nurs 125: peri-op

informed consent

includes name of surgeon to perform procedure

informed consent

components include consent for anesthesia

informed consent

components include consent to administer blood products

full stomach

increases risk for aspiration

preoperative assessment

determine patient’s level of knowledge about procedure

preoperative assessment

confirm informed consent is complete

preoperative assessment

determine patient’s anxiety level

preoperative assessment

obtain relevant information about the patient

patient, procedure, surgeon, position, equipment, imaging studies

surgical pause; series of “correct”s

long-acting antimicrobial soap, 3-5 mins, jewelry removed, nails clean and short

surgical scrub components

malignant hyperthermia

triggering agent causes sustained muscular contraction related to increase in intracellular calcium in concentration

hypermetabolism

acidosis, tachycardia, hypercarbia, glycolysis, hypoxemia, hyperthermia

monitored anesthesia care

MAC

intraoperative assessment

ensure OR consent signed

intraoperative assessment

ensure correct patient positioning

intraoperative assessment

monitor donning of OR attire

intraoperative assessment

ensure supplies are available

intraoperative assessment

check fluid and instruments for temperature

intraoperative assessment

confirm flashed instruments are cool

post-anesthesia care unit

PACU

postoperative assessment

airway patency

postoperative assessment

respiratory status

postoperative assessment

vital signs

postoperative assessment

neurologic function

postoperative assessment

temperature and skin color

postoperative assessment

pain

postoperative assessment

condition of dressings

postoperative assessment

condition of visible incisions

postoperative assessment

patency of IV catheters and drains

postoperative assessment

hydration

preoperative patient teaching

anticipatory guidance

preoperative patient teaching

recovery

preoperative patient teaching

DVT prophylaxis

preoperative patient teaching

mobility

preoperative patient teaching

preventing pneumonia

preoperative nursing actions

ensure removal of jewelry and prosthetics

preoperative nursing actions

inform anesthesia and surgical personnel of presence of any implants

preoperative actions

IV insertion

preoperative patient teaching

what to expect of the OR experience

surgeon, surgical assistants, scrub nurse/surgical technologist

sterile team members

anesthesia provider, circulating RN, unlicensed assistive personnel, OR director/coordinator/manager

nonsterile team members

spinal, epidural, caudal, nerve block

regional anesthesia

intraoperative actions

perform equipment safety check

intraoperative actions

utilize sterile technique

intraoperative actions

assist anesthesia provider during intubation

intraoperative actions

properly ground the patient as indicated

intraoperative actions

keep patient safety belt in place

intraoperative actions

apply support hose and sequential compression devices

intraoperative actions

keep patient warm

intraoperative actions

accurately record number of sponges and sharps

intraoperative actions

accurately measure irrigation fluid

intraoperative actions

keep OR doors closed

intraoperative actions

keep hallways clear of equipment

intraoperative patient teaching

keep family updated

postoperative assessment

urine output

postoperative assessment

pain

postoperative assessment

skin/surgical incision/wounds

postoperative assessment

peripheral pulses, temperature, color

postoperative actions

cardiac monitoring

postoperative actions

document vital signs

postoperative actions

handoff from OR

postoperative actions

document vital signs

postoperative actions

medicate as ordered

postoperative actions

handoff to inpatient unit

postoperative assessment

start admission assessment immediately

postoperative patient teaching

teach family how to care for patient

inpatient unit assessment

full head-to-toe

inpatient unit actions

respiratory care

inpatient unit actions

fluid management

inpatient unit actions

diet management

inpatient unit actions

remove foley catheter

inpatient unit actions

manage constipation

inpatient unit actions

pressure injury prevention

inpatient unit patient teaching

unit education

inpatient unit patient teaching

safety topics

inpatient unit patient teaching

discharge education

jackson-pratt drain

JPD

jackson-pratt drain

wound drain; drain itself in body

jackson-pratt drain

when squeezed and released, excess fluid pulled from body

3

number of times to empty drain through day (more as needed)

milk tube

if drain becomes clogged/not draining properly, you can…

2

number of times per day to milk tube