Chapter 27 Perioperative Care

1. Chapter 27 Perioperative Care

3. Introduction to OperativeCare Perioperative care is care that clients receive before, during, and after surgery Nurses assume general responsibilities when caring for clients during the preoperative, intraoperative, and postoperative periods of perioperative care

4. Preoperative Period Starts when client, or his family in an emergency situation, learn that surgery is necessary Ends when client istransported to the operating room

5. Types of Surgery According to Urgency

7. Preoperative Period (cont’d) Informed consent Permission for a procedure thata client gives after an explanation of the risks, benefits, and alternatives

8. Surgical Consent Form

9. Preoperative blood donation Autologous transfusion: self-donated blood Directed donors: blood donors chosen from among the client’s relatives and friends If directed donation not used, it is available for use by other clients Preoperative Period (cont’d)

10. Immediate preoperative care Nursing assessment Surgical risk factors Low hemoglobin and red cells Cardiopulmonary disease Malnutrition Dehydration Preoperative Period (cont’d)

11. Immediate preoperative care (cont’d) Preoperative teaching Deep breathing Coughing Leg exercises Postoperative pain management Preoperative Period (cont’d)

12. Immediate preoperative care (cont’d) Physical preparation Skin preparation Elimination Food and fluid restrictions Preoperative Period (cont’d)

13. Preoperative Period (cont’d) Immediate preoperative care (cont’d) Physical preparation (cont’d) Care of valuables Surgical attire Disposition of dentures and prostheses

14. Immediate preoperative care (cont’d) Preoperative medications Psychosocial preparation Preoperative checklist Preoperative Period (cont’d)

15. Preoperative Checklist

17. Postoperative Period Immediate postoperative care Initial postoperative assessments Preparing the room Monitoring for complications Continuing postoperative care Food and oral fluid intake

18. Postoperative Period (cont’d) Continuing postoperative care (cont’d) Promoting venous circulation Pneumatic compression device Antiembolism hose Wound management Elimination

19. Pneumatic Compression Device

21. Postoperative Period (cont’d) Continuing postoperative care (cont’d) Discharge instructions How to care for the incision site Signs of complications to report Which foods to consume or avoid When and where to return for a medical appointment

22. Nursing Implications Applicable nursing diagnoses Deficient knowledge, fear, acute pain Risk for ineffective therapeutic regimen management, infection, impaired gas exchange, deficient fluid volume Ineffective breathing pattern, airway clearance Impaired skin integrity, disturbed body image