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Preoperative phase
Intraoperative phase
Postoperative phase
EMERGENT  –Severe bleeding
URGENT  24-30
ELECTIVE
OPTIONAL
MAJOR
MINOR
CLASSIFICATIONS  OF SURGERY <ul><li>Accdg. To Purpose  : </li></ul><ul><li>DIAGNOSTIC   </li></ul><ul><li>EXPLORATORY   </...
<ul><li>Accdg. To Location  : </li></ul><ul><li>INTERNAL  – </li></ul><ul><li>EXTERNAL  –  </li></ul>
FOUR BASIC PATHOLOGIC CONDITIONS THAT REQUIRE SURGERY: <ul><li>OBSTRUCTION </li></ul><ul><li>PERFORATION </li></ul><ul><li...
SURGICAL RISK PATIENTS <ul><li>Extremes of age ( very young & very old ) </li></ul><ul><li>Extremes of weight (emaciation,...
PHASES OF O.R. NURSING : <ul><li>PREOPERATIVE PHASE </li></ul><ul><li>PREPARATION FOR SURGERY </li></ul>
Day of surgery :  <ul><li>History. </li></ul><ul><li>Head-to-toe assessment </li></ul><ul><li>Informed consent </li></ul><...
Psychological Support : <ul><li>Fears, anxieties,  </li></ul><ul><li>Trusting relationship with client. </li></ul><ul><li>...
PREOPERATIVE TEACHING <ul><li>Preoperative medication  </li></ul><ul><li>Breathing exercises, coughing, incentive spiromet...
Diaphragmatic Breathing and Splinting When Coughing
Leg Exercises and Foot Exercises
Ensure the diagnostic <ul><li>CBC </li></ul><ul><li>Electrolytes </li></ul><ul><li>PT/PTT (Prothrombin Time;Partial thromb...
<ul><li>NPO- </li></ul><ul><li>Bowel prep  </li></ul><ul><li>skin prep </li></ul>
Immediate preoperative preparation  <ul><ul><li>Complete checklist and chart </li></ul></ul><ul><ul><li>Hospital gown, voi...
 
<ul><li>Adult client  (over 18 y/o) signs own permit unless unconcious or mentally incompetent. </li></ul><ul><li>If unabl...
 
<ul><li>Consents  are not needed  for  emergency  care if all 4 of the ff. criteria are met: </li></ul><ul><li>There is an...
PREOPERATIVE MEDICATIONS <ul><li>PURPOSES: </li></ul><ul><li>sedative. </li></ul><ul><li>narcotics. </li></ul><ul><li>anti...
 
<ul><li>REVIEW MEDICAL RECORD AND PHYSICIAN’S ORDER: INITIALS </li></ul><ul><li>1.  History  and Physical completed and in...
<ul><li>PREOPERATIVE PREPARATION :  INITIALS </li></ul><ul><li>1 .   Identification  bracelet accurate and affixed to wris...
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Surgery 6th year, Tutorial (Dr. AbdulWahid)

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Nov. 2nd, 2011

Published in: Health & Medicine
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Surgery 6th year, Tutorial (Dr. AbdulWahid)

