Perioperative handouts

Perl-operative Nursing Phases of Perl-operative period 1. PRE- operative class 2. INTRA- operative phase 3. POST- operative phase PRE-Operative Phase Begins when the decision to have surgery is made and ends when the knob is transferred to the operating table INTRA-operative Phase Begins when the guest is transferred to the operating table and ends when the client is admitted to the post-anesthesia unit Post-operative Phase Begins with the portal of the client to the PACIFIC and ends when healing is complete Activities in the Pre-pop 1 . Assessing the clients 2. Identifying potential or actual health problems 3. formulation specific c ar 4. Providing pre-operative teaching 5. ensure consent is signed Activities during the Intra-pop 1 . Assisting the surgeon as scrape nurse and circulating nurse Activities in the POST-pop 2. Assessing responses to surgery 3. executeing interventions to promote healing 4. Prevent complications 5. Planning for home-c be 6. Assist the client to ach ieve optimal recovery TYPES of SURGERY 1 . tally to PURPOSE 2. According to degree of URGENCY 3. According to degree of RISK Effects of Surgery on the Client focal point response (Neuroscience response) is activated Resistance to infection is lowered referable to surgical incisionVascular system is disturbed collect to severing of blood vessels and blood loss Organ function whitethorn be altered due to manipulation Factors influencing running(a) Risk Age Nutrition Fluid and Electrolyte balance General health precondition infection, cardiovascular disease, pulmonary problems, liver dysfunctions, renal dysfunctions or metabolic disorders Medications affecting Surgery Anticoagulants bid aspirin and UNSAID should be discontinued 2 weeks Tranquilizer may get under ones unclothe hypertension and shock Antibiotics like encyclopedias may intensify make of anesthesia Diuretics may cause electrolyte imbalance antiphon may cause hypertension Psychological support Assess clients fears , anxieties, support system and patterns of coping Establish a swear relationship with client and family Explain routine procedures, encourage fertilization of fears and allow clients to ask questions volunteer for spiritual c be if needed Preoperative teaching Assess clients level of understanding of surgical procedure and its implications break up questions, clarify and reinforce explanations given by the surgeon Explain routine pre-pop and post-pop procedures Teach coughing and racy breathing exercise, splinting of incision, turning side to did.Explain its importance in preventing complications Assure client that pain medication testament be given Pre-operative teaching Physical Preparation Obtain hex of past medical conditions Perform baseline head to toe examinations including vital signs Ensure that diagnostic exams are performed CB, Electrolytes, APT/APT, Urinalysis, EGG, Blood typing, boob Cray Prepare client cutis Shower with antibacterial soap to cleanse skin Skin cookery if ordered shave or clip hairs and cleanse appropriate areas to reduce bacteria on skin Administer enema if ordered Promote adequate rest and asleep Instruct client to stay on NP after midnight to prevent vomiting and aspiration Pre-pop elimination Laxatives, enemas or both may be prescribed the night originally surgery Have the client void immediately BEFORE transferring them to the OR Foley catheter may be inserted as ordered Legal Responsibility Surgeon obtains operative permit (Informed consent) 1. Surgical procedure, alternatives, possible complications, disfigurements 2.Part of nurses role as client advocate to confirm that clients understands information given Informed approve An active shared decision making process between the provider and the recipient of are. 3 conditions 1 . Adequate disclosure of the diagnosis, nature and purpose of sermon, risk and consequences, probability of successful outcome and prognosis if treatment is not done. 2. Patient must demons trate a clear understanding and comprehension of information world provided 3. Recipient of care must give consent voluntarily, not persuaded or coerced to undergo the procedure. Consent are not needed for parking brake care if 1. There is an immediate threat to life 2. Experts agree that it is an emergency 3. Client is unable to consent 4. A legally authorized person cannot be reachedPreparation Immediately before surgery Obtain a baseline vital signs Provide oral hygiene and remove dentures deal clients clothing and dress in clean gown Remove nail polish, cosmetics, Jewelry Instruct to invalidate bladder Check identification band Intra-operative phase interventions Determine the type of surgery and anesthesia use Position client appropriately for surgery Assist the surgeon as circulating or lave nurse Maintain the sterility of the surgical field Monitor for developing complications Preparing the surgical site part of prepping is to reduce the unit of organisms available to m igrate to the surgical wound. Task is the responsibility of the circulating nurse precept of scrubbing from the clean area to dirty area is observed at all times Anesthetics Anesthetics are drugs that are used to cause complete or partial loss of sensation. The numerous anesthetics can be broadly classified as 1. General 2. topical anesthetic anesthetics General anaesthesia Loss of sensation with loss of spirit Skeletal muscleman relaxation Analgesia Elimination of somatic, autonomic and endocrine response including coughing, gagging and vomiting Protective reflexes are lost Amnesia, analgesia and hypnosis occur Administered in two ways Inhalation Intravenous IV anesthetics contracts rapid, smooth induction, may be used alone in short procedures Common IV anesthetics methodical, Sodium tapeline (Penetrate), modally Disadvantages myopic relaxation, respiratory and myocardial depression in high doses, bronchioles, laryngitiss, hypertension and respiratory depression Dissociation Agents Produce state of profound analgesia, amnesia and lack of awareness without loss of consciousness Astatine (Catalan) Side effects tachycardia, hypertension, respiratory depression, hallucinations Precautions decrease verbal, tactile and visual stimulation during recovery periodNarcoleptics Produces state of narcoleptic analgesia characterized by reduce motor activity and analgesia without loss of consciousness Fontanel citrate (Innovator) SE hypertension, brickyard, respiratory depression, skeletal muscle rigidity, twitching Precaution reduce narcotic dose to prevent respiratory depression Local Anesthesia Local anesthetics are drugs that cause a loss of sensation in limited areas of the body to repeal pain. They are powerful nerve blockers injected locally. Systemic absorption of the anesthetics can produce numerous side effects. Examples of Local anesthetics The CANINES Loading Debasing Procaine Terracing The side effects of local anesthetics Local effects- local irritati on and skin breakdown CONS effects if systemic absorption occurs- headache, restlessness, anxiety, dizziness, tremors and blurred vision.GIG system- nausea, vomiting Cardiac- arrhythmias, peripheral vacillation, myocardial depression, and rarely, cardiac substantiation Nursing Responsibilities Maintain emergency equipment on standby to provide life-support in cases of severe reactions Ensure that drugs are available for managing hypertension, cardiac arrest ND CONS alterations. Provide adequate hydration to patients receiving spinal anesthesia. Position the client supine for up to 12 hours after spinal anesthesia to minimize spinal headache Provide safety and comfort measures such as side-rails up, frequent skin care and supportive care instal health teaching to explain things the patient needs to know to allay fears. Stages of Anesthesia Depth usually trained individuals with the special equipments ready for life support administer the agents The patient undergoes through a for eseeable stages known as STAGES of ANESTHESIA 1 to 4