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Pre-operative period
is the process of decision making for surgery until…
Pre-operative period
is the process of decision making for surgery until patient is transferred into operating room
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Informed consent
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- Explanation of procedure, risks
- state benifits and alternatives
- Question and answer period
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Incompetent patient
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Who cannot withhold consent
- cognitively impaired
- mentally ill
- neurologically impaired
- General per operative nursing intervention
Providing psychosocial intervention
- Reducing anxiety, decreasing fear
- respecting culture, spiritual, religious beliefs
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- Immediate preoperative nursing intervention
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Intra operative period is the beginning when patient is transferred to the OR bed until transfer to postoperative phase
- Members and role of the surgical team
-Patient
- circulating nurse
- scrub role
- surgeon
- registered nurse first assistant
- anesthetist
Surgical environment:
- unrestricted zone
- semi restricted zone
- restricted zone
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- Gerontologic Considerations
Elderly patients at increased risk for complications of surgery due to anesthesia
- increased reoccurring of coexisting conditions
- aging heart
- changes in response to drugs, anesthetic agents due to aging decreased renal function
- Nursing interventions
- reducing anxiety
- reducing latex exposure
- preventing positioning injuries
- serving as a patient advocate
- monitoring potential complications
- Protecting the patient from injury
- patient identification
- correct informed consent
- verification of records of health history
- results of diagnostic tests
- allergies
- safety measures ( restraints, not leaving a sedated patient)
Postoperative Nursing
Begins with admission to post anesthesia care unit ending with complete recovery and last follow up visit
- Nursing management in the " PACU"
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Resumption of motor and sensory function is oriented, stable vital signs ,no signs of shock
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- PACU nurse responsibility
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Assessments:
- airway and respiratiins
- cardiovascular function
- surgical site
- assess IVs
- equipment and tubes
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Provide report, transfer patient to another unit or discharge patient to home
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Provide written, verbal instructions regarding follow-up care, complications, wound care, medications & diet
Give prescription & phone numbers
- discuss actions to take if complications occur
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Patients are not allowed to drive home or be discharged to go home alone
- anesthesia & sedation may cloud memory, judgment, effect ability
- First dressing is changed by member of surgical team
- the type of dressing materials
- wash hands
- maintain sterile technique
- assessment of wound
- apply dressing & taping methods
- assessment of patient response
- document