Professional Documents
Culture Documents
Definition of Surgery
Perioperative Nursing
Perioperative NursingNursing
Perioperative Nursing
Phases
Preoperative phase
Perioperative Nursing
Types of Surgery
Purpose/reasons
Perioperative Nursing
Type of Surgery (Purpose)
Diagnostic-Allows
Diagnostic
Perioperative Nursing
Types of Surgery (Urgency)
Emergency- performed
immediately to preserve
function or the life of the client.
Elective is performed when surgical intervention
is the preferred treatment for a condition that is not
imminently life threatening or to improve the clients
life.
Urgent Necessary for client health to prevent
additional problem from developing; not necessarily
an emergency.
Required has to be performed at some point; can
be pre-scheduled.
Perioperative Nursing
Type of Surgery (Degree of Risk)
Major
Perioperative Nursing
Surgical settings
Surgical suites
Ambulatory care setting
Clinics
Physician offices
Community setting
Homes
Perioperative Nursing
Surgical settings
Disadvantages
Preoperative Nursing
Consent
Nature and intention of the surgery
Name and qualifications of the person
Preoperative Nursing
Assessment (Nursing History)
Current health status Allergies
Medications- list all current medications
Previous surgeries
Understanding of the surgical procedure and
anesthesia
Smoking
Alcohol and other-altering substances
Coping
Social resources
Cultural considerations
system
Respiratory system
Renal system
Neurological system
Musculoskeletal system
Nutritional status
Gerontological considerations
General surveysurvey
Renal system-abnormal
system
renal function
can altered fluid and electrolyte balance
and decrease the excretion of preoperative
medications and anesthetic agents.
Neurologic systemsystem a clients LOC will
change as a result of general anesthesia
but should return to the preoperative LOC
after surgery.
Musculoskeletal
Respiratory System
Renal System
Musculoskeletal
Decreased elasticity
Decreased lean body mass
Decreased subcutaneous fat
Screening
and secured.
Jewelry is usually removed.
Dentures are removed, labeled and
placed in a denture cup.
Pt. to verbally confirm the surgical
procedures and the surgical site. This
verification process is documented in
the medical record on the preop.
checklist.
Nembutal
Tranquilizers-Ativan, versed, valium
Opiate analgesics- Demerol, morphine
Anticholinergics-Atropine
sulfate,atarax
H2o blockers.- Tagamet, Zantac
Antiemetic- Reglan, Phenergan
Intraoperative Phase
Surgical Team
Surgeon
Anesthesiologist
Scrub Nurse
Circulating Nurse
OR techs
Ensure
sterility
Alert for breaks
Intraoperative Phase
Anesthesia
Greek word- anesthesis, meaning
negative sensation. Artificially induced
state of partial or total loss of sensation,
occurring with or without consciousness.
Intraoperative Phase
Anesthesia
Factors influencing dosage and type:
1. Type
Intraoperative Phase
Types of Anesthesia
General-
Intraoperative Phase
Stages of General Anesthesia
Stage
Intraoperative Phase
Overdose
Hypoventilation
Related to anesthetic agents
Malignant hyperthermia
Related to intubation
Intraoperative Phase
Local or Regional Anesthesia
Temporarily interrupts the transmission of
sensory nerve impulses from a specific area or
region.
Intraoperative Phase
Complications of Local/Regional
Anesthesia
Anaphylaxis
Administration technique
Systemic absorption
Overdosage
Spinal Anesthesia
Indications
diaphragm
-patients with cardiac or respiratory disease
Advantages -mental status monitoring -shorter
recovery
Disadvantages
-necessary extra expertise possible patient pain
Contraindications -coagulopathy -uncorrected
hypovolemia
Spinal Anesthesia
Involved
medications
-lidocaine
-bupivacaine
-tetracaine
Patient assessment
-continuous heart rate, rhythm, and
pulse oximetry monitoring
-level of anesthesia
-motor function and sensation return
monitoring
Spinal Anesthesia
Complications
-hypotension
-bradycardia
-urine retention
-postural puncture headache
-back pain
Spinal analgesia
Indications
Intraoperative Phase
Conscious Sedation
Vital
Ineffective
Postoperative Phase
Assessment of the Postanesthesia Client
Airway
Vital signs
Cardiac monitoring
Peripheral vascular assessment
Level of consciousness (LOC)
Fluid and electrolytes
GI system
Integumentary system
Discomfort/pain
Maintain
a patent airway
Stabilize vital signs
Ensure patient safety
Provide pain
Recognize & manage complications
Wind:
prevent respiratory
complications
Wound: prevent infection
Water: monitor I & O
Walk: prevent thrombophlebitis
Postoperative Phase
Complications
Respiratory-
Dehiscence
Partial or complete separation of the
Evisceration
Total
Postoperative Phase
Postoperative Phase
Mental