Peri-operative nurses work closely with surgeons, anesthesiologists, nurse anesthetist, surgical technologists, and nurse practitioners. They perform preoperative, intraoperative, post operative care primarily in the operating theater. The nurse assesses the patient data; establishing nursing diagnosis; identifies desired patient outcome; develop and implements a plan of care; and evaluates that care in terms of outcomes achieved by the patient All aspects of peri operative care is described. -preoperative care -postoperative care Role of nurse in pre operative nursing: 1.Pre operative assessment. 2.Obtaining informed consent. 3.Pre operative teaching. 4.Physical preparation of patients. 5.Psychological preparation 6.Informed Consent POST OPERATIVE CARE: Post operative phase begins when the client is admitted to the post operative unit and ends with the client’s post operative evaluation in the physician’s office. GOAL: Restore homeostasis and prevent complication. Maintain adequate cardio vascular and tissue perfusion Maintain adequate respiratory function Maintain adequate nutrition and elimination Maintain adequate fluid electrolyte balance Maintain adequate renal function Promote adequate rest, comfort, and safety Promote adequate wound healing Promote and maintain activity and mobility Provide adequate psychological support. TRANSFER FROM OPERATION ROOM: After sending the patient to operating room, prepare a bed to receive the patient undergone surgery. Receive the patient without disturbing the devices attached to the patient. Assessment A- Airway, B- Breathing, C- Circulation, C- Consciousness, S- Safety, D- Dressing, D- Drainage, D- Drugs , E- Elimination F- Foods, F- Fluids P- Pain. Ask the theater staff about any complications during surgery. Check vital signs. Check the operation site for bleeding, discharge, etc. if drainage tube are filled. Keep the patient well covered to prevent draught Never leave the patient alone to prevent injury from fall Observe the patient for swallowing reflexes Quickly observe the functioning of all devices and make sure that they are in its functioning order. Check the doctor’s order for other instruction and treatment. POST OPERATIVE COMPLICATIONS: Haematological: Hemorrhage Respiratory: Atelectesis, Pneumonia, Pulmonary Embolism Cardiovascular: Hypertension, cardiac dysrhythmias, venous thrombosis Urinary: Urinary retention Gastrointestinal: Constipation Neurological: CVA/Stroke Immunological: Infection Wound healing: infection Psychological: Body image problrms POST OPERATIVE NURSING CARE: Maintaining Respiratory function: i.Encourage diaphragmatic breathing exercise at least every two hours while clients are awake ii.Instruct to use incentive spirometers for maximum inspiration iii.Encourage early ambulation iv.Change position every one two hours.

2. Miss. Chowdhury, 15 years
old young girl comes to
Emergency Department
with fever, severe pain in
right illac fossa radiating to
Mc Burney’s point,
associated with rebound
tenderness, and vomitting.

3. Pre-Operative & Post Operative Care
Susmita Halder
M.Sc. Nursing 1st Year
CON BSMC, Bankura

4. Surgery
• Surgery can be defined as the art
and science of treating diseases,
injuries and deformities by
operation and instrumentation.
• Surgical procedures are named
according to :
1.The involved body part, organ,
location.
2.The suffix that describes what is
done during the procedure.

5. SURGICAL PROCEDURES:
• ECTOMY- Removal by cutting( Appendectomy)
• Lysis- Destruction of(electrolysis)
• Orrhapy- Suture of or repair (herniorraphy)
• Oscopy- Looking into(endoscopy)
• Ostomy- Formation of a permanent artificial opening(colostomy)
• Otomy- Incision or cutting into(tracheotomy)
• Plasty- Formation or repair(mammoplasty)

6. INDICATION FOR SURGERY:
C – Correction of defects
A –Alteration of form
R- Restoration of function
D- Diagnosis and treatment

7. SETTINGS FOR SURGERY:
• Inpatient settings: Hospital
• Outpatient settings:
Hospital based ambulatory surgical centers.
Free standing surgical centers
Physicians’' offices
Ambulatory care centers.

