NURSING 465 - Perioperative Nursing Care Med Surg . Summary.

Perioperative Nursing Care Med Surg Perioperative Nursing Care Perioperative - includes pre, intraoperative, post operative care Pre operative- from the decision of surgery until patient goes into the OR Intraoperative- In the OR until their in the post ECHO Phases of Perioperative Nursing  Preoperative phase: period of time from decision for surgery until patient is transferred into operating room  Intraoperative phase: period of time from when patient is transferred into operating room to admission to postanesthesia care unit (PACU)  Postoperative phase: period of time from when patient is admitted to PACU to follow-up evaluation in clinical setting or at home  Sidebar: golytely- laxative and electrolytes for bowel cleansing Preadmission  Initiates initial preoperative assessment  Initiates teaching appropriate to patient’s needs  Operative processes-when, where, how, who, what  Post-operative teaching-PACU processes, monitoring, catheters  Involves family in interview if possible  Verifies completion of preoperative diagnostic testing- time frame of labs needed, radiological studies, medical clearance  Verifies understanding of surgeon-specific preoperative orders: medications and diet restrictions.  Other preparations: Bowel prep, shaving, labeling of site  Discusses, reviews advanced-directive document  Begins discharge planning by assessing patient’s need for postoperative transportation, care  Cholecystectomy- surgical removal of the gallbladder  Initiates teaching appropriate to patient’s needs- 1st thing you should ask if tell me what the doctor you about your surgery- gives you a sense of what the pt. understands, explain that the will be using an incentive spirometer Preoperative Assessment  Labs that may be need to be completed before surgery- CBC because post operative ECHO, CMP (complete metabolic panel ), renal fcn, liver fcn, coagulation panel (if they’re on Heparin, etc.)  Smokers or people over 50 or 60- need Chest X ray before surgery to see if there's respiratory compromise