Perioperative Care

What are the responsibilities of the perioperative nurse?
What are the responsibilities of the perioperative nurse? The perioperative nurse provides care to the patient durin, pre-operative, intraoperative and post op.

What does the circulating nurse do?
Provides care to the patient during the surgical procedure.

Preoperative team
Pre-op nurse, circulating nurse, anesthesia.

Responsibilities of the pre op team
correct client, correct surgical procedure, correct surgical site, review of client history, meds allergies Health history and abnormal labs.

Intraoperative team responsibilities
Name of client, consent, allergies, antibiotic administered, surgical count correct.

Post op team responsibilities.
drains, implants placed, inform of any complications, inform of abuse or suicide threats to be further investigated.

What is critical during the preoperative phase?
nursing care of the client starts with good communication. Pre-op care begins as soon as the client is informed of the need for surgery.

Important items to discuss during pre-op?
1. Length of surgery, whether or not to stop taking meds, communication with surgical team prior to procedure, deep breathing and coughing exercises, surgical site care, constipation, pain control, prevention of clot formation.

Peds, perioperative care.
Maintain normothermia, identify proper electrocautery pad size for the client prior to surgery. If client was anxious in intubation more than likely they will be anxious on extubation. Teens usually wake up very combative and vocal.

Older adults perioperative care.
The older adult is at risk for developing a surgical infection, skin assessment is essential, dementia, confusion, risk for falls and depression need to be considered. Older patient is at higher risk for developing clots. Deep breathing and coughing education starts in the preoperative phase.

Perioperative nutritional assessment includes what?
weight, BMI, food preferences and total protein serum levels.

When does the pain assessment begin?
during the pre-op phase and continues through all perioperative phases.

Essential information to gather during the pre op phase?
allergies, previous surgeries, medications taken, history with the use of anesthesia, hearing aids, glasses, NPO status CLIENT HAS TO REMAIN NPO status 8 hours before surgery, retained hardware or metal, VTE assessment and cultural assessment, communication, drug and alcohol assessment.

Why can’t the patient eat or drink anything 8h prior to surgery?
it increases risk for aspiration.

What increases risk for clot formation?
Longer surgeries. Heparin or lovenox is normally administered.

When is hair clipped for surgical procedures?
The day of surgery, hair is clipped NOT SHAVED.

Showers the day prior to surgery?
clients undergoing surgical procedures below the chin should complete 2 pre-op showers with CHG before surery..

What is intraoperative care?
Constant monitoring of the client and surgical environment,

How does the length of a surgical procedure impact the client?
The longer the procedure the higher the risk of complications for that client. The longer exposure to anesthesia, the longer the recovery time and increase of problems, higher chances of hypothermia, higher risk for clots and greater risk for blood loss.

How would you position a patient who is undergoing an appendectomy?
supine

Anesthesia option for a patient with acute appendicitis?
Local, MAC, general, and block.

Best anesthesia option for an appendectomy
Local anesthesia, the client is wake during the entire procedure, circulating nurse monitors clients vitals, the surgical area receives local anesthetics.

MAC anesthesia.
Used when the patient needs to communicate with the surgen during a surgical procedure,

General anesthesia.
Medically induced coma, client is intubated, client is monitored.

Block, specific region of the client is anesthetized.
birth, foot amputation, hip replacement. The client may be awake, can be used along with general anesthesia.

What is the purpose of a surgical prep?
The purpose of a surgical prep is to help minimize surgical site infections.

When does the wound class needs to be identified?
At the beginning and ending of a procedure.

What happens to the wound class if there is a break in sterility?
The wound class increases one level. The more breaks in sterile technique the higher the wound class.

What does post op care consist of?
PACU, surgical or procedural area to which the client is transferred in order to recover.

Major responsibilities of the post op nurse?
Ensure airway management, reduce the potential for post op complications and address client pain and anxiety.