PERIOP🫀🫁🤢🤢🤢

Peri operative nursing practice- refers to the performance of nursing activities

during the pre-operative and post-operative phase of the patient’s surgical
experience

Phase Start
Pre-operative phase starts when the patient decides to undergo the procedure or
when the procedure is scheduled
Intra-operative phase starts when the palient is admilled to the OR bed until the
palient is transferred to the PACU
Post-operative phase starts when the palient is admitted to PACU until the
patient is transferred to the regular ward

Phase Nursing Activities/Consideration

Pre-operative phase Visit the potient
Interview / Informed Consent
Preparation - Physical and Psychological
Intra-operative phase Safety
Aseptic-controlled environment
Positioning
Input and output S:Traffic control in the OR ; A:Movement of personnel ( kept to a
minimum) Humidity and temp inside the OR
Post-operative phase Temperature and other vital signs
Oxygenation status
Level of Consciousness
Drainage / Dressing
Airway

Informed Consent - on agreement mode by the client to undergo a procedure provided

that the pelient is given the necessary and complete information about the
procedure before giving consent

• Information provided to the potient.

1. Nature and Magnitude of the Procedure
2. Risks and Benefits of the Procedure
3. Alternative Treatment
4. Prognosis

Who cannot give consent?

• Minors
• Unconscious
• Mentally-ill

Conditions requiring Informed Consent

• Minor and Major Procedures
• Anesthesia administration
• Radiographic exam with the use of contrast medium
• Entry to a body cavity- procedure is invasive or intrusive

Classifications of Surgery
• According to Magnitude
• According to Purpose
• According to Urgency

Surgery: According to Magnitude

• Major procedure
• Minor procedure
Characteristics of Major procedure
• High risk for morbidity and mortality
• Extensive or prolonged
• Large amount of blood loss
• Presence of complications

Surgery: According to Purpose

• Diagnostic - biopsy
• Exploratory - to assess the extent of the condition; EX: exploratory
laparotomy
• Curative - cure the condition

⁃ Ablative - removal of a body part - Ectomy

⁃ Constructive - repair of a congenital defect - Cleft palate -
Palatoplasty
⁃ Reconstructive - repair of a damaged or diseased organ - Skin graft

• Palliative - to reduce distressful signs and symptoms

⁃ Rhizotomy - common procedure under palliative; reduce the distressful
s/sx

Surgery: According to Urgency

• Optional - according to patient’s discretion - Cosmetic surgery such as

rhinoplasty, face lift, blepharoplasty
• Elective - according to availability / convenience of the patient -
Surgery for non toxic goiter
• Required - should be done within a few weeks - Surgical procedure for
cataract surgery
• Urgent - should be performed within 24-48 hours - Appendectomy
• Emergency - should be performed immediately - Ruptured Appendectomy

Physical preparation of the Client

Common anxiety associated with surgery: Fear of the unknown
1. Health Teaching - Deep Breathing and coughing exercises, splinting the
wound
Ambulate to prevent deep vein thrombosis
2. Pre-operative Checklist
3. What is to be removed and retained - nail polish, dentures, jewelry,
contact lens and retain hearing aid
4. Methods of Hair Removal
⁃ Shaving - highest risk of infection
⁃ Clipping - surgical clipper is used
⁃ Depillation - depilatory cream (Veet)