PERIOPERATIVE NURSING nursing assistance .pptx

Surgical nursing

1. PERIOPERATIVE NURSING BY ABABIO ERIC NARH

2. PERIOPERATIVE NURSING 

3. PERIOPERATIVE NURSING 

4. Surgical classification 

5. Surgical classification Surgery may also be classified according to the degree of urgency involved: emergent, urgent, required, elective, and optional

6. CATEGORIES OF SURGERY BASED ON URGENCY classification Indication for surgery Examples  Emergent—Patient requires immediate  attention; disorder may be life-threatening Without delay Severe bleeding Bladder or intestinal obstruction Fractured skull Gunshot or stab wounds Extensive burns Urgent—Patient requires prompt attention Within 24–30 hours Acute gallbladder infection Kidney or ureteral stones Required—Patient needs to have surgery Plan within few weeks or months Prostatic hyperplasia without bladder obstruction Thyroid disorders Cataracts Elective—Patient should have surgery Failure  to have surgery not catastrophic  Repair of scars Simple hernia Vaginal repair Optional—Decision rests with patient Personal preferences  Cosmetic surgery

7. PREOPERATIVE PHASE 1. Initiates initial preoperative assessment 2. Initiates teaching appropriate to patient’s needs 3. Involves family in interview 4. Verifies completion of preoperative diagnostic testing. 5. Verifies understanding of surgeon-specific preoperative orders ( eg , bowel preparation, preoperative shower) 6. Discusses and reviews advanced directive document 7. Begins discharge planning by assessing patient’s need for postoperative transportation and care

8. PREOPERATIVE PHASE 8. Assesses patient’s status, baseline pain, and nutritional status 9. Reviews chart 10. Identifies patient 11. Verifies surgical site and marks site per institutional policy 12. Establishes intravenous line

9. PREOPERATIVE PHASE 13 Administers medications if prescribed 14. Takes measures to ensure patient’s comfort 15. Provides psychological support 16. Communicates patient’s emotional status to other appropriate members of the health care team

10. INTRAOPERATIVE PHASE Maintains aseptic, controlled environment 2.  Effectively manages human resources, equipment, and supplies for individualized patient care 3. Transfers patient to operating room bed or table 4. Positions patient based on functional alignment and exposure of surgical site

11. INTRAOPERATIVE PHASE 5. Applies grounding device to patient 6. Ensures that the sponge, needle, and instrument counts are correct 7. Completes intraoperative 8. Calculates effects on patient of excessive fluid loss  orgain

12. INTRAOPERATIVE PHASE 9. Distinguishes normal from abnormal cardiopulmonary data 10. Reports changes in patient’s vital signs 11. Institutes measures to promote normothermia 12. Psychological Support (Before Induction and When Patient Is Conscious) 13 Provides emotional support to patient 14. Stands near or touches patient during procedures and induction 15. Continues to assess patient’s emotional status 

13. Postoperative Phase Communicates intraoperative information 2. Identifies patient by name 3. States type of surgery performed 4. Identifies type and amounts of anesthetic and analgesic agents used 5. Reports patient’s vital signs and response to surgical procedure and anesthesia 5. Describes intraoperative factors ( eg , insertion of drains or catheters, administration of blood, medications during surgery, or occurrence of unexpected events)

14. Postoperative Phase 6. Describes physical limitations 7. Reports patient’s preoperative level of consciousness 8. Communicates necessary equipment needs 9. Communicates presence of family or significant others

15. Postoperative Phase 10. Determines patient’s immediate response to surgical intervention 11. Monitors patient’s vital signs and physiologic status 12. Assesses patient’s pain level and administers appropriate pain relief measures 13. Maintains patient’s safety (airway, circulation, prevention of injury) 14. Administers medications, fluid, and blood component therapy, if prescribed

16. Postoperative Phase 15. Provides oral fluids if prescribed for ambulatory surgery patient 16. Assesses patient’s readiness for transfer to in-hospital unit or for discharge home based on institutional policy  17. Assesses patient’s pain level and administers appropriate pain relief measures 18. Provides teaching to patient during immediate recovery period 19. Assists patient in recovery and preparation for discharge home 20. Determines patient’s psychological status