MED SURG NURS120L Exam 1 Review- West Coast University

1/31/202




1 Perioperative Nursing
• Preoperative Care
• Intraoperative Care
• Postoperative Care
2 Week 1 Objectives
Perioperative Nursing
Summarize the nursing process in the care of perioperative patients.
Classify priorities in the care of perioperative patients using additional applicable concepts: pain,
mobility, nutrition, fluid regulation, infection/inflammation, oxygenation, perfusion, tissue
integrity, safety, elimination, and communication.
Identify inter-professional collaboration/team management needs for perioperative patients.
Examine the pharmacologic, nutritional, developmental, and teaching needs of perioperative
patients.
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3 Topics Covered
Lewis Ch. 11: Inflammation and Healing
Lewis Ch. 17: Preoperative Care
Lewis Ch. 18: Intraoperative Care
Lewis Ch. 19: Postoperative Care
ATI Ch. 94: Anesthesia and Moderate Sedation
ATI Ch. 95: Preoperative Nursing Care
ATI Ch. 96: Postoperative Nursing Care
4 Reasons for Surgery
Curative
Palliative
Cosmetic
Functional
Diagnostic
5 Ambulatory Surgery
(“same day,” “outpatient,” “surgi-center”)
Constitutes the majority of surgical procedures
Can use general, regional, or local anesthesia
Typical hospital stay is < 24 hours
Preferred by both patients and HCPs
Uses minimally invasive techniques
6 Preoperative Assessment
Allows nurse to plan care to ensure patient safety
What patients might be more at risk for complications?
Psychosocial: anxiety, fear, hope
Health History
Previous history with sedation
Medications/Supplements

, 1/31/202




Last dose of medication
Allergies
Obtain baseline data to compare with intra- and post- op data
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7 Documentation
Joint Commission– All surgical patients need H&P on chart
RN should do review of systems and physical assessment
Blood Transfusion Consent, Medical POA, Advance Directives
Informed Consent
RN’s job to ensure pt competence and understanding and witness signature
RN can clarify but cannot give new information
Must include diagnosis, nature of treatment, risks, and alternative treatments
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8 Common Diagnostic Tests
ABGs, Pulse Ox
Blood Glucose
BUN, Creatinine
CBC (Hgb, Hct, WBC)
Electrolytes
hCG
LFTs
Coags (PT, PTT, Platelets, INR)
Albumin
Type & Cross
UA
EKG
CXR
9 Preoperative Medications
Antibiotics
Anticholinergics
Antidiabetics
Antiemetics
Benzodiazepines
Beta-Blockers
Histamine (H2) Receptor Antagonists
Opioids
Give PO meds 60-90 minutes before surgery
Give IV antibiotics one hour before incision
10 Preoperative Teaching
Post-operative teaching
Deep breathing, cough, early ambulation post-op
Incentive Spirometer