Perioperative is providing effective patient care before surgery, during surgery, and after surgery. Preoperative is providing the care that is needed before a surgical procedure. Postoperative is caring for a patient after a surgical procedure has occurred. The patient must first go to the admitting office and get a physical, family and medical history, advance directive, and an EKG done before surgery. Prior to the patient arriving to the hospital for surgery should be NPO after midnight, unless they have blood pressure medication, which is okay to take. The patient should arrive approximately 2 hours prior to surgery to ensure that the patient is prepped and ready for surgery by the scheduled surgery time.
Preparing a patient for surgery
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The surgery nurse tells the postop nurse about how the patient tolerated the surgery overall. The surgeon comes and look at the patient. The surgeon told the nurse the location, length, and how many stitches were associate with the wound. The nurse applied bactroban to the wound and monitored the wound for any bleeding. If there was bleeding to the wound area, then the nurse would tell the patient try not to talk since the surgery was on the lip. Postoperatively, the patient receives the information verbally about discharge instructions that are ordered by the surgeon, but the discharge papers may be handed to the family members. Since the patient is not fully competent after surgery the family member may be asked to assign the form with discharge instructions that were provided. The family is then given a copy of the discharge instructions, anesthesia paper, and the information about the procedure that was done. The planning that takes place when outpatients have surgery and are discharged home directly from the postop area is educating the patient about not driving within the next 24 hours, monitor the site for drainage, and depending on the surgery depends on the additional teaching that is needed. Also the nurse explains the medications that need to be taken, how long the medication needs to be taken for, and why the medication needs to be taken. The nurse tells the patient that if there are any changes cognitively or physically to call the doctor and if it’s an emergency then call 911. Phase 2 of surgery is known as the second part of recovery before the patient is able to go home. During Phase 2, the patient is closely monitored for any complications that may occur such as difficulty breathing, drainage at incision site and many more. The patient’s vital signs are taken every thirty minutes for an hour and if the
Additionally, the LPN cannot push medications into a peripheral intravenous line if the patient “weighs less than 80 lbs, is prenatal, pediatric, or antepartum”, although given that the situation is on a general med-surg floor it is unlikely these patients would be under Sarah’s care at this time. (Rules and Regulations of Practical Nurses. 2015) Sarah can delegate the postoperative patients who need dressing changes and ambulating them to the LPN, but Sarah should assess the wounds for complications initially and serve as resource to the LPN if she has questions about the wounds. Additionally, she could help the nursing assistant with answering calls and serve as a reference for the nursing assistant to ask questions or help with tasks if Sarah is not available. With regards to supervision, the LPN would need continuous supervision given that the working relationship is new. (Cherry and Jacob, 2014) Sarah should be available and willing to answer any questions or address any concerns the LPN
Pre-Op begins momentarily, where the patient meets with nurses, surgical technicians, Dr. Todd, and the anesthesiologist to discuss the operation and go over any new concerns or questions the patient may have. They will be hooked up to an IV where the anesthesiologist with administer the local anesthesia before Dr. Todd begins to operate.
Have you ever wondered why you have no feeling during surgery? The reasoning behind this is a doctor called an anesthesiologist. For those who are wondering who they are and what they do, anesthesiologists are doctors who, after completing many years of school and training, work many hours to make sure patients feel no pain during surgery, and earn a good salary along with good benefits.
It is essential to make sure that the patient is fine once the procedure has been finished and prior to them leaving. If there have been no complications, then the patient will most likely be ok. Nevertheless make sure that the site has stopped bleeding and that they are not feeling faint. If there was any complications, for example, hitting an artery, haematoma or fainting, then make sure you follow the process for dealing with the complication and let the patient know what they need to do if any symptoms
Hinkle, J., Cheever, K., & , (2012). Textbook of medical-surgical nursing. (13 ed., pp. 586-588). Philadelphia: Wolters Kluwer Health
Ignatavicius, D. D., & Workman, M. L. (2013). Care of Intraoperative Patients. Medical-surgical nursing: patient-centered collaborative care (7th ed.). St. Louis: Elsevier.
The hospital promised early ambulation following hernia surgery. The hospital facility was designed to encourage movement without unnecessarily causing discomfort. Postoperative regimen designed and communicated by the medical team to patients
After surgery, they monitor the patient to see if there are any problems while they are coming off an anesthesia (Nurse Anesthetists, Nurse Midwives…) If there are no problems the surgery will be deemed as successful, and the nurse anesthetist will report all findings to the
The first procedure, hemorrhoidectomy, which is the removal of hemorrhoids, the OR nurse was a traveling nurse from Alabama. In the preoperative role, his were to prep the site, administer any medication if needed, insert any catherization needed, chart the patients’ status or changes, and get other supplies, if needed. In the preoperative check list, the scrub team counted out the inventory for the supplies. The OR nurse documented what was opened. During the preoperative observation, the patients
My interest in anesthesia came about like the wounded path along a well traveled hiking trail, one of many that looks enticing and is just right, but didn't reveal itself until I got myself through the hurdles along the road. In anesthesia I am looking for a specialty that values quick thinking and detailed precision, a field with the right balance of intensity and patient interaction, and a career that can challenge me to perform at the top of my abilities.
Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2010). Brunner & Suddarth’s textbook of medical-surgical nursing (12th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Westhead, C. (2007). Perioperative Nursing Management of the Elderly Patient. Canadian Operating Room Nursing Journal, 25(3), 34-41. Retrieved from http://gateway.library.qut.edu.au/login?url=http://search.proquest.com.ezp01.library.qut.edu.au/docview/274594603?accountid=13380.
The role of the nurse in the preoperative area is to determine the patient’s psychological status to help with the use of coping during the surgery process. Determine physiologic factors directly or indirectly related to the surgical procedure that may cause operative risk factors. Establish baseline data for comparison in the intraoperative and postoperative period. Participate in the identification and documentation of the surgical site and or side of body on which the procedure is to be performed. Identify prescription drugs, over the counter, and herbal supplements that are taken by the patient that may interact and affect the surgical outcome. Document the results of all preoperative laboratory and diagnostic tests in the patient’s record
Anecdotal Notes Before Intervention • Adam has a habit of getting distracted by objects at this desk. He especially likes chewing and sucking on his pencil, erasers, and markers. He also doodles, both on paper and his skin. Moving his supplies away does not solve the issue because then he starts playing with his shoes or talking to a peer. • Adam becomes frustrated when he is not called on, despite raising his hand.
I went to the operating room on March 23, 2016 for the Wilkes Community College Nursing Class of 2017 for observation. Another student and I were assigned to this unit from 7:30am-2:00pm. When we got their we changed into the operating room scrubs, placed a bonnet on our heads and placed booties over our shoes. I got to observe three different surgeries, two laparoscopic shoulder surgeries and one ankle surgery. While cleaning the surgical room for the next surgery, I got to communicate with the nurses and surgical team they explained the flow and equipment that was used in the operating room.