Lecture Notes on Perioperative Nursing Care

Introduction

• Active Learning: Engage actively with the content; think beyond exams to real-life nursing situations.
• Self-Reflection: Assess prior knowledge, experiences, and knowledge gaps regarding the topic.
• New Perspectives: Be open to evolving your understanding with new information.

Phases of Operative Care

• Preoperative Nursing Care

  • Learning Objectives: Understand and measure objectives after the session.
  • Patient Assessment & Preparation: Varied based on surgery type and patient factors (e.g., comorbidities like heart failure, COPD).
  • Responsibilities: Include patient education, identity verification, informed consent, and completing legal documentation.
  • Resources: Use videos and checklists available online for additional guidance.
  • Patient Safety & Psychosocial Care: Address anxieties and holistic needs during the pre-op stage.

• Intraoperative Nursing Care

  • Team & Roles: Surgeon (leader), Circulating Nurse (coordinates, verifies ID/procedure), Scrub Role (assists with instruments), Anesthesiologist/CRNA (monitors anesthesia & vitals).
  • Safety & Infection Prevention: Focus on sterility, assessing fire risks, and preventing infections.
  • Anesthesia:
    • Types: General, regional, light sedation, local.
    • Considerations: Loss of reflexes, ventilatory function, and possible impairments.
    • Complications: Anesthesia awareness, nausea/vomiting, aspiration, anaphylaxis, hypoxia, hypothermia, malignant hyperthermia.
    • Malignant Hyperthermia: Rare, often fatal without treatment like dantrolene.

• Postoperative Nursing Care

  • Common Complications: Circulatory issues, infections, dehiscence, evisceration, GI and urinary complications, pneumonia, atelectasis.
  • PACU Responsibilities: Conduct head-to-toe and focused assessments, emphasis on patient safety and comfort.
  • Vital Signs Monitoring: Progress from frequent checks to less frequent as patient stabilizes.
  • Discharge Criteria: Varies if patient is going home or to an inpatient unit.
  • Communication: Effective handoff between PACU and floor nurses is crucial.
  • Advocacy: Ensure stable patients are transferred to the floor to prevent overload.

Reflection & Application

• Pause and Think: Consider nursing responsibilities in different phases and patient scenarios.
• Compare Anesthesia Types: Understand when each type is used and the nursing responsibilities.
• Family Care: Consider family needs during intraoperative phase.
• Prioritize Patient Care: In post-op scenarios, identify priorities and potential complications.

Conclusion

• Review & Test: Continuously review notes and test understanding against learning objectives.
• Focus on Mastery: Identify gaps, seek answers, and ensure mastery of content to achieve learning goals.