lecture recording on 18 February 2025 at 16.11.36 PM

Study Notes for Exam 3

Key Points About the Exam

• Exam consists of 15 questions related to nursing practice.

• Emphasis on critical topics relevant to clinical practice.

• Study guide is available for review.

• Pay attention to details for each lecture and chapter.

Course Assignments

• EACU number 4 is due this Sunday.

• Two assignments due next week, keep track of deadlines.

Focus Areas for This Week

• Patient education, information documentation.

• Stress and sleep management.

• Perioperative nursing care (Chapter 50).

Perioperative Nursing Care

• Definition: Involves nursing care provided before, during, and after surgery.

• Three Phases of Care:

  • Preoperative (Preop): Care before surgery, including obtaining informed consent and patient education.

  • Intraoperative (Intraop): Care during surgery, including monitoring and assisting the surgical team.

  • Postoperative (Postop): Care after surgery, monitoring recovery, and managing complications.

Classification of Surgery

• Major vs. Minor Surgery:

  • Major: Involves extensive procedures (e.g., open-heart surgery).

  • Minor: Less extensive procedures (e.g., cardiac catheterization).

• Urgency of Surgery:

  • Elective: Scheduled in advance (knee surgery).

  • Urgent: Requires prompt attention but not immediate (e.g., gallbladder removal).

  • Emergency: Life-threatening situations needing immediate surgery (e.g., traumatic injury).

Surgical Risk Factors

• Conditions that affect surgical outcomes:

  • Respiratory Diseases: Impaired healing and increased risks.

  • Age: Elderly patients may experience longer recovery.

  • Diabetes: Poor wound healing due to high glucose levels affecting blood supply.

  • Obesity: Higher risk for complications due to comorbidities.

Patient Preparation

• Informed Consent: Must be obtained by the surgeon; nurses witness and confirm understanding.

• NPO Status: Patients must refrain from eating/drinking before surgery.

• Preoperative Education: Teach about postoperative care, pain management, and breathing exercises to prevent complications.

Nursing Roles and Responsibilities

• Preoperative Phase: Assess patient’s physical status, teaching about procedures, and ensuring safety measures.

• Intraoperative Phase: Assist the surgical team, monitor vital signs, and manage sterile techniques.

• Postoperative Phase: Monitor recovery, assess pain, manage complications, educate patients on recovery processes (e.g., deep breathing, mobility).

Complications to Monitor

• Atelectasis: Collapsed lung from prolonged immobility. Use incentive spirometry to prevent this.

• Bladder Retention: Monitor patients post-op; inability to void may require interventions like bladder scans.

• Infection Risk: Checking for elevated temperature, increased WBC count, and using proper hygiene practices.

• Mobility Risks: Prevent deep vein thrombosis (DVT) through early mobility and hydration.

Patient Education

• Importance of effective communication regarding procedures and postoperative care.

• Teaching methods include cognitive discussion, demonstration, and role-play.

• It’s crucial to tailor education to older adults, breaking information into smaller, manageable pieces.

Documentation in Nursing

• Accurate, timely, and comprehensive documentation protects the nurse legally.

• Document subjective (patient reports) and objective (observations, lab results) data.

• Use the ISBAR method for handoff communication between nursing staff.

Stress and Sleep in Nursing Care

• Common Sleep Disorders: Insomnia, sleep apnea, narcolepsy.

• Strategies for improving sleep hygiene include regular sleep schedules and minimizing fluid intake before bed for elderly patients.

• Address patients’ stress levels before teaching or implementing care to enhance learning and retention.

Study Notes for Exam 3

Key Points About the Exam

• The exam consists of 15 questions that assess understanding and application of nursing practice concepts.

• It emphasizes critical topics that are immediately relevant to clinical practice settings.

• A comprehensive study guide is available for review to help focus study efforts on key areas.

• Pay attention to details from each lecture and chapter, as questions may come from varied sources and require a deep understanding of the material.

Course Assignments

• EACU number 4 is due this Sunday. Ensure to allocate time for review before submission.

• Two assignments are due next week; keep track of deadlines to avoid late submissions. Check assignment guidelines and grading rubrics thoroughly.

Focus Areas for This Week

• Prioritize patient education, emphasizing the importance of effectively communicating information to patients.

• Enhance skills in information documentation, ensuring clarity and compliance with legal regulations.

• Study Stress and sleep management techniques, as they are integral to patient care.

