This document discusses pre, intra, and postoperative nursing management. It describes the three phases of the perioperative period and provides details about nursing interventions in each phase. In the preoperative phase, nursing focuses on psychological preparation, informed consent, and physiological assessment. During surgery, nurses serve as circulating or scrub nurses to provide a safe environment and assist the surgical team. In recovery, nursing aims to monitor vital signs, manage pain and complications, and encourage early mobilization.
Basics of nursing initial assessment needed to be done when a patient is received in the department. Done by the registered nurse, initial assessment is the basis on which further care is planned.
Postoperative care is the care you receive after a surgical procedure. The type of postoperative care you need depends on the type of surgery you have, as well as your health history. It often includes pain management and wound care. Postoperative care begins immediately after surgery.
Basics of nursing initial assessment needed to be done when a patient is received in the department. Done by the registered nurse, initial assessment is the basis on which further care is planned.
Postoperative care is the care you receive after a surgical procedure. The type of postoperative care you need depends on the type of surgery you have, as well as your health history. It often includes pain management and wound care. Postoperative care begins immediately after surgery.
Things to ensure and check off the list before a patient is shifted to the OR for surgery. The responsibility rests mainly with the resident doctor and the registered nurse to ensure complete preoperative preparation of the patient.
There is a lot of confusion around Do Not Resuscitate (DNR) orders. This is a medical order that advises healthcare professionals not to attempt a cardiopulmonary resuscitation (CPR) on a person who has suffered a cardiac arrest. Healthcare workers, paramedics, and EMTs are required to attempt CPR on all people who have suffered a cardiac arrest unless a person has a DNR order. This DNR order must be available in the moment or else the assumption is that the person does not have one. This lecture will cover DNR orders and how to complete one.
Nursing management of critically ill patient in intensive care unitsANILKUMAR BR
Critical care nursing: it is the field of nursing with a focus on the utmost care of the critically ill (or) unstable patients.
Critically ill patients : critically ill patients are those who are at risk for actual (or) potential life threatening health problems.
Admission QGeneral appearance (consciousness)
Airway: Patency Position of artificial airway (if present)
Breathing: Quantity and quality of respirations (rate, depth, pattern, symmetry, effort, use of accessory muscles) Breath sounds Presence of spontaneous breathing.
Circulation and Cerebral Perfusion: ECG (rate, rhythm, and presence of ectopy) Blood pressure Peripheral pulses and capillary refill Skin, color, temperature, moisture Presence of bleeding Level of consciousness, responsiveness.
quick Check Assessment in CCU.
Things to ensure and check off the list before a patient is shifted to the OR for surgery. The responsibility rests mainly with the resident doctor and the registered nurse to ensure complete preoperative preparation of the patient.
There is a lot of confusion around Do Not Resuscitate (DNR) orders. This is a medical order that advises healthcare professionals not to attempt a cardiopulmonary resuscitation (CPR) on a person who has suffered a cardiac arrest. Healthcare workers, paramedics, and EMTs are required to attempt CPR on all people who have suffered a cardiac arrest unless a person has a DNR order. This DNR order must be available in the moment or else the assumption is that the person does not have one. This lecture will cover DNR orders and how to complete one.
Nursing management of critically ill patient in intensive care unitsANILKUMAR BR
Critical care nursing: it is the field of nursing with a focus on the utmost care of the critically ill (or) unstable patients.
Critically ill patients : critically ill patients are those who are at risk for actual (or) potential life threatening health problems.
Admission QGeneral appearance (consciousness)
Airway: Patency Position of artificial airway (if present)
Breathing: Quantity and quality of respirations (rate, depth, pattern, symmetry, effort, use of accessory muscles) Breath sounds Presence of spontaneous breathing.
Circulation and Cerebral Perfusion: ECG (rate, rhythm, and presence of ectopy) Blood pressure Peripheral pulses and capillary refill Skin, color, temperature, moisture Presence of bleeding Level of consciousness, responsiveness.
quick Check Assessment in CCU.
Peri-operative Nursing/Anesthesia/Pain ManagementWasim Ak
The care provide during surgical intervention (pre-operative, intra-operative and post-operative period) is known as Peri-operative Nursing Care.
Peri-operative Nursing Care includes :
Pre-operative Nursing Care
Intra-operative Nursing Care
Post-operative Nursing Care.
Anesthesia means “loss of sensation with or without loss of consciousness” .
