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the surgical client

Classifications. SeriousnessUrgencyPurpose. Reasons for Performing. DiagnosticReconstructiveCurative (Ablative)PalliativeTransplant. PREOPERATIVE PHASE. ConsentNature and intentionPerson performing surgeryRisksChance of successPossible alternative measures. Informed consent. Right to refuseConscious, speaks same language, mentally competent, and NOT sedatedAnesthesiologist.

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the surgical client

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    1. The surgical client Preoperative Intraoperative Postoperative

    3. Reasons for Performing Diagnostic Reconstructive Curative (Ablative) Palliative Transplant

    4. PREOPERATIVE PHASE Consent Nature and intention Person performing surgery Risks Chance of success Possible alternative measures

    5. Informed consent Right to refuse Conscious, speaks same language, mentally competent, and NOT sedated Anesthesiologist

    6. Consent Why? Physician has legal responsibility Includes��. Client needs to be��

    7. Preoperative assessment History Current health status Chronic disease Allergies Medications Previous surgeries Mental status

    8. Nursing History Current Health Status Chronic diseases Allergies Medications Previous surgeries Mental status Habits Coping/cultural/social resources

    9. Nursing History Current health status Understanding Smoking Alcohol Coping Social resources Cultural consideration Spiritual consideration

    10. Physical Assessment

    11. Screening Tests UA CBC Type and crossmatch Chest xray ECG Other:

    12. Nursing Diagnoses Deficient knowledge Fear Ineffective coping Anticipatory grieving ???

    13. Planning Expected outcomes

    14. Implementing Surgical Consent Signed? Preop teaching Why??? Surgical Incision Leg Exercises Deep Breathing Pain Control Equipment Turning Pre-op Checklist Physician Preparation

    15. Surgical prep NPO Hygiene Nailpolish Catheter Preop meds Valuables Special orders

    16. Preop checklist

    17. Evaluation Does pt understand surgery? Does pt understand exercises? Post-op plan? Is pt prepared physically & emotionally? ***DOCUMENT, DOCUMENT, DOCUMENT***

    18. Intra-Operative Phase Surgical Area � 3 zones Unrestricted Semi-restricted Restricted

    19. Surgical Team Surgeon Anesthesia Provider Surgical Assistant Scrub Nurse Circulating Nurse

    20. Anesthesia General Regional Local Conscious sedation

    21. Nursing role in operative phase Circulating nurse Scrub nurse

    22. Operative phase focus: Patient safety

    23. Intra-Operative Nursing Process ASSESSMENT DIAGNOSIS OUTCOME IDENTIFICATION & PLANNING

    24. Intra-Operative Nursing Process INTERVENTIONS EVALUATION

    25. Postoperative Phase PACU PRIMARY GOAL:

    26. Post-op Nursing Process ASSESSMENT NURSING DX OUTCOME IDENTIFICATION & PLANNING

    27. Post-op Nursing Process INTERVENTIONS Maintain resp status Maintain circulatory status Maintain neurologic status Manage pain

    28. Post-operative care Pain Positioning Deep breathing and coughing Leg exercises Moving/ambulation

    29. Post-op Hydration Gastric suction Diet Urinary elimination Dressings/drains

    30. Post-op Nursing Process EVALUATION

    31. Ongoing Post-op Care Continues until client is released from surgeon�s care Primary goals: Rest of post-op care based on nursing dx.

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