8. Surgery
Purpose Urgency Risk
Extent of
degree

9. COSMETIC
PALLIATIVE
RECONSTRUCTIVE
ABLATIVE
DIAGNOSTIC
CONSTRUCTIVE

10. EMERGENCY
URGENT
BASED ON URGENCY
OPTIONAL
ELECTIVE

11. MINOR MAJOR
Based on RISK

12. simple radical
Based on Extent of surgery

13. 01
Pre Operative
Care

14. Preoperative care of the patient begins as
soon as the surgeon makes a diagnosis and
decide that an operation is necessary for
the patient which continues until the client
has reached the operating area.

15. Goals of pre-operative care
1.Assessing and correcting physiologic and psychological problems that
may increase surgical risk.
2.Giving the person and significant others complete learning / teaching
guidelines regarding surgery.
3.Instructing and demonstrating exercises that will benefit the person during
post operative period.
4.Planning for discharge and any projected changes in lifestyle due to
surgery.

16. Role of nurse in pre
operative nursing:
1.Pre operative
assessment.
2.Obtaining informed
consent.
3.Pre operative teaching.
4.Physical preparation of
patients.
5.Psychological
preparation
6. Informed Consent

17. Pre operative assessment:
Nutritional and fluid
status
Drug or alcohol use Respiratory status Cardiovascular status
Hepatic and renal
function
Endocrine function Immune function
Previous medication
use
Psychological factors
Spiritual and cultural
beliefs
Review preoperative
laboratory and
diagnostic studies.
Review the client’s
health history.

18. Informed Consent
Purpose:
• To ensure that the client understands the nature of the treatment
including the potential complications and disfigurement.
• To indicate that the client’s decision was made without pressure.
• To protect the client against unauthorized procedure.
• To protect the surgeon and hospital against legal actions by a
client who daims that an unauthorized procedure was performed.

19. Informed subject refers to informed
consent in writing which should contain
the following points
oExplanation of procedure and its risks
oDescription of benefits and alternatives
oAn offer to answer questions about
procedure
oInstructions that the patient may withdraw
consent
of statement informing the patient that if the
protocol differs from the customary
procedure

20. Pre-operative teaching

21. Incentive
spirometer

22. Diaphragmatic
breathing

23. Coughing
and
Splitting

24. • Turning
• Foot and
leg exercise
• Early
ambulation.

25. REVIEW PRE OPRATIVE LABORATORY AND
DIAGNOSTIC STUDIES:
Complete blood count
Blood type and cross match
Serum electrolytes
Urinalysis
Chest x rays.
Electro cardiogram.
Other tests related to procedure or client’s medical conditions like
prothrombine time, urea, creatinine, other radiographic studies.

26. REVIEW OF PATIENT HISTORY
History of present illness and reason for surgery.
Past medical history
Medical conditions(acute or chronic)
Previous hospitalization and surgeries
History of any past problem with anesthesia.
Allergies.
Present medications.

27. REVIEW OF PATIENT HISTORY
Substance use: alcohol, tobacco, drugs
Review of system
Ability to communicate
Vital signs
Level of consciousness: confusion, drowsiness, unresponsiveness
Weight and height
Ability to move/ ambulatory
Level of exercise
Prostheses
Circulatory status

28. PREPARATION OF THE PATIENT IN THE EVENING
BEFORE SURGERY:
• Preparing the skin.
• Preparing the G I tract
• Preparing for anaesthesia
• Promoting rest and sleep : administer sedatives as
ordered.

29. Awaken 1 hour before pre operative medications.
Morning bath, mouth wash
Provide clean gown.
Remove hair pins, braid long hair, cover hair with cap if
available.
Remove dentures , colored nail polish hearing aid,
contact lenses jewelleries.
Take baseline vital signs before pre operative
medication.

