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Amanda Stack #3 NP
Care of the Peri-Operative Patient
| Question | Answer |
|---|---|
| Peri-Operative Nursing | The period that begins with the decision to have surgery and ends with recovery |
| Surgery | A means of treating injury and disease. The goal of surgery is to return the client to the highest form of functioning and health possible, as soon as possible, within the limits imposed by the disease state or injury. |
| Diagnostic Surgery | Confirmation of a suspected diagnosis |
| Diagnostic Surgery Examples | Biopsy, culture, endoscopy, fluid tap |
| Explorative Surgery | Confirms the type & extent of a disease process |
| Explorative Surgery Examples | Laparotomy, joint exploration |
| Reconstructive Surgery | Repairs physical deformities or improves appearance |
| Reconstructive Surgery Examples | Rhinoplasty, mammoplasty, skin grafting |
| Curative Surgery | Diseased or damaged body organ or structure is removed or repaired and the client is cured |
| Curative Surgery Examples | Appendectomy, hysterectomy, fixation of fractures |
| Transplant Surgery | Diseased or damaged body organs and structures are replaced with donated or artificial organs |
| Transplant Surgery Examples | Heart, kidney, cornea, bone, liver, lung, pancreas, or skin transplants |
| Palliative Surgery | Alleviates pain or other disease symptoms; slows the progression of diseases but does not cure |
| Palliative Surgery Examples | Tumor debulking, nerve blocks, placement of feeding tubes |
| Emergent Surgery | Preserves function of body parts or life of client |
| Emergent Surgery Examples | Repair of major vessel to stop severe bleeding |
| Urgent Surgery | Requires prompt attention within 24-48 hours |
| Urgent Surgery Examples | Repair of a fracture, incision & drainage of a wound infection |
| Required Surgery | Indicated for health problems but immediacy is not necessary to preserve function of life |
| Required Surgery Examples | Gallbladder removal, excision of cancerous growth |
| Elective Surgery | Satisfies client's desire but not needed to preserve life or function |
| Elective Surgery Examples | Cosmetic surgery, breast implantation, hair implantation |
| Pre-operative Phase | Begins when the decision to have surgery is made & ends when the client is transferred to the operating room bed. |
| Intra-operative Phase | From the time the patient is transferred to the operating room, until he/she is transferred to the recovery room. |
| Post-operative Phase | Involves the period after the client is discharged from the recovery room & ends with the resolution of all surgical consequences. This phase may be short (1 day) or lengthy (several months). |
| PACU (postanesthesia care unit) | A designated area of the hospital where immediate post-operative care is given. |
| To keep all objects sterile..... | Use the appropriate means of sterilizing, check expiration dtae, check package for dryness/intactness, check chemical indicators |
| Sterile objects become unsterile when touched by unsterile objects so..... | Sterile objects must be handled with sterile gloves/forceps, discard sterile objects that touch unsterile objects, if sterility is questionable-it's contaminated |
| Resident bacteria | Bacteria that stays with us and is always on us |
| Out of vision/ below the waist means..... | An unattended sterile field is considered unsterile, do not turn back on sterile field, keep sterile gloved hands in view |
| Sterile objects can become unsterile when..... | Prolonged exposure to airborne microorganisms, traffic is heavy, hair gets in the way, you sneeze or cough, you talk a lot, or you reach around a field |
| Fluids flow in the direction of gravity so..... | Don't let fluid flow on unsterile area |
| Moisture draws microorganisms so..... | Pour liquids- don't spill or drip & keep sterile items dry |
| Newborn & Infant =Undergoing Surgery | Separation from caregivers is traumatic, their ability to understand what is happening is limited, and they perceive the experience as strange, frightening, and lonely. |
| Newborn & Infant =Interventions | Promote a calm, comfortable environment by holding them, lowering background noises, and/or providing a stuffed animal or toy. Provide careful explanations to the parents & include them in their childs care as much as possible. |
| Newborn & Infant =Health Watch | Minimize blood loss & heat loss from the body, use items that are gentle to the skin & use extra care when applying/removing dressings, and use instruments, equipment, & medications that are size appropriate. |
| Toddler & Preschooler = Undergiong Surgery | Separation anxiety is more pronounced because the child is more aware of their surroundings, they perceive the situatuation as frightening and lonely. |
| Toddler & Preschooler = Interventions | Having all instruments & equipment ready before the child arrives; removing the childs clothing, applying the grounding pad, and applying monitoring devices after the child is anesthetized are all helpful |
| Toddler & Preschooler = Health Watch | Appropriately sized instruments; minimize blood loss & ensure temperature control; cribs with side rails & soft restraints; allowing parents in the recovery room as they regain consciousness |
| School-Age = Undergoing Surgery | Will benefit from a more detailed preoperative teaching program; more likely to cope better with separation from parents. |
| School-Age = Interventions | Include a tour of the operating room, the anesthesia machine, and the mask used to administer the anesthetic; allow them to participate in the administration of anesthesia by holding the mask. |
| Adolescent = Undergoing Surgery | Concerned with body image and possible disfigurement; self-conscious and embarrassed when private body areas are exposed; may attempt to hide feelings. |
| Adolescent = Interventions | Benefit from a detailed preoperative teaching program; demonstrate support and acceptance of such feelings and behaviors. |
| Adult & Older Adult = Undergoing Surgery | Risks are increased for people with chronic illness & chronic organ dysfunction; may require special considerations when having surgery because of alterations in hearing, vision, mobility, or chronic disease. |
| Adult & Older Adult = Interventions | Leave glasses on until just before an anesthetic is administered; speak clearly and directly to the client. |
| General Fears of Surgery | Fear of the unknown, loss of control, loss of love from significant other, threat to sexuality. |
| Specific Fears of Surgery | Diagnosis of malignancy, anesthesia, dying, pain, disfigurement, permanant limitations. |
| Informed Consent | An active, shared decision-making process between the provider and the recipient of care; must be complete before nonemergency surgery can be performed. It protects the surgeon, the hospital, and it's employees |
Created by:
amandac
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