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• Pexy – fixation(organ)
• Plasty – moulding Terms: Suffixes
• Ectomy – removal
Plaque a) Craniectomy
Intima b) Mastectomy
Peri-operative Nursing
Media c) Appendectomy
Adventitia • Otomy – creation of an opening
EJ Flaminiano
a) Craniotomy
Angioplasty!!! b) Fasciotomy
Trac eal Compression!
Nephroptosis
Aortopexy

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c) Tracheotomy • Centesis– aspiration

d) Thoracotomy
a) Arthrocentesis
• Ostomy – maintenance of an b) Amniocentesis
opening
• Clasis – to break
tube
Thromboclasis
stoma - Normal – red and moist
- Dry (dehydration) streptokinase
- Pale (cyanosis)
retavase
- Black(necrosis)
- Pus (infection) eminase

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Phases of surgery: Pre-operative:

• Pre-op • Consent - Surgeon
• Intra-op - Understood
- 18y/o and up
THANK
• Post-op - Parents or
guardians - Below 18
YOU!!! but allowed to
sign(emancipated minor) -
Witnessed! (nurse)
- For telephone
consent – 2 witnesses

Set-up: Transition
• Rraphy – suturing
Episiorrhaphy Unrestricted
-Street clothes
Restricted
-OR cap
-Scrub suit Semi-restricted
-OR Shoes -OR cap
-Mask -Scrub suit
-OR Shoes

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• Pre-operative teachings: To raise awareness of Deep breathing Incentive

what to expect in the
POST-OP
Inhale: Nose Inhale: Mouth
Exhale: Mouth Exhale: Mouth
coughing Pursed lip Pursed lip
S - Splint- Increased IAPsneezing Hold: 3 secs. Hold: 5 secs.
repositioning
P - Pain- Analgesics Repeat: 3x/hr Repeat: 10x/hr
A - Atelectasis - DBE, IS, coughing
technique
D - Devices (invasive) - IV line, NGT,
Drains, FC
E - Exercises

• Skin care - Cleanse surgical

• Nutrition - NPO! GA (6-8hrs) site
SA (6-8hrs) - Use mild
LA (3hrs) antiseptic soap and
- IVF water
- Malnutrition(TPN) - As much as
• Elimination- Void immediately before possible, clip hair -
procedure Shaving is a second
- FC option
- Laxatives as ordered
- Enema as ordered

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DRAINS!!! Exercises:
Closed 1. Calf pumping - Dorsiflexion &
Open extension of the
High risk Low risk foot
for for - Gastrocnemius
infection infection exercises

OS for Bottle for

collection collection
(penrose) (JP drain)

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2. Foot circles

3. Quadriceps
setting

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• Pre-operative Checklist: (Nurse)

•PHASES OF OPERATION:Universal Precaution: • Principles of aseptic technique:
Avoid Dmistakes
- Dentures, hairpins, glasses - removed 4. Hip and knee exercise
1. Sterile to sterile, non to non
I - Informed consent(signed)
1. Sign 2. Confirm sterility-
A -in- X – markings - Before
Allergies(latex)
induction(Universal prec.)
M - Monitor V/S(baseline) Check expiry date -
2. Time out- Indelible
O - Observe ink- Before
accuracy DRY!!!
incision(Introduction)
N - Note for PE and History - OR – tape
3. Sign
D - out- Bila eral
Document organs-
(last Before
voiding & pre-op meds) 3. Opening of packs - Closest to time of use
closure(Post-op orders)
S - Secure client’s belongings (15-20mins)
- “Sign in” phase st
- 1 – top flap (away)
- 2nd – side flaps
rd
- 3 – bottom flap(towards)

Intra-operative:
• Sterile field- Absence of microorganisms
- Barriers: Packs (s) inside
Gowns (s) outside
Gloves(s) outside
• Surgical team - Sterile - Surgeon, 1st assist, Scrub nurse
non-sterile - Anesth, Circulating,
Radiologist

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4. When in doubt, consider unsterile

5. Table – sleeves – shoulders (s)
6.

7. No coughing,sneezing,laughing,
excessive talking

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8. Always face sterile field Lid: (U)

- Front to front Lip: (U)
- Back to back
9. Dropping of instrumentsOutside: (U )
- 1 arm length
- 6-8 inches high Inside:(S)
10. Sterile water
Water:(S)

Bottom:(U)

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• Counting- Instruments, sponges and needles Post-operative:

- Audibly - Singly
- All are accountableCaptain of the • Vital signs:
ship!
- Res ipsa Loquitur
1st hr- Every 15 Every 15 mins mins
- 3x - Initial(before incision)
- 2nd(before closure of cavity) Every 30 mins
- Final(before closure of skin) 2nd & 3hr -rdEvery 30 hr- Every 30 minsmins
Every hour
thrd
43 to 7thhr - Every hour- Every hour

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Immediate Intermediate Extended

1 – 4 hrs 4 – 24 hrs 1 – 4 days
Report active COD – minimal WOF signs of
bleeding bleeding is normal infection
11. Pouring- 1 arm length
(+) PM – feeding High protein, high
NPO resumes vitamins
- 4 – 6 inches high
12. Honesty… (-) UO 30 cc/hr Normal UO
Report (+) Homan’s Anti-embolic
sign stockings
ROME
Dorsiflexion & Supported Independent
extension of foot Ambulation ambulation

Post-op complications:
• Post-op considerations:
• Hypoxia - O2Decreased O2
- ReferAllergies:
Latex!
-- Failure to put
I Allergies – Anti-
NU histaminesoropharyngeal tube
- Pale skin
D - Numbness
E - Tingling sensation
- Restlessness
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• ShockHemorrhage- Loss of Constipation

Paralytic Ileus
vital processof blood amount
significant High FiberAbsence of
Hemorrhage NGTAbsence of PM
500 cc or more feces
Causes: AllergiesLengthy NPOProkinetics
FeedingLaxatives
surgery Infection Anesthesia
Anesthesia
- Hypotension Absent bowel
Hypoactive sounds
- TachBradycardia - Pressure!Elevate
bowel sounds
- TachBradypnea lower ext. Hypoactive bowel
Absent bowel
- Paleness - Refer! sounds
sounds
- Numbness - IVF (Isotonic) Abdominal
Abdominal
- Tingling sensation - BT distension
distension

• Pulmonary embolism • Atelectasis- Lung collapse

• Hemoptysis - Diminished
Coughing technique
breath
• Dyspnea -sounds
DBE
- Decreased O2
I. spirometry
• Petechial rash
Hypoxia
- AB - pneumonia
- chest
- neck - Secretions
• O2 – 2L/min - Productive cough
• Heparin - Pneumonia

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Thrombophlebitis: Dehiscence Evisceration

• Inflammation of the
blood vessels related to Protrussion
thrombus formation
- Inflammation Lumen- Elevate legs w/o Loops of bowel

pressure of blood vessels in popletialIntima Initial –

area popping sound

- Pain - Anti-embolic stockingsMedia

6 – 8 days
Adventitia
Separation of wound
- Paleness(distal) - AP – fever edges
- Numbness - AC (Heparin)
- (+) Homan’s sign - Analgesics Underlying tissues
- Fever - Thrombolytics Initial –
popping sound

6 – 8 days

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Management:
C - Cover (SSS)

L - Low fowler’s with knees flexed

O - Observe for signs of shock

V - Vomiting – administer AE as ordered

E - Educate pt. (never carry objects more than 10

lbs)

S - Splint

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