Pre and Post Op Care

8/9/2019 Pre and Post Op Care

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Pre and Post op Care

By

Elaine Jones + Anne Wright.


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Definitions.

Perioperative nursing is a term used to

describe the nursing functions in the totalsurgical experience of the patient, pre

operative, intra operative, and post operative

!ipincott "anual of #ursing Practice $th

edition%


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Pre operative phase.

&his is from the time the decision

is made for surgical intervention

to the transfer of the patient to theoperating room.


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Intra operative phase.

&his is from the time the patient is

received in the operating room

until transferred to the recoveryroom.


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Post operative phase.

'rom the time of transfer to the

recovery room to transfer bac( to

)ard.


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Types of surgery.

*ay

Elective

Emergency

rgent

e-uired

optional

urgery


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Criteria for day surgery

selection. urgery for short duration up to $/ minutes%. &ype of operation in )hich post operative complications

are predictably lo).

Age based on biological0physiological age rather than

chronological%.

B"1.

upport at home for 23 hrs

)ithin 4 hours 5ourney from hospital

access to telephone

Ade-uate toilet facilities inside%


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Exercise 1.

6n admission for surgerypatients undergo an

assessment, )hat factors

need to be considered


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Answers.

eason for admission

Biographical information

7urrent health status0illness

"edications

ymptoms0complaints0disabilities Previous medical problems

7hronic illness

'amily medical history #utritional status

1ntegrated 7are Path)ay


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Continued>>>>

Baseline observations. pecimen collection.

"obility Assessment.

#utritional assessment.7ardiovascular assessment

espiratory assessment.

rinary assessment. ocial assessment

is( assessment


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Psychological Assessent.

Patient may be anxious

for numerousreasons88..


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!uggestions".

'ear of the un(no)n

Anaesthetic + side effects 0 not )a(ing up

nrelieved painestricted in bed post op.

se of bed pan

Body image 0effect on relationship, family*ependant relatives.

'inancial problems if sole provider for family.


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In what ways can the nurse alleviate anxiety in the

pre op patient#

Pre operative education9:

Patient information leaflets, diagrams,

posters

Pre op visit from recovery nurses.

pecialist nurses: pain control team, surgical

nurse specialist.


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Consent.

;!egal re-uirement.

;1nformed consent

Written consent should be obtained identifying that the

sub5ect has received and understood9:

&he procedure offered easonable alternatives to the procedure

Possible benefits of the procedure to the patient.

is(s, inconveniences, and discomforts of the

procedure.

Ans)ers to all patient


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Iediate pre operative

preparation.

What are the fasting

re-uirements for a patient pre

operatively>


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1t is routine to fast patients for a

minimum of four hours before a

general anaesthetic, to empty the

stomach and avoid peri:or post

operative vomiting, or regurgitation,

)hich increases the ris( of aspiration.

2hrs Preop for )ater tap not fi??y%


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$astrointestinal preparation.

1s this re-uired for all types of

surgery>


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Bo)el evacuation is carried out 9:

4. &o prevent defaecation during surgery

2. &o reduce the ris(s of accidental damage tothe colon during abdominal surgery.

1t is not re-uired for all types of surgery, and

should not be seen as routine.


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!%in preparation.

Why is s(in preparation

necessary pre op>


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1t is necessary to remove dirt and transient

micro organisms from the area.

!ocal procedures should be follo)ed.


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7ontroversial area of discussion@@

Against

Pre operative shaving increases ris( of postoperative )ound infection.

In favour of shaving'(

Avoidance of hairs trapping in the incision A clear field of vision.


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Pre op chec% list.

Exercise

*iscuss each item on the chec(list,

and provide a rationale for its

importance.'eedbac( to group.


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Preedication.

Prior to any pre medication being given, the nurse

must 9:

Ensure identity bands are )orn and labelled

correctly. 7onsent form is signed by patient and doctor.

Patient has voided urine.

7hec( all other items on the chec(list. Premedication to be given as prescribed at

appropriate time, )ith explanation to the patient.


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)inal chec%

Ensure chec(list is )ith patients notes, along

)ith consent form, x:rays, laboratory results,

nurses records.

Patient is transferred to theatre.


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P*!T *PE+ATI,E CA+E

What factors should you consider )hen

caring for a patient post operatively

this starts from accepting the patient from

the recovery room%


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Post op care

Answers

=andover from recovery nurse to determine postop instruction from surgeon0anaesthetist

6bservations Air)ay patency, level of

consciousness,BP, pulse, respirations%

&emperature

Wound chec( e.g per vagina, per rectum%

'luid balance catheter, 11, naso gastric tube,

catheter, )ound drain%Pain pain score, positioning, analgesia%

eneral appearance colour, pallor, s)eating,

shivering%


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Coon post operative coplicationsespiratory complications

Air)ay obstruction, chest infection

7ardiovascular complications

shoc(, haemorrhage, *&, PE

astrointestinal

vomiting, constipation, paralytic ileus, retentionof urine

Wound infection


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A- /0E!TI*-!

Documents

Pre and Post Op Care