Download presentation
Presentation is loading. Please wait.
1
Nursing Care of Patients Having Surgery
Chapter 12 Nursing Care of Patients Having Surgery
2
Surgery Urgency Levels
Emergency Urgent Elective Optional
3
Purposes of Surgery Preventive Diagnostic Exploratory Curative
Palliative Reconstructive
4
Types of Surgery Open Incision Minimally Invasive Surgery
“Keyhole,” “Endoscopic” Scope Robotic Laser
5
Robotic Surgery – da VINCI
6
Three Perioperative Phases
Preoperative Decision for Surgery to Transfer to Surgery Intraoperative Transfer to Surgery to PACU Postoperative PACU to Recovery
7
Preoperative Phase LPN/LVN Role Assist in Data Collection
Reinforce Explanations/Instructions Provide Emotional/Psychological Support
8
Factors Influencing Surgical Outcomes
Emotional Responses Age Hydration/Nutrition Smoking and Alcohol Diseases
9
Preadmission Surgical Patient Assessment
Health History Risk Factors Education Discharge Planning Referrals Diagnostic Testing
10
Preadmission Surgical Patient Assessment (cont’d)
Pregnancy Test Advance Directive
11
Preoperative Teaching
12
Preoperative Routines
Date/Time of Admission/Surgery Admission Procedures Length of Stay, Items to Bring and Wear Recovery after Surgery Family Information Discharge Criteria
13
Preoperative Instructions
NPO Medications Bowel Prep Pain Control
14
Preoperative Instructions (cont’d)
Postoperative Exercises Deep Breathing and Coughing Incentive Spirometry Leg Exercises
15
Incentive Spirometry
16
Preoperative Patient: Assessment
Health History Medications Physical Assessment
17
Preoperative Nursing Diagnoses
Anxiety Fear Deficient Knowledge
18
Preoperative Consent Gives Legal Permission for Surgery
Informed Consent Physician’s Responsibility No Sedation When Signing Voluntary Can Withdraw at Any Time Valid 30 Days
19
LPN/LVN Role: Witnessing Consents
Ensure Patient Has Been Informed Direct Questions to Physician Signature Indicates Observed Voluntary Signing of Consent
20
Preparation for Surgery
Preoperative Preparation Checklist Preoperative Medications
21
Preoperative Checklist
22
Transfer to Surgery Holding Area
23
Holding Area Verifications IV Insertion IV Antibiotic Patient Data
Surgical Site Time Out IV Insertion IV Antibiotic
24
Intraoperative Phase Begins
25
Arrival in Surgery Explain What to Expect Position Safety
Tubes Placed After Anesthesia Skin Prep
26
Intraoperative Phase Scrub Nurse LPN/LVN Role Sterile Instrument Field
Assists Physician
27
Anesthesia General Anesthesia Local Anesthesia
Loss of Sensation, Consciousness, Reflexes IV or Inhalation Route Local Anesthesia Loss of Sensation to Body Region Injection of a Local Agent
28
Endotracheal Tube
29
Malignant Hyperthermia
Rare Hereditary Muscle Disease Triggered by Some Types of General Anesthesia Agents
30
Spinal Anesthesia
31
Anesthesia Adjunct Agents Conscious Sedation
32
Surgery
33
PACU
34
Postoperative Phase Risk for Aspiration Ineffective Breathing Pattern
PACU Nursing Diagnoses Risk for Aspiration Ineffective Breathing Pattern Ineffective Airway Clearance Deficient Fluid Volume Risk for Injury
35
Postoperative Phase (cont’d)
PACU Nursing Diagnoses (cont’d) Disturbed Sensory Perception Acute Pain
36
Family Visitation Keep Informed Maintain Confidentiality (HIPAA)
37
PACU Discharge Criteria
Stable Vital Signs Sao2 Greater Than 90% Awake, Baseline Level of Consciousness Respirations Not Depressed Bleeding Controlled
38
Nursing Diagnoses for Postoperative Patients
Ineffective Airway Clearance Ineffective Breathing Pattern Acute Pain Deficient Fluid Volume Ineffective Tissue Perfusion Impaired Urinary Elimination
39
Nursing Diagnoses for Postoperative Patients (cont’d)
Urinary Retention Risk for Infection Impaired Skin Integrity Imbalanced Nutrition Constipation Impaired Physical Mobility
40
Complication Prevention
41
Complication Prevention (cont’d)
42
Stapled Incision
43
Healing Phases
44
Wound Dehiscence/Evisceration
45
Ambulatory Surgery Discharge Criteria
Stable Vital Signs No Bleeding No Nausea/Vomiting Controlled Pain Voided as Indicated No Dizziness When Upright
46
Discharge Instructions
Written Instructions/Signed Teaching Wound Care Medications Complications Equipment
47
Discharge Instructions (cont’d)
Follow-up Physician’s Visit Prescriptions
48
Discharge Teaching
49
Home Health Care Assessment, Complex Nursing Care, Teaching RN LPN/LVN
Basic Nursing Care Assistants ADLs, Chores
Similar presentations
