Peri-Operative Nursing.docx - Peri-Operative Nursing I II...

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Peri-Operative Nursing I. Perioperative Nursing a. Preoperative phase i. Period of time from decision for surgery until the patient is transferred into the operating room b. Intraoperative Phase i. Period of time from when a patient is transferred into the operating room to admission to the PACU c. Postoperative Phase i. Period of time from when patient is admitted to PACU to follow-up evaluation in clinical setting or at home II. Classification of Surgery a. Seriousness i. Major or Minor b. Urgency i. Elective 1. A surgery that you choose to do ii. Urgent 1. We need to do it now iii. Emergency 1. Patient will die if you don’t do it now c. Purpose i. Diagnostic 1. Determines origin and cause of disorder ii. Ablative 1. Excision or removal of diseased body part iii. Palliative 1. Reduces intensity of disease symptoms iv. Reconstructive/Restorative 1. Restores function or appearance v. Procurement for transplant 1. Requires a perfusionist vi. Constructive 1. Restores function (anatomically abnormal) vii. Cosmetic 1. Alters/enhances personal appearance III. Surgical Risk Factors a. Smoking b. Age c. Nutrition (electrolyte balance) d. Obesity e. Obstructive Sleep Apnea (OSA) – Stop Bang f. Immunosuppression- Risk for infection g. Fluid and Electrolyte imbalance h. Postoperative Nausea and Vomiting (PONV) i. Venous Thrombo-embolism (VTE) j. ASA Classifications (American Society of Anesthesiologists)
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i. ASA I 1. A normal healthy patient ii. ASA II 1. A patient with mild systemic disease iii. ASA III 1. A patient with severe systemic disease iv. ASA IV 1. A patient with a severe systemic disease that is a constant threat to life v. ASA V 1. A moribund patient who is not expected to survive without the operation vi. ASA VI 1. A patient declared brain dead whose organs are being removed for donor purposes IV. Preoperative Assessment a. Preadmission Testing i. Labs, UA (electrolyte balance, renal fxn) b. Nutritional and fluid status c. Dentition d. Drug or alcohol use e. Respiratory Status f. Cardiovascular Status g. Hepatic and Renal Function h. Endocrine Function i. Immune Function j. Previous Medication Use k. Psychosocial factors l. Spiritual and Cultural beliefs m. Surgical History V. Special considerations a. Patients who are obese b. Patients with disabilities c. Patients undergoing ambulatory surgery i.e. outpatient surgery
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  • Spring '18
  • postoperative nausea and vomiting, A. Patient Education, surgical wound infection, c. Patient Safety

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