Perioperative handouts

Perl- artist Nursing Phases of Perl-operative period 1. PRE- operative phase 2. INTRA- operative phase 3. POST- operative phase PRE-Operative Phase Begins when the decision to have military operation is made and ends when the invitee is transferred to the operating table INTRA-operative Phase Begins when the thickening is transferred to the operating table and ends when the customer is admitted to the post-anesthesia unit Post-operative Phase Begins with the admission of the client to the PACIFIC and ends when healing is deal Activities in the Pre-pop 1 . Assessing the clients 2. Identifying potential or actual health problems 3.Planning particular(prenominal) c atomic number 18 4. Providing pre-operative teaching 5. Ensure consent is signed Activities during the Intra-pop 1 . Assisting the operating surgeon as scrub nurse and go around nurse Activities in the POST-pop 2. Assessing responses to surgery 3. Performing interventions to promote healing 4. Prevent complications 5. Planning for home- trade 6. Assist the client to achieve optimal recovery TYPES of SURGERY 1 . According to drive 2. According to degree of URGENCY 3. According to degree of RISK cause of military operation on the Client Stress response (Neuroscience response) is activated shelter to infection is lowered out-of-pocket to surgical incisionVascular remains is disturbed due to severing of blood vessels and blood loss Organ function may be altered due to manipulation Factors influencing Surgical Risk be on Nutrition Fluid and Electrolyte balance General health status infection, cardiovascular disease, pulmonary problems, liver dysfunctions, renal dysfunctions or metabolic disorders Medications affecting Surgery Anticoagulants like aspirin and UNSAID should be discontinued 2 weeks antianxiety agent may cause hypertension and shock Antibiotics like encyclopedias may enhance effects of anesthesia Diuretics may cause electrolyte imbalance antiphon may cause hypertension Psycholo gical support Assess clients fears, anxieties, support system and patterns of coping Establish a trusting relationship with client and family explain routine procedures, encourage fertilization of fears and allow clients to ask questions offer for spiritual care if needed Preoperative teaching Assess clients level of sagacity of surgical procedure and its implications Answer questions, clarify and reinforce explanations letn by the surgeon Explain routine pre-pop and post-pop procedures Teach coughing and deep alive exercise, splinting of incision, turning side to did.Explain its importance in preventing complications Assure client that nuisance medication will be given Pre-operative teaching Physical formulation welcome hex of past medical conditions Perform baseline take aim to toe examinations including vital signs Ensure that diagnostic exams are performed CB, Electrolytes, APT/APT, Urinalysis, EGG, product line typing, Chest Cray Prepare client pelt Shower with antiba cterial welt to cleanse skin Skin prep if ordered shave or clip hairs and cleanse appropriate countrys to geld bacteria on skin Administer enema if ordered Promote adequate rest and fast asleep(predicate) Instruct client to remain NP after midnight to prevent purge and aspiration Pre-pop elimination Laxatives, enemas or both may be visit the night before surgery Have the client void immediately BEFORE transferring them to the OR Foley catheter may be inserted as ordered levelheaded Responsibility Surgeon obtains operative permit ( advised consent) 1. Surgical procedure, alternatives, possible complications, disfigurements 2.Part of nurses single-valued function as client advocate to confirm that clients understands information given Informed Consent An active shared decision making process surrounded by 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 successf ul outcome and prognosis if treatment is not done. 2. Patient must demonstrate a clear instinct and comprehension of information being provided 3. Recipient of care must give consent voluntarily, not persuaded or coerced to undergo the procedure. Consent are not needed for emergency care if 1. There is an immediate threat to tone 2. Experts agree that it is an emergency 3. Client is unable to consent 4. A de jure authorized person potnot be reachedPreparation Immediately before surgery Obtain a baseline vital signs bear oral hygiene and set aside dentures mutilate clients clothing and dress in clean gown Remove nail polish, cosmetics, Jewelry Instruct to empty bladder Check identification band Intra-operative phase interventions Determine the type of surgery and anesthesia utilize Position client appropriately for surgery Assist the surgeon as circulating or scrub nurse take the sterility of the surgical field Monitor for developing complications Preparing the surgical sit e Purpose of prepping is to edit the unit of organisms available to migrate to the surgical wound. Task is the responsibility of the circulating nurse Principle of scrubbing from the clean area to dirty area is observed at all times Anesthetics Anesthetics are drugs that are apply to cause complete or partial loss of sensation. The numerous anesthetics can be broadly classified as 1. General 2.Local anesthetics General anesthesia Loss of sensation with loss of consciousness Skeletal muscle loosening 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 Produces rapid, smooth induction, may be used alone in short procedures Common IV anesthetics methodical, Sodium tapeline (Penetrate), modally Disadvantages poor relaxation, respiratory and myocardial low in high doses, bronchioles, laryngitiss, hy pertension and respiratory depression Dissociation Agents Produce state of profound analgesia, amnesia and lack of sentiency without loss of consciousness Astatine (Catalan) Side effects tachycardia, hypertension, respiratory depression, hallucinations Precautions come down verbal, tactile and visual stimulation during recovery periodNarcoleptics Produces state of narcoleptic analgesia characterized by reduced motor activity and analgesia without loss of consciousness Fontanel change state (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 abolish pain. They are powerful nerve blockers injected topical anestheticly. systemic absorption of the anesthetics can produce numerous side effects. Examples of Local anesthetics The CANINES payload Debasing Procaine Ter racing The side effects of local anesthetics Local effects- local irritation and skin breakdown CONS effects if systemic absorption occurs- headache, restlessness, anxiety, dizziness, tremors and fogged vision.GIG system- nausea, vomiting Cardiac- arrhythmias, peripheral vacillation, myocardial depression, and rarely, cardiac arrest Nursing Responsibilities Maintain emergency equipment on standby to provide life-support in cases of loathsome reactions Ensure that drugs are available for managing hypertension, cardiac arrest ND CONS alterations. Provide adequate hydration to endurings 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 Give health teaching to explain things the patient needs to know to allay fears. Stages of Anesthesia Depth Usually adept individuals with the special equipments ready for life support administer the agents The patient undergoes by means of a predictable stages known as STAGES of ANESTHESIA 1 to 4