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Course Outline |
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PERIOPERATIVE CONSIDERATIONS AND MANAGEMENT
11. Basic Concepts a. Definition and suffixes b. Four major types of pathological processes requiring surgical intervention c. Surgical classification d. Effects of surgery to client e. Phases of surgical experience 111. Preoperative Nursing Care Management A. Preparing the Patient for Surgery 1. Psychological Preparation a. Assessment and Intervention 2. Physiological Preparation 2.1 Assessing the Surgical Risk Factors and its Potential Complications a. Age b. Nutritional Status c. Respiratory Status d. Cardiovascular Status e. Hepatic and Renal function f. Endocrine Function g. Immunologic Function h. Previous Medical History i. Drug or Alcohol Use j. Head, Ears, Eyes. Throat Status k. Neurologic Status l. Musculo skeletal Status (extremities and skin) 2.2 Assessing the Ambulatory Surgical Patient 2.3 Gerontologic Considerations 2.4 Preoperative Diagnostic Test 3. Legal Preparation a. Informed Consent
4. Preoperative Patient Education a. Deep breathing b. Coughing exercise c. Encouraging mobility and active body movement
5. Physical Preparation a. Managing nutrition and fluids b. Preparing the bowel for surgery c. Preparing the skin 6. Immediate Preoperative Nursing Intervention a. Early morning care (day of surgery) b. Preoperative Medications c. Administering the Pre-anaesthetic medications d. Maintaining the preoperative record e. Transporting the patient to the pre-surgical unit f. Attending to the family needs
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Intraoperative Nursing Care Management A. Intraoperative Goal 1. Emotional well being 2. Surgical Asepsis 3. Safety 4. Control of the surgical environment B. The Surgical Environment 1. Three Surgical Zones 2. Proper Attire 3. Health Hazards Associated with the Surgical Environment and Universal precaution 4. Principles of Aseptic technique 5. Surgical scrub, Gowning, and Gloving C. The Surgical Team 1. The Nonsterile Team 2. The Sterile Team D. The Surgical Experience a. Anesthesia b. Position of client for surgery c. Draping d. Instrumentation Classification of instruments · Cutting and dissecting · Clamping and occluding · Grasping and holding · Dilating and enlarging · Retracting (hand-held and self -retaining) · Suctioning Different Surgical set · Minor instrument Set · Major Instrument Set Surgical Sutures and Surgical needles · Absorbable and non- absorbable · Traumatic and atraumatic e. Common operative Events E. Potential Intraoperative Complications 1. Nausea and Vomiting 2. Hypoxia and other Respiratory Complications 3. Hypothermia 4. Malignant Hyperthermia F. Caring for the Patient During Surgery 1. Reducing Anxiety 2. Maintaining Safety 3. Preventing positioning & other Injuries 4. Maintaining patient’s dignity 5. Absence of complication
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V. Postoperative Nursing Care Management A. Post-Operative Goals B. Three Phases of Postoperative Care Phase 1. Immediate post-operative care Nursing Care Management in the PACU a. Assessing the Patient b. Maintaining a Patent Airway c. Maintaining Cardiovascular Stability d. Relieving Pain & Anxiety e. Determining readiness for Discharge from the PACU |
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Phase 2. Intermediate/ Convalescent post-operative care Admitting Patient to the Surgical unit a. Performs initial assessment b. Review client’s chart c. Review post-operative orders Care in the Surgical unit a. Vital signs b. Maintaining client’s airway c. Hydration d. Relieving pain e. Encouraging Activity & Promoting Self Care f. Resuming Oral Intake g. Promoting Bowel Function & Urinary Function h. Wound Care i. Care of drains Prevention of Post-operative Complications a. Pneumonia b. Pulmonary Embolism c. Hemorrhage d. Hypovolemic Shock e. Nausea and Vomiting f. Abdominal Distention g. Wound Infection h. Urinary Retention Phase 3. Discharge Planning, Teaching Referral Promoting Home and Community-Based Care |
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WOUND MANAGEMENT
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ABDOMINAL SURGERIES
1. Gastroscopy 2. Gastrectomy 3. Small Bowel Resection 4. Appendectomy 5. Colostomy 6. Resection of Sigmoid and Rectum 7. Hemorroidectomy 8. Herniorrhaphy 9. Cholycystectomy
1. Procedure 2. Positioning 3. Surgical Skin Preparation 4. Draping 5. Instrumentation, equipment, and supplies E. Intraoperative Nursing Management |