Copyright © 2008 Delmar Learning. All rights reserved. Unit 29 The Surgical Patient

Copyright © 2008 Delmar Learning. All rights reserved.

Unit 29

The Surgical Patient


Objectives

• Spell and define terms.• Describe the concerns of patients who

are about to have surgery.• List the various types of anesthesia.• Shave the area to be operated on.• Prepare the patient’s unit for the

patient’s return from the operating room.


Objectives

• Give routine postoperative care when the patient returns to the room.

• Assist the patient with deep breathing and coughing.

• Apply elasticized stockings or bandages and pneumatic hosiery.


Introduction

• Patients facing any surgical procedure tend to be fearful.

• Remember that these patients require great emotional and physical support.

• Such support should be given from the time each patient is admitted through the time the patient is discharged.


Hair Removal

• Follow facility policies for preoperative hair removal:– A doctors’ order may be required to do a

shave– Some people have coarse body hair that

dulls the razor• Replace as often as needed


Hair Removal

• Follow facility policies for preoperative hair removal:– Clippers and scissors may also be used for

hair removal– Remove hair as close to the time of

procedure as possible


Preoperative Responsibilities

• Nursing assistant should do the following before a patient has surgery:– Remove patient’s dentures– Remove prostheses, including contact

lenses, hearing aids, and glasses– Recheck vital signs

• Inform RN if they are abnormal


Pain Perception

• Before surgery– Patient is given medication to promote

relaxation

• Keep the side rails up– Do not allow the patient to get up

unattended after medication has been given


Pain Perception

• During surgery– Anesthetics are given to prevent pain

• After surgery– Medications are given to reduce discomfort


Anesthesia

• Given to prevent pain, to relax muscles, and to induce forgetfulness


Anesthesia

• Anesthetic agent and method of administration – Determined by the location and type of

surgery to be performed– Length of time needed for surgery– Patient’s physical condition


Anesthesia

• Two main types of anesthetics:1. General anesthetics induce the patient to

become unconscious


Anesthesia

• Two main types of anesthetics:2. Local anesthetics induce the loss of

feeling in a specific area– Spinal anesthesia is given by inserting a long

needle into the cerebrospinal fluid– If this anesthesia is given, keep the head of the

bed flat postoperatively until instructed by the RN


Surgical Care

• The care of the surgical patient can be divided into three parts:– Preoperative– Operative– Postoperative


Perioperative Hypothermia

• Anesthesia and some sedatives– Disrupt internal ability to regulate

temperature

• Drugs – Promote heat loss by reducing shivering

response– Prevent blood vessel constriction



• Opening body cavities during surgical procedure– Further cools internal structures

• Open body cavities combined with administration of blood and IV fluids– Further contribute to temperature loss



• Some facilities:– Monitor patients’ temperatures throughout

procedure, especially children

• Body temperature – Cannot return to normal until anesthetic

wears off – This allows normal temperature regulating

responses to take over



• Pain – Further decreases effectiveness of these

responses

• Return to normal temperature may take two to five hours– Depending on degree of hypothermia and

age of patient


Antiembolism Hosiery

• Physician may order antiembolism hosiery– Also called elastic hosiery or GPS

compression hosiery



• Never guess at hosiery size• Measure legs with a disposable tape

measure– Compare measurements with size chart– Refer to Figure 29-16

• Follow policies for periodic hosiery removal and circulation checks



Documents

Copyright © 2008 Delmar Learning. All rights reserved. Unit 29 The Surgical Patient