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Perioperative Care

By: Katie Helms, April Greene, Erin Mosher & Wyatt Withers

Why perioperative care is important?

To care for the patient before, during, and after surgery

To address patients concerns, fears, and anxieties about


surgery

To ensure comfort before and after surgery

Identify the learning needs to patient and family

To ensure a quick recovery with minimal complications

To prepare the patient both physically and psychologically


for surgery

Assessment

Obtain a health history

Perform a physical health assessment

Identify risk factors and allergies

Identify patients medications and treatments

Determine the teaching and psychosocial needs of both


the patient and family

Identify any postsurgical support and referral needs of


the patient

Pain Management

Gather past experiences with pain and how they manage pain at home

Ensure that the patient isnt in any pain before surgery

Discuss the availability of analgesic medication postoperatively

Ensure the patient understands the patient controlled analgesia

Explore alternative methods to reduce pain:

Position change

Massage

Relaxation/diversion

Guided imagery

Meditation

Have patient express when pain level reaches a 5 on the 1-10 pain scale

Medication can be given or adjusted

3 Phases of Perioperative Care


1.

2.

3.

Preoperative

Begins when the decision to have surgery is made

Ends when the patient is transferred to the OR or procedural bed

Intraoperative

Begins when the patient is transferred to the OR bed

Ends with the transfer to the postoperative recovery area

Postoperative

Begins when the patient is transferred to the recovery room

Ends when the patient are completely recovered from surgery, and the last follow-up
physician visit

Preoperative Care

Check patients chart for type of surgery and review medical orders

Gather any supplies needed

ALWAYS perform hand hygiene

Identify patient and close curtains to ensure patient safety

Ensure patient understands surgery

Witness the signature of signed consent form

Encourage the patient to express concerns or fears

Answer the questions within our scope of practice

If necessary contact physician/surgeon for any further questions

WASH YOUR HANDS!

Breathing Exercises
Deep Breathing
Deep Breathing with
Coughing
Incentive Spirometer

Importance:
Breathing exercises help to keep lungs clear of
fluid and buildup postoperatively
Prevents complications and alterations in
cardiovascular and respiratory function
Patient should informed of these exercises prior
to surgery

Splinting

Education about splitting is important:

Protect the incision

Give more comfort to patient when sitting and laying in bed

Help patient to comfortably sit up and turn in bed without


affecting incision site

Keep the pain level as low as possible

Preoperative Concerns:

Leg exercises/Anti-embolism stockings

Important for increasing circulation and blood flow

Important to maintain muscle strength

Dietary/Fluid Restrictions

NPO= nothing by mouth

Important to make sure stomach contains minimal gastric secretions in order to reduce risk of
aspiration.

Skin Preparation

Ask patient to bathe and use antiseptic solution

Make sure the surgical site is clean to help prevent infection

Intestinal Preparation

Prepare bowel; sometimes laxatives or enema is needed.

Important to reduce intestinal bacteria

Postoperative Care

Identify patient and close curtains or door to ensure privacy

ALWAYS preform hand hygiene

Get patient into semi or high fowlers or sideline position

Check all vitals

Temperature

Pulse

Respiratory rate

Pulse Ox

Blood Pressure

Ensure that patient is awake and oriented to check mental status

Check dressings around incision site for drainage or bleeding

Patient Comfort
Ensure that the patient is:
Warm
Comfortably positioned
Pain has been assessed
Medications have been administered or
adjusted as needed.

Ongoing Care

Vitals should be obtained at specific intervals

Make sure patient is doing breathing/coughing exercises and using the


incentive spirometer

Ensure that any continuing concerns or anxieties about recovery are


addressed

Ensure that patients overall well being is addressed

Promote optimal wound healing

References:
Lynn, P. (2011). Clinical Nursing Skills (3rd ed., pp. 277-303). Philadelphia, PA: Wolters Kluwer.
Taylor, C. R., Lillis, C., LeMone, P., & Lynn, P. (2011). Fundamentals of Nursing
(7th ed., pp. 817-838). Philadelphia, PA: Wolters Kluwer.

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