Pre and post operative care for patients undergoing general anesthesiaJewel George Thomas
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Pre and post operative care for patients undergoing general anesthesiaJewel George Thomas
Guys if you are desirous of a Personalized PowerPoint Presentation, then feel free to screen into my SlideShare profile and pick up the most suitable Contact method to get in touch with me.
*Statutory Declaration - The Slides are congested as they contain a number of animations. Please download it and play Slideshow for proper understanding. Thank You.
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.
Management Of Patient Undergoing Surgerykalyan kumar
Preoperative care refers to health care provided before a surgical operation. The aim of preoperative care is to do whatever is right to increase the success of the surgery.
At some point before the operation the health care provider will assess the fitness of the person to have surgery.
During the perioperative period, specialised nursing care is needed during each phase of treatment. For nurses to give effective and competent care, they need to understand the full perioperative experience for the patient.
Perioperative refers to the three phases of surgery.
Preoperative stage
Intraoperative stage
Postoperative stage
Within these stages there are many different roles for nurses and different care needed for the patient dependent on which stage they are in.
As with any nursing care, the goal during these stages is to provide holistic and evidence based care as well as support to the individual.
There are different nursing roles throughout the perioperative process including: admissions nurse, anaesthetic nurse, circulating nurse or scout nurse, instrument or scrub nurse, post anaesthesia care unit (PACU) nurse and the surgical ward nurse. Other nurses may be included in the perioperative process such as pain management specialist nurses, diabetes educators.
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.
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.
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.
Management Of Patient Undergoing Surgerykalyan kumar
Preoperative care refers to health care provided before a surgical operation. The aim of preoperative care is to do whatever is right to increase the success of the surgery.
At some point before the operation the health care provider will assess the fitness of the person to have surgery.
During the perioperative period, specialised nursing care is needed during each phase of treatment. For nurses to give effective and competent care, they need to understand the full perioperative experience for the patient.
Perioperative refers to the three phases of surgery.
Preoperative stage
Intraoperative stage
Postoperative stage
Within these stages there are many different roles for nurses and different care needed for the patient dependent on which stage they are in.
As with any nursing care, the goal during these stages is to provide holistic and evidence based care as well as support to the individual.
There are different nursing roles throughout the perioperative process including: admissions nurse, anaesthetic nurse, circulating nurse or scout nurse, instrument or scrub nurse, post anaesthesia care unit (PACU) nurse and the surgical ward nurse. Other nurses may be included in the perioperative process such as pain management specialist nurses, diabetes educators.
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.
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.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
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Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
2. Surgery
Surgery is any procedure performed on
the human body that uses instruments to
alter tissue or organ integrity.
3. Reasons for surgery
Diagnostic
Curative
Palliative
Preventive
Explorative
Cosmetic
4. Definitions.
Perioperative nursing is a term used
to describe the nursing functions in
the total surgical experience of the
patient, pre operative, intra operative,
and post operative
5. A.Pre operative phase.
This is from the time the decision
is made for surgical intervention
to the transfer of the patient to the
operating room.
6. B.Intra operative phase.
This is from the time the patient is
received in the operating room
until transferred to the recovery
room.
8. A. PREOPERATIVE NURSING
CARE
Welcome and greet the patient to alley anxiety
and gain cooperation.
Introduce yourself to the patient to aid
understanding and allay anxiety.
Explain the procedure to the patient and
significant others.
Patient should sign consent form
9. Perform preoperative assessment.
Ask about patient’s current heath, allergies,
current medication, previous surgeries
understanding of surgical procedure and
anesthesia, smoking, alcohol and substance
abuse, social support, religious and cultural
considerations, mental status and activities of
living.
Check vital signs: temperature, pulse,
respirations and blood pressure.
Commence intravenous fluids
11. Suggestions….
Fear of the unknown
Anaesthetic + side effects / not waking up
Unrelieved pain
Restricted in bed post op.
Use of bed pan
Body image /effect on relationship, family
Dependant relatives.
Financial problems if sole provider for family.
12. Carry out all investigation/interventions
ordered i.e. Full blood count + Grouping and
X- match.
Give patient nothing in the mouth for 6-8
hours before surgery depending on the type
of surgery and hospital protocol to prevent
vomiting and aspiration of stomach contents.
Ask patient to open bowels before or
administer enema if necessary.
Give a bath in the morning of surgery for
hygienic purposes.
13. Allow patient to pass urine or catheterize to
prevent bladder trauma during the procedure
Check vital signs and record to serve as
baseline data in order to detect any deviation
from normal during surgery.
Remove jewelry and dentures to prevent trauma.
Put identification band on the patient to ensure
that the procedure will be done on the right
patient and right part of the body.
14. CONTD………………..
Give pre-medication an hour before surgery as
prescribed to meet requirement.
Preoperative teaching
Give the patient information about what will
happen to them and when, and what they will
experience such as expected sensations and
discomfort
Teach about ways of improving their recovery
such as:
How to move postoperatively.
Deep breathing and coughing exercises
15. How to splint incisions to ease pain when
moving or coughing
Leg exercises to reduce the risk of clots
forming in the veins in the legs
Teach the possible complications.
Dress patient in a theatre attire to reduce cross
infection
When theatre staff calls for the patient put
patient on a trolley
16. Take the patient’s notes, x-ray films,
laboratory investigation results and blood with
the patient. These may be needed before,
during and after surgery.
Take the patient to theatre and give full
handover to theatre staff for continuity of
care.
17. Pre op check list.
Exercise
Discuss each item on the checklist,
and provide a rationale for its
importance.
Feedback to group.
18. Premedication.
Prior to any pre medication being given, the nurse
must :-
Ensure identity bands are worn and labelled
correctly.
Consent form is signed by patient and doctor.
Patient has voided urine.
Check all other items on the checklist.
Premedication to be given as prescribed at
appropriate time, with explanation to the patient.
19. Final check
Ensure checklist is with patients notes, along
with consent form, x-rays, laboratory results,
nurses records.
Patient is transferred to theatre.
20. POST OPERATIVE CARE
Handover from recovery nurse to determine
post op instruction from surgeon/anaesthetist
Note patient’s time of arrival in the ward.
Assess airway for patency
Position the patient in recovery position
Assess breathing
Respiratory rate, rhythm and depth
Use of accessory muscles
Assess breath sounds
21. Assess circulation
Check the incision wound for bleeding.
Assess the patient’s skin colour
Heart rate, rhythm and strength
Capillary refill if necessary (OPTIONAL).
Assesses the level of consciousness
using Glasgow Coma Scale.
22. MAKES INITIAL OBSERVATION
Checks the theater notes to establish operation
performed, presence and location of any drains,
anesthesia used, estimated blood loss,
medications received in recovery room and post-
operative diagnosis.
Monitor vital signs such as Temperature, pulse,
respirations and Blood pressure ¼ hourly for the
first hour then ½ hourly for the next hour then 4
hourly if stable.
23. • Observe type and integrity of dressing and
drains
• Checks and secure , urinary catheter or any
drainages for patency
• Checks fluid status
- Checks, records and interprets intake and
output
24. Assess activity and ability to move extremities.
RELIEVING PAIN AND ANXIETY:
Administer Opioid analgesia such as
Pethidine 50- 100mg intramuscularly when
the patient has regained consciousness
Make sure the patient is safe(raise side
rails)