Podcast
Questions and Answers
What is the significance of obtaining informed consent prior to surgery?
What is the significance of obtaining informed consent prior to surgery?
Informed consent ensures that the patient understands the risks, benefits, and alternatives of the procedure, promoting ethical patient autonomy.
Explain the role of deep breathing and coughing techniques in postoperative care.
Explain the role of deep breathing and coughing techniques in postoperative care.
These techniques facilitate lung expansion, gas exchange, and the expulsion of mucus, helping to prevent complications such as pneumonia.
What immediate assessments should be performed on the day of surgery before the patient enters the operating room?
What immediate assessments should be performed on the day of surgery before the patient enters the operating room?
Vital signs, blood glucose levels, and completion of the preoperative surgical checklist should be assessed.
Identify the signs and symptoms of pulmonary embolism.
Identify the signs and symptoms of pulmonary embolism.
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What preparations are needed for a patient regarding food and fluid intake preoperatively?
What preparations are needed for a patient regarding food and fluid intake preoperatively?
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Describe the purpose of using anti-embolic stockings in postoperative patients.
Describe the purpose of using anti-embolic stockings in postoperative patients.
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What are the primary assessments a nurse should perform at the insertion site of an intercostal catheter?
What are the primary assessments a nurse should perform at the insertion site of an intercostal catheter?
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Describe the importance of documenting the drainage from an intercostal catheter.
Describe the importance of documenting the drainage from an intercostal catheter.
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What immediate actions should be taken when recognizing deteriorating patient signs postoperatively?
What immediate actions should be taken when recognizing deteriorating patient signs postoperatively?
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What should a nurse observe for in the water seal chamber to assess for an air leak?
What should a nurse observe for in the water seal chamber to assess for an air leak?
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How is thoracentesis defined, and what is its purpose?
How is thoracentesis defined, and what is its purpose?
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List the criteria used to assess the status of a stoma and its care.
List the criteria used to assess the status of a stoma and its care.
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What does a thorough review of a patient's history entail in preoperative nursing management?
What does a thorough review of a patient's history entail in preoperative nursing management?
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List the key components of postoperative documentation.
List the key components of postoperative documentation.
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What are the signs that indicate a stoma may require nursing intervention?
What are the signs that indicate a stoma may require nursing intervention?
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Study Notes
Preoperative Nursing Management
- Informed consent is essential before surgery and includes education about food/fluid restrictions and cannula preparation.
- Teaching deep breathing and coughing techniques enhances gas exchange and lung expansion, while leg exercises promote blood circulation and prevent DVT.
- Comprehensive examination by the anaesthetist and surgeon ensures full medical assessment before gaining consent.
- Laboratory tests conducted include blood type, full blood count (FBC), prothrombin time, liver function tests, and ECG.
Immediate Patient Preparation on Day of Surgery
- Complete preoperative surgical checklist is mandatory, including verification of two patient ID bands (hand and leg).
- Consent form signed prior to surgery.
- Perform assessments like vital signs and blood glucose levels (BGL).
- Preoperative medications administered alongside regular medications.
- IV cannula inserted prior to surgery and allergies should be documented.
- Ensure pathology results are available, valuables are secured, and patient is fasting.
- Conduct skin preparation, including removal of jewelry and hair, surgical wash, and provision of a patient gown.
- Obtain a body mass index (BMI) for accurate drug dosing and conduct a head-to-toe assessment.
Postoperative Nursing Management
- Handover to nursing staff in recovery is critical for continuity of care.
- Assess readiness for transfer from PACU to the ward.
- Pain control must be established with appropriate medications.
- Document vital signs, bowel chart, fluid balance, and skin assessments.
- Wound assessment includes checking surgical sites, skin condition, and dressing integrity.
- Perform neurological observations and pain assessments post-surgery.
- Record details about the operation, including anesthesia used and any complications encountered.
- Assess swallowing reflex; refer to a speech pathologist if necessary.
- Execute complete risk assessments and facilitate mobility by referring to physiotherapy and occupational therapy.
- Provide oral care and skin care as part of postoperative management.
- Develop discharge plans, including necessary referrals for follow-up care.
Anti-Embolic Stockings
- Indicated for DVT prevention in postoperative and bedridden patients and to aid circulation in trauma patients.
- Nursing management includes gathering patient history, assessing skin condition, and educating on proper application.
- Monitor effectiveness and adjust interventions as necessary.
Deteriorating Patient Management
- Recognize early signs of deterioration, including abnormal vital signs, altered mental status, and respiratory distress.
- Conduct an initial assessment focusing on Airway, Breathing, Circulation, Disability, and Exposure (ABCDE).
- Utilize MetCall for emergencies and provide oxygen therapy and IV fluids as needed.
- Medications administered based on patient condition; keep family informed.
Respiratory System Conditions
- Pulmonary embolism symptoms: shortness of breath (SOB), chest pain, cough, tachypnea, tachycardia.
- Pleural effusion symptoms: SOB, chest pain, dry cough, decreased breath sounds, hypoxia.
- Acute pulmonary edema presentation: SOB, cough, tachypnea, crackles, frothy sputum.
- Pneumothorax symptoms: SOB, chest pain, hypoxemia, tachypnea.
- Haemothorax symptoms: SOB, chest pain, hypoxemia, hypotension.
- Hemopneumothorax symptoms: SOB, chest pain, hypoxemia, hypotension, tachycardia.
- Thoracentesis is performed to remove excess fluid or air from the pleural space.
UWSD Nursing Care
- Inspect the insertion site for subcutaneous emphysema, infection signs, and ensure dressing is intact.
- Check for suction presence and amount of suction measured in cmH2O (typically 105-160).
- Observe the water seal chamber for bubbling and swinging of the water column.
- Record drainage amounts on the fluid balance chart, typically at 1200 and 2400 hours, or hourly for large volumes.
- A chest X-ray is required to confirm the placement of the intercostal catheter, with daily X-rays while in situ.
Emergency Airway Management
- Utilize artificial airways including oropharyngeal and nasopharyngeal airway, and endotracheal tubes.
- Suction with Yankauer suction tip and suction catheters for airway clearance.
GI System Overview
- Colostomy: involves bringing a part of the large intestine through the abdominal wall to create a stoma.
- Stoma care includes assessing stoma color, odor, and output consistency, alongside checking the bag for fit and leakage signs.
- Complete appropriate documentation regarding stoma care and patient assessments.
- Referral options available for stoma nurse, specialist, and wound care nurse as needed.
- Assess dietary requirements relevant to stoma management.
NGT Indications and Nursing Care
- Indications include gastric obstruction and enteral feeding needs.
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Description
This quiz focuses on the essential aspects of preoperative nursing management, including patient education about food and fluid restrictions, preparation for cannulation, and teaching crucial activities like deep breathing and leg exercises. It also covers the roles of the anaesthetist and surgeon in the consent and assessment process.
