Intraoperative care : Physical environment
Intraoperative care : Physical environment 150 150 Tony Guo

Physical environment Unrestricted areas People in street clothes interact with those in scrubs Holding area Locker room Information areas Nursing station Control desk Semi-restricted areas Peripheral support areas and corridors with only authorized staff Must wear surgical attire and cover all head and facial hair Restricted areas Operating rooms Scrub sink areas Sterile core Surgical…

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Transportation to the OR (Operating Room)
Transportation to the OR (Operating Room) 150 150 Tony Guo

Transportation to the OR Via stretcher or wheelchair Communication “handoff” Situation J.D. is a 45 year-old female with history of breast biopsy positive for breast cancer. She is here today for a right breast lumpectomy to be performed by Dr. Evans. Background She has a family history of breast cancer and appeared anxious this morning,…

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Day-of-surgery preparation
Day-of-surgery preparation 150 150 Tony Guo

Day-of-surgery preparation Final preoperative teaching Assessment and report of pertinent findings Verification of signed consent Labs History and physical examination Baseline vitals Proper skin preparation Nursing notes Hospital gown Patient should not wear any cosmetics Observation of skin color is important Remove nail polish for pulse oximeter Valuables are returned to family member or locked…

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Nursing management : Surgery
Nursing management : Surgery 150 150 Tony Guo

Nursing management Preoperative teaching Patient has the right to know what to expect and how to participate Increases patient satisfaction Reduces fear, anxiety, stress, pain, and vomiting Teach deep breathing, coughing, and early ambulation as appropriate Inform if tubes, drains, monitoring devices, or special equipment will be used postoperatively Provide surgery-specific information Ambulatory surgery information…

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Fluid and electrolyte status
Fluid and electrolyte status 150 150 Tony Guo

Fluid and electrolyte status Vomiting, diarrhea, or preoperative bowel preps can cause imbalances Identify drugs that alter F and E status such as diuretics Evaluate serum electrolyte levels NPO status Surgery delay may also lead to dehydration Patients with or at risk for dehydration  may require additional fluids and electrolytes before surgery

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Preoperative Care : Review of systems
Preoperative Care : Review of systems 150 150 Tony Guo

Review of systems Body systems review Confirms the presence or absence of diseases Alerts to areas to closely examine Provide essential data to determine specific preoperative tests Cardiovascular system Report Any cardiac problems so they can be monitored during the intraoperative period Use of cardiac drugs Presence of pacemaker/ICD 12-lead electrocardiogram (ECG) Coagulation studies Possible…

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Preoperative Care : Nursing assessment
Preoperative Care : Nursing assessment 150 150 Tony Guo

Nursing assessment Overall goals Identify risk factors Plan care to ensure patient safety Establish baseline data for comparison intraoperative and postoperative Determine psychologic status to reinforce coping strategies Determine physiologic factors of procedure contributing to risks Identify and document surgical site Identify drugs, OTC medications,  and herbs taken that may affect surgical outcome Review results…

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Preoperative Care
Preoperative Care 150 150 Tony Guo

Preoperative Care Surgery The art and science of treating diseases, injuries, and deformities by operation and instrumentation Performed for Diagnosis Cure Palliation Prevention Cosmetic improvement Exploration Types of surgical settings Elective surgery )planned event) vs. emergency surgery (may arise with unexpected urgency) Inpatient Same-day admission Ambulatory (same day or outpatient) Patient interview Check documented information…

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Gerontologic considerations : Burn
Gerontologic considerations : Burn 150 150 Tony Guo

Gerontologic considerations Normal aging puts the patient at risk for injury because of the possibility of Unsteady gait Limited eyesight Diminished hearing The fact that wounds take longer to heal Emotional needs of patient and family Self-esteem may be adversely affected Address spiritual and cultural needs Issue of sexuality must be met with honesty Family…

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