Lecture Notes on Perioperative NursingPrepared By: Mark Fredderick R Abejo R.N, MANMS Perioperative Nursing Abejo
MEDICAL AND SURGICAL NURSING
Mark Fredderick R. Abejo RN, MAN __________________________________________
used to describe the nursingcare provided in the total surgical experience of thepatient: preoperative, intraoperative and postoperative.
, extends from the time the client isadmitted in the surgical unit, to the time he/she isprepared for the surgical procedure, until he istransported into the operating room.
, extends from the time the client isadmitted to the OR, to the time of administration of anesthesia, surgical procedure is done, until he/she istransported to the RR/PACU.
extends from the time the client isadmitted to the recovery room, to the time he istransported back into the surgical unit, discharged fromthe hospital, until the follow-up care.
4 Major Types of Pathologic Process RequiringSurgical Intervention (OPET)Obstruction
impairment to the flow of vital fluids(blood,urine,CSF,bile)
rupture of an organ.
wearing off of a surface or membrane.
abnormal new growths.
Classification of Surgical ProcedureAccording to PURPOSE:Diagnostic
to establish the presence of a diseasecondition. ( e.g biopsy )
to determine the extent of diseasecondition ( e.g Ex-Lap )
to treat the disease condition.*
removal of an organ*
repair of congenitallydefective organ.*
repair of damage organ
to relieve distressing sign and symptoms,not necessarily to cure the disease.
According to URGENCYClassification Indicationfor SurgeryExamplesEmergent
patientrequires immediateattention, lifethreatening condition.Withoutdelay- severebleeding- gunshot/ stab wounds- Fracturedskull
Urgent / Imperative
patient requires promptattention.Within 24 to30 hours- kidney / ureteralstones
patientneeds to have surgery.Plan within afew weeks ormonths- cataract- thyroid d/o
patientshould have surgery.Failure tohave surgerynotcatastrophic- repair of scar- vaginalrepair
According to DEGREE OF RISKMajor Surgery
- High risk / Greater Risk for Infection- Extensive- Prolonged- Large amount of blood loss- Vital organ may be handled or removed
- Generally not prolonged- Leads to few serious complication- Involves less risk
Ambulatory Surgery/ Same-day Surgery / OutpatientSurgery
- Reduces length of hospital stay and cuts costs- Reduces stress for the patient- Less incidence of hospital acquired infection- Less time lost from work by the patient; minimal
disruptions on the patient’s activities and family life.
- Less time to assess the patient and performpreoperative teaching.- Less time to establish rapport- Less opportunity to assess for late postoperativecomplication.
Example of Ambulatory Surgery
Teeth extractionCircumcisionVasectomyCyst removalTubal ligation
ObesityPoor NutritionFluid and Electrolyte ImbalancesAge