30. Check ID band, skin preparation.
Check for special orders enema, IV line
Check NPO
Have client void before pre operative medication
Continue to support emotionally.
Accomplished “pre operative checklist"

31. PHYSICAL PREPARATION OF THE PATIENT:
Nutrition
and fluids
Hygiene Sleep Prostheses
Surgical
skin
preparation
Vital signs Elimination Medication
Care of
valuables
Special
orders
Safety
protocols

32. Pre Operative Nursing Care

33. 02
Post Operative
Care

34. Post operative phase begins when the client is
admitted to the post operative unit and ends with
the client’s post operative evaluation in the
physician’s office.
Post Operative
Care

35. • Restore homeostasis and prevent complication.
• Maintain adequate cardio vascular and tissue
perfusion
• Maintain adequate respiratory function
• Maintain adequate nutrition and elimination
• Maintain adequate fluid electrolyte balance
• Maintain adequate renal function
• Promote adequate rest, comfort, and safety
• Promote adequate wound healing
• Pomote and maintain activity and mobility
• Provide adequate psychological support.
GOAL:

36. • After sending the patient to operating room, prepare a bed to
receive the patient undergone surgery.
• Receive the patient without disturbing the devices attached to
the patient.
• Assessment A- Airway, B- Breathing, C- Circulation, C-
Consciousness, S- Safety, D- Dressing, D- Drainage, D- Drugs ,
E- Elimination F- Foods, F- Fluids P- Pain.
• Ask the theater staff about any complications during surgery.
• Check vital signs.
TRANSFER FROM OPERATION ROOM:

37. • Check the operation site for bleeding, discharge, etc. if drainage tube
are filled.
• Keep the patient well covered to prevent draught
• Never leave the patient alone to prevent injury from fall
• Observe the patient for swallowing reflexes
• Quickly observe the functioning of all devices and make sure that they
are in its functioning order.
• Check the doctor’s order for other instruction and treatment.
TRANSFER FROM OPERATION ROOM:

38. Haematological: Hemorrhage
Respiratory: Atelectesis, Pneumonia, Pulmonary Embolism
Cardiovascular: Hypertension, cardiac dysrhythmias, venous thrombosis
Urinary: Urinary retention
Gastrointestinal: Constipation
Neurological: CVA/Stroke
Immunological: Infection
Wound healing: infection
Psychological: Body image problrms
POST OPERATIVE COMPLICATIONS:

39. Post Operative Nursing Care

40. Post Operative Nursing Care
Maintaining
Respiratory function
Prevent circulatory
stasis, Promotes
normal venous return
and circulatory blood
flow
Promote adequate
nutrition and normal
elimination
Maintain adequate
dietary intake
Promote urinary
elimination
Promote wound
healing
Provide rest and
comfort
Maintain self
concept of the client
Post operative
exercises
Post operative
teaching

41. BIBLIOGRAPHY:
Basser P. Shebeer, Khan S Yasmin, A concise Textbook of advanced Nursing Practice, Second Edition, EMMESS,
Medical Publishers, Banglore, 2019
Clement I. Basic Concept of Nursing procedure. Third Edition. Jaypee Brothers Medical Publishers (p) LTD.
New Delhi. 2018.
Jacob Annamma et al. Clinical nursing Procedures: The art of Nursing Practice. Third edition. Jaypee The Health
Science Publishers.New Delhi.2025.
Kaur Brar Navdeep, Rawat HC. Textbook of Advanced Nursing Practice, First Edition. Jaypee Brothers Medical
Publishers (p) LTD. New Delhi 2015
Nancy.SR. Stephanie’s Principles and practice of Nursing. Sixth edition. N R Brothers Publishers.Indore.
TNAI. Fandamentals of Nursing; a Procedure manual.First edition. Secretary General on behalf of the TNAI. New
Delhi.2009
www. Slide share.net ( Peri Operative Nursing)

42. THANK YOU!