Introduction to Perioperative Nursing.pdf

PERIOPERATIVE NURSING LEARNING OBJECTIVES On completion of this module, the learner will be able to: 1. Define the three phases of the perioperative period 2. Describe a comprehensive preoperative assessment to identify surgical risk factors. 3. Identify the causes of preoperative anxiet...

PERIOPERATIVE NURSING LEARNING OBJECTIVES On completion of this module, the learner will be able to: 1. Define the three phases of the perioperative period 2. Describe a comprehensive preoperative assessment to identify surgical risk factors. 3. Identify the causes of preoperative anxiety and describe nursing measures to alleviate it. 4. Identify legal and ethical considerations related to informed consent. 5. Describe preoperative nursing measures that decrease the risk for infection and other postoperative complications. 6. Describe the immediate preoperative preparation of the patient. 7. Develop a preoperative teaching plan designed to promote the patient's recovery from anesthesia and surgery, thus preventing postoperative complications PERIOPERATIVE NURSING ü IT IS USED TO DESCRIBE THE NURSING CARE PROVIDED IN THE TOTAL SURGICAL EXPERIENCE OF A PATIENT. ü THE PROVISION OF NURSING CARE BY A NURSE PREOPERATIVELY, INTRAOPERATIVELY, AND POSTOPERATIVELY TO A PATIENT UNDERGOING AN OPERATIVE OR INVASIVE PROCEDURE  Preoperative Phase Admission to the surgical unit PREPARATION FOR SURGERY Physiologic, Psychological, Spiritual, Legal Transport to the Operating Room Intraoperative Phase ADMISSION TO THE OR ANESTHESIA/SURGERY RECOVERY ROOM/PACU Post-operative Phase ADMISSION TO THE RR/PACU BACK TO SURGICAL UNIT DISCHARGE FOLLOW-UP CARE Common Surgical Terminology SUPRA - ABOVE MYO - MUSCLE ARTHRO - JOINTS OOPHOR - OVARIES CHOLE - GALL OR BILE NEPHRO - KIDNEYS CYSTO - BLADDER NEURO - NERVE ENCEPHALO - BRAIN PNEUMO - LUNGS ENTERO - INTESTINE SALPHINGO - FALLOPIAN TUBE HYSTERO - UTERUS THORACO - CHEST MAST - BREAST VISCER - ORGAN MENINGO - MEMBRANE Common Surgical Terminology RRHAPY- SUTURING OR STITCHING OF A PART OF AN ORGAN PLASTY - REPAIR OR TO RESTORE ITIS - INFLAMMATION ECTOMY - REMOVAL OF ORGAN OR PART OF AN ORGAN OSCOPY - TO VISUALIZE OR TO LOOK INTO OTOMY - MAKING AN OPENING OSTOMY - MAKING AN OPENING AND INSERTION OF TUBE LITHIASIS - STONE IN A PARTICULAR OR PART OF AN ORGAN Conditions Requiring Surgery erforation - rupture of an organ, artery or bleb bstruction - blockage rosion - wearing away of a surface of a tissue umor - abnormal growth Categories of Surgery According to: ü URPOSE ü RGENCY, DEGREE OF ü ISK, DEGREE OF According to PURPOSE: CLASSIFICATION OF SURGICAL PROCEDURES 1. DIAGNOSTIC- VERIFIES SUSPECTED DIAGNOSIS 2. Palliative – relieves symptoms but does not cure the diseases 3. Curative- to treat the disease condition. a. Ablative- Removal of an organ. -Suffix “ectomy” Types of CURATIVE Surgery: ONSTRUCTIVE - repair of a congenitally defective organ by improving its function or appearance e.g. plastic surgery of a cleft palate, cheiloplasty BLATIVE - removal of diseased organs e.g. nephrectomy, appendectomy ECONSTRUCTIVE - partial or complete restoration of a damaged organ or tissue to its original appearance and function. e.g. plastic surgery after burns CONSTRUCTIVE- REPAIRING CONGENITALLY DEFECTIVE ORGAN BACK ORIG. APPEARANCE AND FUNCTION. SUFFIX “PLASTY”, “ORRHAPY”, “PEXY”. CHEILOPLASTY ABLATIVE- REMOVAL OF DISEASED ORGANS Nephrectomy RECONSTRUCTIVE – PARTIAL OR COMPLETE RESTORATION OF A DAMAGED ORGAN OR TISSUE TO ITS ORIGINAL APPEARANCE AND FUNCTION. PLASTIC SURGERY AFTER BURNS 4. Exploratory- estimates the extent of the disease or injury. According to: URGENCY, Degree of CLASSIFICATION INDICATION EXAMPLE Emergent – requires immediate Severe bleeding attention; Disorders maybe life- WITHOUT DELAY GSW – Gun shot wound threatening. VA- Fracture skull Urgent- surgical problem requires prompt attention Within 24-48 hrs Kidney – Ureteral stones Cataract Required- condition requires surgery within a few weeks Thyroid Elective- approximate time for surgery Failure to have surgery Repair of scar is at the convenience of the patient not catastrophic Vaginal repair Optional- is scheduled completely at Personal preference Cosmetic surgery the preference of the patient. According to: RISK, DEGREE OF Major Surgery Minor Surgery Ø Involves high degree of Ø Involves less risk risk Ø Complicated or Ø Produces few prolonged complications Ø Large amount of blood Ø Generally not loss prolonged; described as Ø Extensive: Vital organs “one-day surgery” or may be handled or outpatient surgery removed Ex: cyst removal Ex: liver biopsy, colectomy § THE EXTENT OF THE DISEASE § THE LOCATION OF THE DISEASED ORGAN § THE MAGNITUDE OF THE REQUIRED OPERATION § MENTAL ATTITUDE OF THE PERSON TOWARD SURGERY § RESOURCES AND PREPARATION OF THE SURGEON, NURSES, AND THE HOSPITAL  AMBULATORY Surgery Advantages: Disadvantages: Reduces length of hospital Less time to assess the stay and cuts costs patient and perform Reduces stress for the preoperative teaching. patient Less time to establish Less incidence of hospital rapport acquired infection Less time lost from work by Less opportunity to assess the patient; minimal for late postoperative disruptions on the patient’s complication. activities and family life.