Perioperative Nursing Care 1

Perioperative Nursing Care
1
Perianesthesia and
Perioperative Nursing
is the field of nursing that addresses the nursing
roles associated with the three phases of
surgical experiences : pre operative
postoperative and intraoperative
2
Preoperative Nursing Care:
• begins when the decision to proceed with
surgical intervention is made and end with the
transfer of patient to the operation table
3
Examples of nursing activities in the preoperative
phase include :
Pre admission testing
• Initial preoperative assessment
• Initiate teaching appropriate to patients needs
• Involve family in interview
• Verify completion of preoperative testing
4
Admission to surgical unite or center
• Complete the preoperative assessment
• Assess for risk of complications
• Report upnormal findings
• Verify that informed consent obtained
• Answers family questions
• Develop a plan of care
5
Others also in the holding area prior to the surgery
• Review patient chart

• Identify patient
• Verify surgical site
• Establish intravenous line eg canula
• Administer prescribed medications
• Provide support
6
Intraoperative Nursing Care
• Begins when patient is transferred to onto the operation

table and ends with admission to the post anesthesia care
unite
Main nursing activities include

• Maintain safety
• Maintain aseptic environment
• Transfer patient to operation room or table
• Position the patient in correct alignment
• Ensure that instruments count are correct
• Complete documentation
7
Physiologic monitoring
• Calculate fluid loss or gain
• Distinguish normal and abnormal data
• Report changes in vital sign
Physiologic support
• Provide emotional support
8
Postoperative Nursing Care
• Begins when patient is admitted to the post anesthesia care

unite and end with follow up evaluation in home or clinical
setting
Activities include
• Maintain airway
• Monitor vital sign
• Assess the effect of anesthetic agents
• Assess complications assess pain
• Promote recovery and initiate teaching
• Initiate discharge plan
9
Surgical classification ( according to
urgency)
• Emergent : immediately with no delay eg sever

bleeding
• Urgent: patient needs prompt attention must be done

within 24 hrs eg gall bladder infection and kidney stone
• Required : patient must have surgery within few weeks
or months eg cataract, Thyroid disorder
• Elective : failure to have surgery has some impact on
patient life but not very dangerous eg repair of scare
and simple hernia
• Optional : personal preference eg cosmetics
10
Preparation for Surgery
Informed Consent
• process for getting permission before conducting a healthcare
intervention on a person. A health care provider may ask a patient
Which procedures need informed consent ?
• Invasive procedure such as need anesthesia

• Non surgical procedure that carry considerable risk such as
arteriography
• Procedures that involve radiation
11
Criteria for valid informed consent
• Voluntary
• Must be written
• Patient must be competent and able to comprehend
• In case of incompetent patient family member or law
representatives may give consent
• Should contain explanation of procedure
• Instruction that patient can withdraw consent
• Explanation that all patients questions would be
answered and if there is any significant notes such as
change in customary procedure
12
Assessment of health factor that affect patient
preoperatively
• Nutritional and fluid status
• Drug and alcohol abuse
• Respiratory status
• Cardiovascular status
• Hepatic and renal function
• Endocrine function
• Immune function
• Previous medication use
• Psychosocial factors
• Spiritual and cultural beliefs
13
Special situations
• Ambulatory surgery : patient discharge the
same day of surgery
• Obese patient
• Emergency surgery
14
Preoperative nursing intervention
• Preoperative teaching
• Deep breathing coughing exercise
• Teach patient how to promote mobility and active body
movement by frequent position
• Leg exercise
• Getting out of bed
• Pain management
• Coping strategies
• Reduce anxiety and fear
15
• Maintain patient safety
• Manage fluid status
• Prepare the bowel
• Prepare the skin
16
Immediate preoperative nursing interventions
• Administer pre anesthetic medications
• Maintain preoperative records
• Transport patient to the operation room
17

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Perioperative Nursing Care

• Review patient chart

• Begins when patient is transferred to onto the operation

Main nursing activities include

• Begins when patient is admitted to the post anesthesia care

• Emergent : immediately with no delay eg sever

• Urgent: patient needs prompt attention must be done

Which procedures need informed consent ?

• Invasive procedure such as need anesthesia

• Reduce anxiety and fear

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