Perioperative Nursing Management Overview

The phase that begins when the decision to proceed with surgery is made and ends when the patient is transferred to the operating room bed.

The phase that begins when the patient is transferred to the operating room bed and ends when the patient is admitted to the recovery room.

The phase that begins when the patient is admitted to the recovery room and ends with the follow-up evaluation.

A comprehensive assessment that identifies crucial health and surgical risk factors.

A document that grants legal approval for a surgical procedure.

A statement from the patient about known allergies that can trigger adverse reactions during surgery.

A key consideration in surgery, especially for older adults, as reduced reserves can impact recovery.

A critical element in surgical preparation that ensures proper hygiene and reduces infection risk.

The area where street clothes are allowed. This is the least restrictive area in the surgical suite.

The area where scrub clothes and caps are required. This zone is less restrictive than the restricted zone.

The area where full surgical attire is required. This includes scrub clothes, shoe covers, caps, and masks. This zone is the most restrictive.

The process of preventing contamination of sterile wounds and surgical instruments during surgery.

The first stage of general anesthesia, characterized by feelings of warmth, dizziness, and detachment. It's usually the first stage when the patient breathes in the anesthetic mixture.

The second stage of general anesthesia, characterized by excitement, yelling, hitting, and crying. It's important to administer anesthesia quickly and smoothly to avoid this stage.

The third stage of general anesthesia, where the patient is unconscious but stable. The patient's pupils are small and reactive, the pulse is regular, and respirations are regular.

The fourth and final stage of general anesthesia occurring when too much anesthesia has been given. It's characterized by shallow respirations, a weak pulse, and dilated pupils.

Deep breathing helps to eliminate residual anesthetic agents.

Turn the client onto their side to prevent aspiration from vomitus.

Ambulation, sequential compression devices, and anti-embolism stockings promote venous return.

Restlessness or a change in mental status could indicate hypoxia.

Reduce the risk for infection with elderly; drink plenty of fluids unless contraindicated, use lotion, assessing for signs of skin breakdown, change incontinence pads frequently, void after intercourse, pneumococcal and influenza vaccine, cough and deep breathing exercise, sit up while eating.

Pain stimulates the sympathetic nervous system and could result in an increase in blood pressure, heart rate and respirations.

Provide around the clock administration of analgesics for chronic and postoperative pain, never wait for chronic pain to reoccur.

A systolic blood pressure less than 90 is typically reported immediately unless it's consistent with the client's baseline.

A condition where cells are not receiving enough oxygen due to reduced blood flow. It can be caused by problems with heart function (cardiogenic shock), inadequate blood volume (hypovolemic shock), or widespread dilation of blood vessels (distributive shock).

A weak, rapid pulse, often felt as a faint fluttering, indicating a decrease in blood flow from the heart.

The process of replenishing the blood volume in cases of hypovolemic shock, typically with fluids like saline solution.

A position where the patient lies flat on their back with their legs elevated at a 20-degree angle, used to improve blood flow to the heart in shock.

The amount of fluid within the blood vessels, contributing to blood pressure and the overall circulatory system.

A significant decrease in urine production, often a sign of blood loss or dehydration.

An increased risk of developing a low body temperature in older individuals, especially during times of stress such as surgery.

A serious sign of fluid loss or insufficient blood flow, requiring immediate notification to healthcare professionals.

A life-threatening condition characterized by rapid heart rate and stiff muscles. This reaction can be triggered by certain anesthetic medications.

The drug used to treat Malignant Hyperthermia.

Decreased oxygen levels within the body's cells, often worsened during surgery due to anesthesia and inactivity.

A state of reduced blood flow to tissues, a potential complication during and after surgery.

A life-threatening immune reaction that can occur instantly, causing severe allergic response.

A condition where the blood is too acidic, often caused by reduced glucose metabolism.

The process of ensuring patients receive enough fluids, especially important during procedures with risks of dehydration.

The removal of waste products from the body, essential for safe medication use and recovery

A trained medical interpreter is required when the patient does not understand English. Family members should not be used as translators.

Prior to surgery, the patient and surgeon should mark the surgical site to prevent errors.

The post anesthesia care nurse is responsible for ensuring the patient's safe recovery from the effects of anesthesia. This includes monitoring vital signs, assessing airway, consciousness, and pain, as well as administering medication and managing drainage tubes.

Common postoperative complications include hypotension/tachycardia/tachypnea, shock/hemorrhage, hypertension, arrhythmias, VTE/PE, hematoma, infection, wound dehiscence, and evisceration.

Hypotension, tachycardia, and tachypnea are signs of a decrease in blood volume, and the body's attempt to compensate.

Shock/hemorrhage can be identified by pallor, cool, moist skin, rapid respirations, cyanosis (late sign), rapid, weak, thread pulse, decreasing pulse pressure, low blood pressure, and concentrated urine.

Wound healing is affected by factors such as age, pre-op care (e.g., CHG wipes), hemorrhage, hypovolemia, and hypothermia.

First intention healing occurs in wounds that are closed directly, such as sutures. Second intention healing occurs in wounds that are left open to heal, such as burns.