Medications that cause anaesthesia, are called Anesthetics.
Anesthesia is defined as a temporary state consisting of unconsciousness, loss of memory, lack of pain, and muscle relaxation.
Anesthesia is defined as a loss of feeling or awareness caused by drugs or other substances which keeps patient free from feeling pain during surgery or other procedures.
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.
Post-Operative Managment
• The post operative period begins from the time
• The patients leaves the operating room and ends with the
follow up visit by the surgeon.
• The post operative care is provided by
-- PACU
-- SICU
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
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Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
2. Pre, Intra and Post Operative
Nursing Management
• Perioperative Period: The time that constitute the
surgical experience, include the preoperative,
intraoperative, postoperative phases.
• Preoperative Phase: The time from when decision for
surgical intervention is made to when the patient is
transferred to the operating room table.
• Intaroperative Phase: Period of time from when the
patient is transferred to the operating room table to when
he or she is admitted to the postanesthesia care unit.
• Postoperative Phase: Period of time that begins with
the admission of the patient to the postanesthesia care
unit and ends after follow-up evaluation in the clinical
setting or home.
3. Purposes of surgery
-Diagnostic→e.g. Biopsy
Exploratory→e.g. laparotomy
Curative →e.g. excision of a tumor or an inflamed
appendix
- Reconstructive or cosmetic → e.g.mammoplasty
- Palliative→ relieve of symptoms as pain
4. Categories of surgery
1- Emergency:
Must be performed immediately:
1)Maintain life
2)Maintain organ or limb function
3)Stop hemorrhage (Intestinal obstruction/Gunshot & stab
wounds).
2- Urgent:
Must be performed within 24 to 48 hours(Bleeding of duodenal
ulcer)
5. 3- Planned
Scheduled weeks or months ahead of the
proposed operation (cataract removal)
4- Elective
Not absolutely necessary (hernia)
5- Optional
Requested by the person (Mammoplasty)
6. Risk factors for surgical
complications:
- Age, obesity, malnutrition, immobility , hypovolemia ,
infection, pregnant, diabetes mellitus, hepatic
disease,
cardiovascular disease, renal disease and
pulmonary disease.
- Nature of condition (Malignant)
- Location of condition (Heart/Brain)
7. IV-Nursing intervention
I- Psychological Aspect:
• Provide explanations or printed information about health
care facility routines & visiting hours & meal times
• Explain the procedures involved in the upcoming surgery
(Complete idea of what the • pre, intra & post operative
course entails).
• Introduce the person who is to undergo a major surgical
procedure to people who have successfully recovered from
this operation.
Helps to relieve anxiety
8. 2. Informed Consent :
• Anyone undergoing surgery must sign an operative permit. It
protects the health care facility staff from legal action
3. Physiologic Aspects
Before the day of surgery
• Correct any dietary deficiencies
• Reduce an obese person's weight.
• Correct fluid & electrolyte imbalances.
• Restore adequate blood volume with blood transfusion.
• Treat chronic disease.
• Cure infections process
9. Preparing the person the evening before
surgery.
• Hygienic care ( bathing or scrubbing )
• Skin preparation( shaving)
• Document observation of the surgical site. (note cuts or
breaks)
• Restricting food & fluid eight to ten hours preop. NPO
after midnight.
• intravenous infusions may receive for debilitated or
malnourished patient
• Enemas not routinely ordered except for G.I.T s
• NG tube sometimes is inserted the evening before or the
morning of surgery
10. • Remove colored nail polish
• Assist the person in donning a hospital gown, cap
• Check for laboratory record
• Blood available
• Pre-anesthetic medication given e,g. 1 gram claforan
11. • Pre-operative teaching:
• Deep breathing and coughing exercises To prevent
pneumonia
• Incentive spirometer
• Turning & moving, leg exercise to prevent DVT
• Getting out of bed
• Pain management
14. Intraoperative Phase
• Begins when patient is transferred to
operating room table
• Provide for patient safety
• Maintain aseptic environment
• Provide surgeon with supplies and
instruments
• Documentation
16. Intraoperative nursing
management:
I-Nurse's roles in the operating room a. Circulating
nurse b. Scrub nurse
A-Circulating nurse
.Prepares operating room with necessary equipment and
supplies and ensures that equipment is functional.
.Arrange sterile and nonsterile supplies; opens sterile
supplies for scrub nurse.
.Sends for client at proper time.
