Management of the Perioperative Patient 1

1
Management of the Perioperative Patient 1

• The Surgical Experience

2
Objectives

• Identify vocabulary associated with perioperative
  nursing.
• List key risk factors associated with surgical
  complications.
• Identify medications with anaesthetic interaction
  potential.
• Describe preoperative nursing measures that
  decrease the risk of infection and other
  postoperative complications.

3
Objectives

• Outline preoperative patient education with
  consideration of age requirements.
• Discuss immediate preoperative nursing
  interventions.
• Describe roles of the surgical team.
• Outline principles of surgical asepsis and its
  maintenance.

4
Objectives

• Identify environmental hazards in the OT.
• Discuss nursing care of the patient during
  surgery.

5
Risk Factorsfor Surgical Complications

• Hypovolaaemia
• Dehydration
• Nutritional deficits
• Extremes of age
• Extremes of weight
• Infections and sepsis
• Toxic conditions
• Immunologic abnormalities

• Pulmonary disease
• Renal/Urinary tract disease
• Pregnancy
• Cardiovascular disease
• Endocrine dysfunction
• Hepatic disease
• (S B, 2000, p323)

6
Medications

• Adrenal Corticosteroids
• Diuretics
• Phenothiazines
• Antidepressants MOAs
• Tobacco

• Tranquilizers
• Insulin
• Antibiotics mycin group
• Alcohol
• Illicit or recreational drugs
• (SB, 2000,p322

7
Preoperative Patient Education

• Preadmission program
• Deep breathing and coughing exercises
• Encouraging mobility
• Proposed pain management

• Providing Information
• Alleviating Fear
• Spiritual Needs

8
Preoperative Nursing Interventions

• Food and Fluids
• Bowel preparation
• Skin preparation

• Pre-medication
• Pre-op check list
• Family needs
• Transfer

9
The Surgical Team

• The patient
• Circulating or Scout Nurse
• Scrub Nurse
• Anaesthetics Nurse
• Anaesthetist
• Surgeon
• Surgeons Assistant

10
Principles of Asepsis

• All equipment in direct contact is sterilised.
• Personnel in contact with sterilised equipment
  must be scrubbed, gowned masked and gloved.
• Unscrubbed personnel must observe sterile zones.
• Patient skin prepped and draped with sterile
  drapes.
• Environmental controls.

11
Hazards

• Laser risks
• Exposure to blood and body fluids
• Latex allergy

12
Anaesthesia

• General Anaesthetic
• Inhalation
• Intravenous
• Conscious sedation
• Muscle relaxants

• Regional Anaesthetic
• Spinal
• Epidural
• Nerve blocks
• Local

13
Potential Intraoperative Complications

• Nausea and vomiting
• Hypoxia
• Hypothermia
• Malignant Hyperthermia

14
Nursing Interventions

• Reduce Anxiety
• Protect patients safety
• Prevent intraoperative positioning injury
• Patient advocate
• Monitoring and managing potential complications