Perioperative Nursing in Cellular Aberration

Perioperative Nursing in Cellular Aberration

Perioperative nursing describes the wide variety of nursing functions associated with the patient’s surgical management. It has three phases of the surgical experience namely:

Preoperative phase.
Intraoperative phase.
Postoperative phase.

Preoperative phase. This phase begins when the decision for surgical intervention is made and ends when the patient is transferred from the operating room.

Intraoperative phase. This phase begins when the patient is admitted or transferred to the surgery department and ends when he or she is admitted to the recovery area.

Postoperative Phase

This phase begins with the admission of the patient to the recovery area and ends with a follow-up evaluation in the clinical setting or at home.

Multiple Choice

What are the three phases of Perioperative Nursing?

• Preoperative phase, Interoperative phase, Postoperative phase

• Preoperative phase, Intraoperative phase, Postoperative phase

• Prooperative phase, Intraoperative phase, Postoperative phase

• Preoperative phase, Intraoperative phase, Pastoperative phase

Physiologic Assessment during the Preoperative Phase

Before any treatment is initiated, a health history is obtained and a physical examination is performed during which vital signs are noted and a data base is establish for future comparisons.

Diagnostic tests may be carried out during the preoperative phase such as:

• Blood analyses

• X-ray studies

• MRI and CT scans

• Electrodiagnostic studies

• Bone scan

• Tissue biopsies

• Endoscopies

The following are the physiologic assessments necessary during the preoperative phase:
Age
Nutritional status and needs
Fluid and Electrolyte Imbalance
Infection
Respiratory status
Cardiovascular status
Hepatic and renal function
Endocrine function
Immunologic function
Previous medication therapy 

Multiple Choice

All are the assessment during the Preoperative Phase except:

• Diagnostic tests

• Immunologic function

• Previous medication therapy

• All are correct

Psychological Nursing Assessment during the Preoperative Period

Fear of the unknown, Fear of death, Fear of anesthesia

Concerns about loss of work,  time, job and support from the family

Concerns on threat of permanent incapacity

Spiritual beliefs

Cultural values and beliefs

Fear of pain

Psychological Nursing Interventions:

Explore the client’s fears, worries and concerns.

Encourage patient verbalization of feelings.

Provide information that helps to allay fears and concerns of the patient and Give empathetic support.

Multiple Choice

All are psychological Nursing Interventions EXCEPT:

• Give empathetic support.

• Concerns on threat of permanent incapacity

• Explore the client’s fears, worries and concerns.

• Provide information that helps to allay fears and concerns of the patient.

Informed consent

• Protects the patient against unsanctioned surgery.

• Protects the surgeon and hospital against legal action by a client who claims that an unauthorized procedure was performed.

• To ensure that the client understands the nature of his or her treatment including the possible complications and disfigurement.

• To indicate that the client’s decision was made without force or pressure.

Open Ended

What are the purpose of Informed consent?

Intraoperative Phase

The intraoperative phase extends from the time the client is admitted to the operating room, to the time of anesthesia administration, performance of the surgical procedure and until the client is transported to the recovery room or postanethesia care unit (PACU). 

Throughout the surgical experience the nurse functions as the patient’s chief advocate.

The nurse’s care and concern extend from the time the patient is prepared for and instructed about the forthcoming surgical procedure to the immediate preoperative period and into the operative phase and recovery from anesthesia. 

The patient needs the security of knowing that someone is providing protection during the procedure and while he is anesthetized because surgery is usually a stressful experience.

Multiple Choice

The nurse function throughout the surgical experience is:

• provides smooth induction of the patient’s anesthesia in order to prevent pain

• He or she is ultimately responsible for performing the surgery effectively and safely

• continually monitors the physiologic status of the patient for the duration of the surgical procedure and the physiologic status of the patient

• patient’s chief advocate

Intraoperative Nursing Functions

Circulating NurseThe circulating nurse manages the operating room and protects the safety and health needs of the patient by monitoring activities of members of the surgical team and checking the conditions in the operating room.

Responsibilities of a circulation nurse are the following:

• Assures cleanliness in the OR.

• Guarantees the proper room temperature, humidity and lighting in OR.

• Make certain that equipments are safely functioning.

• Ensure that supplies and materials are available for use during surgical procedures.

• Monitors aseptic technique while coordinating the movement of related personnel.

• Monitors the patient throughout the operative procedure to ensure the person’s safety and well being.

Scrub Nurse

• Scrubbing for surgery

• Setting up sterile tables.

• Preparing sutures and special equipment.

• Assists the surgeon and assistant during the surgical procedure by anticipating the required instruments, sponges, drains and other equipment.

• Keeps track of the time the patient is under anesthesia and the time the wound is open.

• Checks equipments and materials such as needles, sponges and instruments as the surgical incision is closed.

Multiple Choice

One role of the scrub nurse during intraoperative phase is to:

• Monitors aseptic technique while coordinating the movement of related personnel.

• Make certain that equipments are safely functioning.

• Keeps track of the time the patient is under anesthesia and the time the wound is open.

• Monitors the patient throughout the operative procedure to ensure the person’s safety and well being.

Anesthesia

The nurse is responsible to assist the anesthesiologist during induction of anesthesia

Nursing Assessment after Spinal Anesthesia

1. Monitoring vital signs.

2. Observe patient and record the time when motion and sensation of the legs and the toes return.

Position a Patient on the Operating Table

The nurse should have an idea which patient position is required for a certain surgical procedure to be performed. There are lots of factors to consider in positioning the patient 

Nursing Responsibility during the Intraoperative Phase

• Safety. Is the Highest Priority of nurses.

• Simultaneous placement of feet. This is to prevent dislocation of hip.

• Always apply knee strap.

• Arms should not be more than 90°

• Prepare and apply cautery pad. Cautery is used to stop bleeding.

Open Ended

Whar are the Nusrsing Responsibility during Intraoperative Phase?

Postoperative Nursing Care

• During the postoperative period, reestablishing the patient’s physiologic balance, pain management and prevention of complications should be the focus of the nursing care. 

• To do these it is crucial that the nurse perform careful assessment and immediate intervention in assisting the patient to optimal function quickly, safely and comfortably as possible.

• Maintaining adequate body system functions.

• Restoring body homeostasis.

• Pain and discomfort alleviation.

• Preventing postoperative complications.

• Promoting adequate discharge planning and health teaching.

Multiple Choice

One of the nursing responsibility during postoperative phase is/are:

• Maintaining adequate body system functions.

• Preventing postoperative complications.

• Pain and discomfort alleviation.

• All of the correct