Perioperative Care

Card Set Information

Author:
Anonymous
ID:
48153
Filename:
Perioperative Care
Updated:
2010-11-08 14:42:37
Tags:
jag
Folders:

Description:
Perioperative Care
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user Anonymous on FreezingBlue Flashcards. What would you like to do?


  1. Professional Role of Nurse
    • Assessment,
    • Advocacy,
    • Assure Safety,
    • Assure Informed Consent, & Education
  2. Preoperative Care
    • When?
    • Where?
    • What is the nurses role?
  3. Patient Interview
    Patient Interview

    • }Reason for surgery
    • }Health History
    • Cardiac
    • Pulmonary
    • Musculoskeletal
    • Endocrine
    • }Complications from anesthesia
    • }Emotional state and readiness
  4. Patient Interview cont
    • Family History
    • Complications from anesthesia
    • Undiagnosed problems
    • (cardiac, diabetes, pulmonary)
    • Medications
    • Prescription
    • Over the Counter (aspirin, ibuprofen)
    • Vitamins
    • Herbal
    • Recreational drug use
  5. Patient Interview
    • Allergies
    • On chart and patient banded
    • >Food, medications,chemicals, environmental, latex
    • >Autogolous or directed blood
    • >Cultural/Spiritual issues
    • Jehovah Witness-blood transfusions
    • Decision making
    • Advanced Directives,DNR
  6. Physical Examination
    • >The Joint Commission requires PE to be on chart
    • >Complete Head to Toe assessment
    • >Review pre-op labs and medication
    • >Assess for problems that may increase risk for
    • complications during and after surgery
  7. Lab/Diagnostic Tests
    • >Standard panels covered by insurance
    • >May be specific based on diagnosis
    • >EKG
    • >UA
    • >CXR
    • >Chemistry panel (electrolytes, renal function)
    • >CBC
    • >Clotting studies: PT/INR, aPTT
    • >Type and Crossmatch for blood transfusion
    • >Pregnancy
    • >Sometimes: ABGs,
    • pulmonary function tests, liver function tests
  8. Factors That Increase Surgical Risk
    • }-
    • }-
    • }-
    • }-
    • }Anemia
    • }Fever, infection
    • }Smoker, drug abuse
    • }Emotional instability
  9. Focus on older Adult
    • }More chronic diseases & allergies
    • }Greater malnutrition
    • }Decreased ability to handle stress & anesthesia
    • }Decreased immune response
    • }Increased risk heart complications
    • }Increased risk of confusion
    • }Increased fall risk
  10. Professional Role as Educator
    Preoperative Preparation/Education
  11. Preoperative Preparation/Education
    • }Provide pre-operative recommendations
    • }Stop smoking 6 weeks before sx

    • }Specifics given for medications
    • }Stop aspirin 2 weeks before sx

    }Stay healthy & report acute illness, fever
  12. What Can I Expect???
    • }Preoperative Routine
    • }When to arrive to hospital
    • }How pain will be managed
    • }Management of equipment
  13. Patient Education
    • }NPO Status: The American Society of Anesthesiologist, 1999 task force recommendations
    • }Clear liquids 2 hours
    • }Breast milk 4 hours
    • }Nonhuman milk and formula 6 hours
    • }Light meal 6 hours
    • }Regular or heavy meal 8 hours
  14. Education: Nursing Interventions to Prevent Life-Threatening Postop Complications
    • Atelectasis,
    • Pneumonia,
    • DeepVein Thrombosis
  15. Respiratory & Vascular PostopComplications
    • }Explanation and
    • demonstration of postoperative procedures and exercises that will be used
    • following surgery to prevent complications
    • }-
    • }-
    • }-
    • }-
    • }-
    • }-
    • }-
    • }-
    • }
  16. Expected Outcome of Preop Education
    • }Reduced anxiety and fear
    • }Increased cooperation/participation in care following sx

    • }Decreased respiratory
    • and vascular complications
    • }Prevent atelectasis, pneumonia
    • }No DVT
  17. Professional Role as Patient Advocate
    Ensure A Culture Of Safety
  18. Advocacy
    • }Informed Consent”
    • }Invasive Procedure
    • }Consent for blood transfusion
    • }Confirm preoperative checklist is completed
    • }Assess readiness for surgery
    • }physical and emotional
    • }Advanced Directives & DNR
    • }orders are on the chart
    • }acknowledged by all members of the healthcare surgical team



    • Right to be informed and involved in health care
    • decisions
    • Informed Consent implies that patient has sufficient
    • knowledge to understand:
    • Nature of and reason for surgery
    • Who will perform and if others are present
    • Available options and risks
    • Risks of surgery and anesthesia
    • Possibility of blood transfusions
  19. }Surgeons vs. NursesRole in Informed Consent
    • Surgeon
    • }Detailed information regarding surgical procedure, blood use and risks


    • Nurse
    • }May clarify information
    • }Verifies that consent form is signed before sedation
    • occurs & signs as a witness
  20. Assure Safety
    }Identify andreport “Key Abnormal Findings” to surgeon
    • }-
    • }-
    • }-
    • }-
    • }-
    • }-
    • }
  21. }Day of Surgery Preoperative Checklist
    • }Skin prep (bath, scrub, shower)
    • }Hospital Gown only
    • (no underwear)
    • }No jewelry
    • }Tape ring
    • }No nail polish
    • }No make up
    • }Identification and allergy band
    • }Prosthesis removed
    • }Glasses and hearing aid sent with patient sometimes
    • }Antiembolism stockings applied/
    • SCD sleeves
  22. }Day of Surgery Preoperative Checklist
    • }Chart
    • }Physical Examination
    • }Consent
    • }Laboratory/Diagnostic results
    • }Old Chart sent sometimes
    • }Medication Administration Record
    • }Addressograph
    • }Valuables secure
    • }Preop Medications sent
    • with patient
  23. }Day of Surgery Preoperative Checklist
    • }When called:
    • }Check vital signs and record
    • }Check blood sugar if diabetic
    • }Have pt void and record time
    • }Preop medication given and record time
    • }Or given in preoperative holding area
    • }Sign preoperative checklist
    • }Family may accompanyto OR, then sent to wait in OR waiting area}
  24. }Intraoperative Care Preoperative Holding
    • }Preoperative Holding Area
    • }Verify chart completeand consent form signed
    • }Check identificationby two methods and verify surgery scheduled}Start IV line
    • }Cover hair withhairnet
    • }Patient Education
    • }Steps of procedure (holding OR PACU)
    • }Cold in OR
  25. }Intraoperative Care Preoperative Holding
    • }Complementary/Alternative therapy
    • }Administer Preoperative Medications
    • }Antibiotics
    • }Sedatives
    • }Antiemetics/ H2 blockers/anticholinergics
    • }Anxiolytics
  26. Intraoperative CarePreoperative Holding
    • Ensure Safety
    • Joint Commission National Patient Safety Goal
    • }For Preventing Wrong Site, Wrong Procedure, Wrong Person Surgery
    • }For surgeries that are site specific have the patient mark the surgery site with a indelible marker
    • }Nonoperative site NOT marked
  27. INTRAOPERATIVE CARE
    • WAKE UP?
    • kuta
  28. Surgical Team
    • }Surgeon
    • }Anesthesiologist}
    • CRNA}
    • Scrub nurse
    • }Circulating nurse
    • }OR Surgical Tech

What would you like to do?

Home > Flashcards > Print Preview