.Visits with client preoperatively; explains role, verifies
operative permit, identifies client, and answers
any questions.
.Confirms client's allergies.
.Checks medical record for completeness.
17. .Assists in safe transfer of client to operating room table.
.Positions client on operating room table in accordance with
type of procedure, and surgeon's preference.
.Counts sponges, needles, and instruments with scrub nurse
before surgery.
.Assists scrub nurse and surgeons by tying gowns and
preparing client's skin.
.Assists scrub nurse in arranging tables to create sterile field.
.Maintains continuous observations during surgery to
anticipate needs of client, scrub nurse, surgeons, and
anesthesiologist.
.Provides supplies to scrub nurse as needed.
18.
19.
20.
21.
22.
23. .Observes sterile field closely for any breaks in aseptic
technique and reports.
.Cares for surgical specimen.
.Documents operative record and nurses' notes.
.Counts sponges, needles, and instruments when closure
of wound begins.
.Transfers client to stretcher for transport to recovery area
.Accompanies client to a recovery room and provides a
report.
24. b. Scrub nurse
.Performs surgical hand scrub.
.Dons sterile gown and gloves aseptically.
. Arranges sterile supplies and instruments in manner
prescribed for procedure.
.Checks instruments for proper functioning.
.Counts sponges, needles, and instruments with circulating
nurse.
.Gowns and gloves surgeons as they enter operating
room.
25. • Assists with surgical draping of client.
• Maintains sterile field.
• Recognizes and corrects breaks in aseptic technique.
• Observes progress of surgical procedure.
• Hands surgeon instruments, sponges, and necessary
supplies during procedure"
• Identifies and handles surgical specimens correctly.
• Watches sponges, needles, and instruments so none
will be misplaced or lost in wound.
26.
27. Postoperative Phase
• Admission to the recovery room
• Maintain airway
• Monitor vital signs
• Assess effects of anesthesia
• Assess for complications of surgery
• Provide comfort and pain relief
• Ends with follow-up evaluation in clinical
setting or home
28.
29. Nursing management in the post
anesthesia care unit:
I-Assessing the patient:
Frequent assessment of the patient oxygen saturation,
pulse volume and regularity, depth and nature of
respiration, skin color ,depth of consciousness.
II- Maintaining a patent airway:
− The primary objectives are to maintain pulmonary
ventilation and prevent hypoxia and hypercapenia.
− The nurse applies oxygen, and assesses respiratory
rate and depth, oxygen saturation.
30. Nursing management in the post
anesthesia care unit:
III- Maintaining cardiovascular stability:
− The nurse assesses the patient’s mental
status, vital signs, cardiac rhythm, skin
temperature, color and urine output.
− Central venous pressure, arterial lines and
pulmonary artery pressure.
− The primary cardiovascular complications
include hypotension, shock, hemorrhage,
hypertension and dysarrythmias.
31. Nursing management in the post
anesthesia care unit:
IV- Relieving pain and anxiety:
− Opioid analgesic.
V- Assessing and managing the surgical site:
− The surgical site is observed for bleeding, type and
integrity of dressing and drains.
VI- Assessing and managing gastrointestinal function:
− Nausea and vomiting are common after anesthesia.
− Check of peristalsis movement.
32. Nursing management in the post
anesthesia care unit:
VII- Assessing and managing voluntary voiding:
− Urine retention after surgery can occur for a verity of reasons.
Opioids and anesthesia interfere with the perception of bladder
fullness.
- Abdominal, pelvic ,hip may increase the like hood of retention
secondary to pain.
VIII- Encourage activity:
− Most surgical are encouraged to be out of bed as soon as
possible. Early ambulation reduces the incidence of post
operative complication as ,atelectasis ,pneumonia,
gastrointestinal discomfort and circulatory problem.
33. Post Operative Complication:
1- Shock:
Is the response of the body to a decrease in the circulating volume of
blood, tissue perfusion impaired, cellular hypoxia and death.
2- Hemorrhage:
Is the escape of blood from a blood vessel.
3- Deep vein thrombosis. (DVT).
Occur in pelvic vein or in lower extremities, and it’s common
after hip surgery.
34. Post Operative Complication:
4- Pulmonary embolism.
It’s the obstruction of one or more pulmonary
arterioles by an embolus originating some where in the
venous system or in the right side of heart.
5- Urinary Retention.
6- Intestinal obstruction.
Result in partial or complete impairment to the forward
flow of intestinal content.