PERIOPERATIVE NURSING Flashcards
Nursing care provided in the total SURGICAL experience of the Patient
Perioperative nursing
ZONES in the OR
- outside the OR complex
- hospital lobby
Outer zoens (non restricted Sub a)
ZONES in the OR
- interchange
- dressing rooms
Outer Zones (non restricted sub B)
ZONES in the OR
- Holding Area
- Storage Room
- Scrubbing Area
- PACU
CLEAN ZONE (Semi Restricted Zone)
ZONES in the OR
- OR room
- Storage area w/ sterile supplies
- open sterile package
Restricted Zone (Sterile)
ZONES in the OR
- close to the exit doors
Disposal Zone
Pathologic Process
- wearing of surface
Erosion
Pathologic Process
- Impairment of vital fluids
Obstruction
Pathologic Process
- Abnormal new growth
Tumor
Pathologic Process
- rupture
ex. due to abdominal alterations
Perforation
CLASSIFICATION OF SURGERY BY PURPOSE
- To make a diagnosis
ex. Biopsy
Diagnostic
CLASSIFICATION OF SURGERY BY PURPOSE
- Extensive way to diagnose
- manual or with cameras
- expensive
ex. Ex-Lap
Exploratory
CLASSIFICATION OF SURGERY BY PURPOSE
- Relieve of burden
- give comfort
- last treatment modalities
ex. Amputation
Palliative
CLASSIFICATION OF SURGERY BY PURPOSE
- Treatment of disease
ex. Angioplasty
Curative
CLASSIFICATION OF SURGERY BY PURPOSE
TYPES of CURATIVE:
- Removal of Organ
- -ectomy
Ablative
CLASSIFICATION OF SURGERY BY PURPOSE
TYPES of CURATIVE:
- Repair of organ (Congenital)
- Constructive
CLASSIFICATION OF SURGERY BY PURPOSE
TYPES of CURATIVE:
- Repair of organ (Damaged)
Reconstructive
CLASSIFICATION OF SURGERY BY PURPOSE
- Beautification
- correction of defect
Cosmetic surgery
CLASSIFICATION OF SURGERY BY URGENCY
- Save life
- w/o delay
ex. gunshot wounds, Stab wounds
EMERGENT
CLASSIFICATION OF SURGERY BY URGENCY
- can be delayed up to 24-30 hours
Urgent
CLASSIFICATION OF SURGERY BY URGENCY
- planned surgeries
- it will not cause harm if surgery is not performed
Elective
CLASSIFICATION OF SURGERY BY URGENCY
- few weeks to months
ex. thyroid surgeries
Required
CLASSIFICATION OF SURGERY BY URGENCY
- patient decision
ex. Cosmetic surgeries
Optional
CLASSIFICATION OF SURGERY BY DEGREE OF RISK
- not prolonged
- local anesthesia
- minor bleeding
Minor Surgeries
CLASSIFICATION OF SURGERY BY DEGREE OF RISK
- Prolonged (more than 2hrs)
- local or general anesthesia
- > < 300 ml of blood
Major Surgeries
CLASSIFICATION OF SURGERY BY EXTENT:
- only affected area is involved
Simple
CLASSIFICATION OF SURGERY BY EXTENT:
- (+) extension beyond surgery
Radical
CLASSIFICATION OF SURGERY BY DEGREE OF RISK
If minor becomes radical it will be considered as?
MAJOR
PHASES OF PERIOPERATIVE NURSING
- Patient is admitted up to endorsement in the OR
Preoperative Phase
PHASES OF PERIOPERATIVE NURSING
PREOPERATIVE
What is obtained by the MD
given by the patient
and witnessed by the nurse
Consent
PHASES OF PERIOPERATIVE NURSING
PREOPERATIVE
how many hours atleast for the patient to fast before a surgery
Atleast 8 hours
PHASES OF PERIOPERATIVE NURSING
PREOPERATIVE
How many days should the patient be bowel prep before the surgery
3 days
PHASES OF PERIOPERATIVE NURSING
PREOPERATIVE
Why nail polish is removed before a surgery?
Pulse Ox Accuracy
PHASES OF PERIOPERATIVE NURSING
PREOPERATIVE
Why jewelries and underwear are removed before a surgery?