  1. 1. Preoperative phase
  2. 2. Intraoperative phase
  3. 3. Postoperative phase
  4. 4. EMERGENT –Severe bleeding
  5. 5. URGENT 24-30
  6. 6. ELECTIVE
  7. 7. OPTIONAL
  8. 8. MAJOR
  9. 9. MINOR
  10. 10. CLASSIFICATIONS OF SURGERY <ul><li>Accdg. To Purpose : </li></ul><ul><li>DIAGNOSTIC </li></ul><ul><li>EXPLORATORY </li></ul><ul><li>CURATIVE </li></ul><ul><li>ABLATIVE </li></ul><ul><li>PALLIATIVE </li></ul><ul><li>RECONSTRUCTIVE </li></ul>
  11. 11. <ul><li>Accdg. To Location : </li></ul><ul><li>INTERNAL – </li></ul><ul><li>EXTERNAL – </li></ul>
  12. 12. FOUR BASIC PATHOLOGIC CONDITIONS THAT REQUIRE SURGERY: <ul><li>OBSTRUCTION </li></ul><ul><li>PERFORATION </li></ul><ul><li>EROSION </li></ul><ul><li>TUMORS </li></ul>
  13. 13. SURGICAL RISK PATIENTS <ul><li>Extremes of age ( very young & very old ) </li></ul><ul><li>Extremes of weight (emaciation, obesity) </li></ul><ul><li>Dehydrated pts. </li></ul><ul><li>Nutritional deficits </li></ul><ul><li>Pts. with severe trauma or injury, infection/sepsis </li></ul><ul><li>Pts. with cardiovascular disease </li></ul><ul><li>Endocrine dysfunction (diabetes mellitus) </li></ul><ul><li>Hypertensive & hypotensive pts. </li></ul><ul><li>Hepatic disease </li></ul><ul><li>Preexisting mental or physical disability </li></ul>
  14. 14. PHASES OF O.R. NURSING : <ul><li>PREOPERATIVE PHASE </li></ul><ul><li>PREPARATION FOR SURGERY </li></ul>
  15. 15. Day of surgery : <ul><li>History. </li></ul><ul><li>Head-to-toe assessment </li></ul><ul><li>Informed consent </li></ul><ul><li>Pt.’S identity & surgical site verified </li></ul><ul><li>Ivf started. </li></ul><ul><li>Necessary tests. </li></ul>
  16. 16. Psychological Support : <ul><li>Fears, anxieties, </li></ul><ul><li>Trusting relationship with client. </li></ul><ul><li>Explain pre- ,operative & post-op procedures </li></ul><ul><li>Allow client to ask questions. </li></ul><ul><li>Demonstrate confidence in surgeon & staff. </li></ul><ul><li>Provide for spiritual care. </li></ul>
  17. 17. PREOPERATIVE TEACHING <ul><li>Preoperative medication </li></ul><ul><li>Breathing exercises, coughing, incentive spirometer </li></ul><ul><li>Leg exercises </li></ul><ul><li>Position changes and movement </li></ul><ul><li>Pain management </li></ul>
  18. 18. Diaphragmatic Breathing and Splinting When Coughing
  19. 19. Leg Exercises and Foot Exercises
  20. 20. Ensure the diagnostic <ul><li>CBC </li></ul><ul><li>Electrolytes </li></ul><ul><li>PT/PTT (Prothrombin Time;Partial thromboplastin time) </li></ul><ul><li>Urinalysis </li></ul><ul><li>ECG </li></ul><ul><li>Blood typing & crossmatch </li></ul>
  21. 21. <ul><li>NPO- </li></ul><ul><li>Bowel prep </li></ul><ul><li>skin prep </li></ul>
  22. 22. Immediate preoperative preparation <ul><ul><li>Complete checklist and chart </li></ul></ul><ul><ul><li>Hospital gown, voiding, removal of dentures, jewelry, </li></ul></ul><ul><ul><li>Preoperative medication </li></ul></ul><ul><li>Transporting </li></ul>
  23. 24. <ul><li>Adult client (over 18 y/o) signs own permit unless unconcious or mentally incompetent. </li></ul><ul><li>If unable to sign, relative (spouse or next of kin) or guardian will sign. </li></ul><ul><li>In an emergency, permission via telephone or telegram is acceptable; have a 2 nd listener on phone when telephone permission is given </li></ul>
  24. 26. <ul><li>Consents are not needed for emergency care if all 4 of the ff. criteria are met: </li></ul><ul><li>There is an immediate threat to life. </li></ul><ul><li>Experts agree that it is an emergency. </li></ul><ul><li>Client is unable to consent. </li></ul><ul><li>A legally authorized person cannot be reached. </li></ul>
  25. 27. PREOPERATIVE MEDICATIONS <ul><li>PURPOSES: </li></ul><ul><li>sedative. </li></ul><ul><li>narcotics. </li></ul><ul><li>anticholinergics. </li></ul><ul><li>antiemetics and H2-blockers. </li></ul>
  26. 29. <ul><li>REVIEW MEDICAL RECORD AND PHYSICIAN’S ORDER: INITIALS </li></ul><ul><li>1. History and Physical completed and in chart </li></ul><ul><li>2. Laboratory studies/Reports in chart 3. EKG report in chart </li></ul><ul><li>4. Chest X-ray report in chart </li></ul><ul><li>5. Operative Permit completed, signed, & witnessed in chart </li></ul><ul><li>6. Anesthesia Permit completed, signed, & witnessed in chart </li></ul><ul><li>7. Consent for blood transfusion completed, signed, & witnessed in chart </li></ul><ul><li>8. Medication Reconciliation Form Completed & Signed </li></ul>
  27. 30. <ul><li>PREOPERATIVE PREPARATION : INITIALS </li></ul><ul><li>1 . Identification bracelet accurate and affixed to wrist or ankle prior to transport </li></ul><ul><li>2 . Allergies checked, allergies bracelet on and allergy sticker on chart </li></ul><ul><li>3 . Isolation label on chart </li></ul><ul><li>4 . Jewelry, hairpieces, hairpins, contact lenses, glasses, prosthesis, underwear, money removed .. </li></ul><ul><li>5 . Vital signs taken and recorded ................................................................................................ 5 . ____ </li></ul><ul><li>Time taken_________ BP_________ Temp_______ HR_______ Resp_______ </li></ul><ul><li>6 . Dentures : Full : Upper Lower Partial : Upper Lower </li></ul><ul><li> Removed : Sent Home Left at bedside </li></ul><ul><li> Left in place as requested by : Anesthesiologist Patient </li></ul><ul><li>7. Patient NPO yes since ________ </li></ul><ul><li>If no: O.R. notified (Time) _______ </li></ul><ul><li>8. Medication sheets on chart.. </li></ul><ul><li>9. Most recent nursing assessment attached </li></ul><ul><li>10. Report called to____________ at________________(time) </li></ul>

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