• Review Perioperative nursing care in detail focusing on Chapter 50, understanding roles, responsibilities and patient outcomes associated with surgical interventions.

Perioperative Nursing Care

• Definition: Involves nursing care provided at three key stages: before (preoperative), during (intraoperative), and after (postoperative) surgery, ensuring optimal patient outcomes.

Three Phases of Care:

1. Preoperative (Preop): Involves comprehensive patient assessments, obtaining informed consent, and providing education about the procedure and recovery process to prepare patients.

2. Intraoperative (Intraop): Involves monitoring patient vitals, assisting the surgical team, maintaining a sterile environment, and ensuring patient safety throughout the procedure.

3. Postoperative (Postop): Involves closely monitoring patient recovery, addressing pain management, preventing complications, and educating patients on discharge instructions.

Classification of Surgery

• Major vs. Minor Surgery:

  • Major: Involves more extensive procedures that often require significant recovery time, e.g., open-heart surgery.

  • Minor: Involves less extensive procedures that typically have shorter recovery periods, e.g., cardiac catheterization.

• Urgency of Surgery:

  • Elective: Scheduled in advance; patients do not require immediate surgery (e.g., knee replacement).

  • Urgent: Requires prompt attention but is not life-threatening (e.g., gallbladder removal).

  • Emergency: Involves life-threatening situations that necessitate immediate surgical intervention (e.g., trauma from car accidents).

Surgical Risk Factors

• Identified conditions that affect surgical outcomes include:

  • Respiratory Diseases: Conditions can lead to impaired healing and increased surgical risks, emphasizing the need for preoperative optimization.

  • Age: Elderly patients may present unique risks, including prolonged recovery times and increased susceptibility to complications.

  • Diabetes: Poor wound healing is a risk due to high glucose levels affecting circulation and healing.

  • Obesity: Patients with higher body mass index (BMI) have increased risks for surgical complications related to anesthesia and wound healing.

Patient Preparation

• Informed Consent: Must be obtained by the surgeon; nurses should facilitate understanding and ensure the patient’s questions are addressed prior to the procedure.

• NPO Status: Patients must abstain from food and drink for a specified period before surgery to reduce the risk of aspiration.

• Preoperative Education: It is essential to educate patients on pain management techniques, potential complications, and postoperative care strategies to facilitate smoother recovery phases.

Nursing Roles and Responsibilities

• Preoperative Phase: Includes assessing the patient's physical status, educating about the procedure, and implementing safety measures.

• Intraoperative Phase: Involves assisting the surgical team, monitoring vital signs, and addressing any immediate concerns during the operation.

• Postoperative Phase: Encompasses vigilant monitoring of recovery, managing pain levels, preventing complications (like infections), and educating patients on necessary post-discharge behaviors.

Complications to Monitor

• Atelectasis: Prevention strategies include using incentive spirometry to promote lung expansion and prevent collapsed lungs following prolonged bed rest.

• Bladder Retention: Monitor patients postoperatively to address inability to void; may require bladder scans or catheterization.

• Infection Risk: Vigilantly monitor for elevated temperature, increased WBC counts, and ensure adherence to proper hygiene practices to mitigate the risk of surgical site infections.

• Mobility Risks: Early mobility and hydration practices help prevent deep vein thrombosis (DVT), promoting safer recovery for patients.

Patient Education

• The significance of effective communication regarding procedures and postoperative care cannot be overstated; it greatly impacts patient recovery.

• Utilize varied teaching methods, including cognitive discussion, demonstration, and role-play to enhance understanding.

• Tailor education strategies specifically for older adults, splitting complex information into smaller, manageable pieces for better retention.

Documentation in Nursing

• Accurate, timely, and comprehensive documentation is critical to protect the nurse from legal liabilities.

• Ensure to document both subjective (what patients report) and objective data (observations, lab results, etc.) appropriately.

• The ISBAR method (Identify, Situation, Background, Assessment, Recommendation) is recommended for clear and efficient handoff communication between nursing staff.

Stress and Sleep in Nursing Care

• Identify and address common sleep disorders, including insomnia, sleep apnea, and narcolepsy, which can significantly impact patient health and recovery.

• Strategies for improving sleep hygiene include establishing regular sleep schedules, minimizing caffeine and fluid intake before bedtime (especially for elderly patients).

• Assess and address patients’ stress levels prior to delivering care teaching or interventions to enhance learning and retention.