To maintain sterility
PHASES OF PERIOPERATIVE NURSING
PREOPERATIVE
If the patient had this, it should be remove to prevent possible aspiration of the object
Dentures
PHASES OF PERIOPERATIVE NURSING
- the patient is endorsed to OR up to being enrolled in the PACU
IntraOperative Phase
PHASES OF PERIOPERATIVE NURSING
INTRAOPERATIVE
Members of the OR team
- Surgeons
- Assist Surgeons
- Anesthesiologist
- Scrub Nurse
- Circulating Nurse
PHASES OF PERIOPERATIVE NURSING
INTRAOPERATIVE
- The one in-charge of the overall sterile area
- handling of instruments
SCRUB NURSE
PHASES OF PERIOPERATIVE NURSING
INTRAOPERATIVE
- Coordinates transaction inside the OR
- Responsible for counting instruments
- the gives the go signal before starting the closing
CIRCULATING NURSE
PHASES OF PERIOPERATIVE NURSING
INTRAOPERATIVE
Scrub nurse’s responsibility after surgery
Cleaning of instruments
PHASES OF PERIOPERATIVE NURSING
Patient enrolled in pacu up to stepping down in the Ward
POST OPERATIVE PHASE
PHASES OF PERIOPERATIVE NURSING
POST OPERATIVE
COMPLICATIONS OF SURGERY
Caused by paralysis of vasomotor nerve and volume loss due to dhn or bleeding
Hypotension
PHASES OF PERIOPERATIVE NURSING
POST OPERATIVE
COMPLICATIONS OF SURGERY
Rapid movement of CSF from the brain to the spinal cord vice versa
Spinal Headache
PHASES OF PERIOPERATIVE NURSING
POST OPERATIVE
COMPLICATIONS OF SURGERY
- Break in the aseptic technique
- signs of fever, foul smelling discharges, swelling
Wound infection
PHASES OF PERIOPERATIVE NURSING
POST OPERATIVE
COMPLICATIONS OF SURGERY
Disruption in phases of healing
Wound healing problem
PHASES OF PERIOPERATIVE NURSING
POST OPERATIVE
COMPLICATIONS OF SURGERY
WOUND HEALING PROBLEM:
- Partial or total loss wound edges caused by poor surgical closure, inc. intra abdominal pressure
Wound dehiscence
PHASES OF PERIOPERATIVE NURSING
POST OPERATIVE
COMPLICATIONS OF SURGERY
WOUND HEALING PROBLEM:
- uncontrolled evisseration manifested by seroussangenous discharge
Evisseration
PHASES OF PERIOPERATIVE NURSING
POST OPERATIVE
COMPLICATIONS OF SURGERY:
Prevention of dehiscence or evisseration
- Control activities that inc. intra abdominal pressure such as vomiting, coughing and splinting
- daily wound care
- ambulation; if poor healing, bed rest
DEFINITION OF ASEPSIS
- clean technique
- freedom fr most pathogen
- prevention of transmission
MEDICAL ASEPSIS
DEFINITION OF ASEPSIS
- Sterile technique
- freedom to all pathogen
- prevention of entry of microorganisms
SURGICAL ASEPSIS
CLASSIFICATION OF BASIC SURGICAL INSTRUMENTS
Used to hold tissue or organs together; also obstructs blood vessels
ex. Forceps
Clamping or Hemostats
CLASSIFICATION OF BASIC SURGICAL INSTRUMENTS
used to open or hold body cavity for a better vision
ex. Army navy, richardsons
Retracting Instruments
CLASSIFICATION OF BASIC SURGICAL INSTRUMENTS
Used to cut muscles and tissues
ex. Mayo scissors, Metz
Cutting/dissecting Instruments
CLASSIFICATION OF BASIC SURGICAL INSTRUMENTS
used to hold tissues together w/ a needle in surgical closing and also ligates blood vessels
types:
Sutures
Ligatures
Suturing Instruments
CLASSIFICATION OF BASIC SURGICAL INSTRUMENTS
TYPES OF SUTURES
- comes from environment
- silk
- (+) for allergic reaction due to latex content
- absorbable
NATURAL MADE SUTURES
CLASSIFICATION OF BASIC SURGICAL INSTRUMENTS
TYPES OF SUTURES
- Fine materials
- lesser reactions
- non absorbable
- returns in hospi in 7-10 days for removal of sutures
SYNTHETIC MADE SUTURES
TYPES OF ANESTHESIA
It blocks the nerve impulses
- no sensory
- no motor
- no ans
- can be topical or IV, SubQ
LOCAL ANETHESIA
TYPES OF ANESTHESIA
- it produces a. total loss of consciousness resulting to certain conditions:
- Amnesia
- analgesic
- hypnosia
- seizures
GENERAL ANESTHESIA
TYPES OF ANESTHESIA
infiltrating a peripheral nerve with an anesthetic agent and blocking transmission to avoid or relieve pain.
- numbs a greater portion of the body (abdomen downward)
REGIONAL ANESTHESIA
TYPES OF ANESTHESIA
REGIONAL ANESTHESIA:
- injected in the subarachnoid area
- numbs lower abdominal area, lower extremities
- used in abdominal surgeries
- may progress in to general anes
SPINAL ANESTHESIA
TYPES OF ANESTHESIA
REGIONAL ANESTHESIA:
- introduced in the epidural area
- used in labor and delivery
EPIDURAL ANESTHESIA
TYPES OF ANESTHESIA
REGIONAL ANESTHESIA:
- introduced in the epidural area
- used in labor and delivery
EPIDURAL ANESTHESIA
