PeriopConcepts
PeriopConcepts
PeriopConcepts
Section: BSN 3C
Date Submitted: August 22, 2022
Module 1
NCM 112
College of Nursing
WMSU-ISMP-GU-001.00
Effective Date: 7-DEC-2016
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Welcome to the realm of the Perioperative Nursing. It is an area that is fast-paced and
dynamic as well as enlightening, since you will get to appreciate the actual picture and
structure of the human anatomy. It is also rewarding because most often than not you get to
see the improvement of your patient’s quality of life, which is the outcome of the erudite,
compassionate care of the health team.
The patient’s physical and psychological needs are in the hands of the perioperative
nurse and the rest of the team who are expected to ensure the safety and well-being of the
patient. A patient’s pathway through the perioperative environment starts when the patient
learns of the need for the surgery and agrees to the mode of treatment (preoperative), to the
surgical intervention (intraoperative), and finally to recuperation phase, wherein the
patient’s state of health is comparable to the pre-illness state or an improvement of the
patient’s health status achieved (postoperative).
Hence, the perioperative nurse provides care for patients in the period before, during,
and after surgical intervention. Each phase requires nurses to render comprehensive attention,
that will ensure the safety of the patient under one’s care.
However, while each nurse plays a different role, they work as a team focusing on one
patient at a time with one goal in mind, the betterment of their patient. The competence,
meticulous attention to detail, and altruism, ensure that these goals will come to fruition.
This module addresses Perioperative Care in three lessons. Lesson 1 introduces
preoperative phase, Lesson 2, the intraoperative phase, and Lesson 3 discusses about the
postoperative period. Throughout all these lessons, the nursing process framework will be in
the forefront of the discussion.
INTRODUCTION
The preoperative period starts when the patient, the patient’s family, or significant
other, is advised on the need for surgery and decides to undergo the surgical procedure. This
is the phase where the professional bond is established between the patient and the health
team. It is also during this phase that the patient is prepared physically and psychologically
for the impending surgery. This period ends when the patient is received by the intraop nurse
and transferred to the operating room bed.
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LEARNING OUTCOMES
Topic Outline:
TRY THIS!
“You go in through the front door of the hospital and depending on how successful your
treatment is, determines whether you leave through the front door
or in a box out of the back door.”
― Steven Magee
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THINK AHEAD!
For lesson 1, you need to select only one identified individual from your short list.
Record the experiences of your participant from the time of admission, and before
being transported to the operating room. The table below will serve as your guide in
this activity as you vicariously journey along with your learning partner.
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The information you have gathered will direct you as to the process of interacting and
caring for a preop patient. As you go through this module, you will realize that there might be
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some procedures/activities that were not carried out or additional ones were done. There is
nothing to be alarmed about since each individual situation is unique and is treated according
to the hospital’s policy where they were confined.
Congratulations! You may not have been exposed to the surgical areas; nonetheless,
you were able to vicariously experience the care that is given to a patient in this area. One
tiny step at a time toward achieving the goal of familiarizing yourself with the role of a
perioperative nurse.
We start with the familiarization of some surgical terms. The best method of doing this is by
exploring the medical prefixes and suffixes. Medical terms will be easier to understand once
you grasp the meaning of the combined words. For additional examples you can click on the
hyperlinks included. https://www.caregiverology.com/medical-prefixes-suffixes.html
https://www.thoughtco.com/biology-prefixes-and-suffixes-otomy-tomy-373769
A. Glossary of Terms
1. Prefixes can be seen at the beginning of a medical word. They refer to the site or the
body part being discussed.
a. (angio-) signifies a type of receptacles such as vessel (e.g. angioplasty)
b. (arthro-) refers to a joint or a junction that separates different parts
(e.g. arthroplasty, arthroscopy)
c. (endo-) means inner or internal (e.g. endoscopy)
d. (epi-) indicates a position that is above, on, or near a surface (e.g. episiorrhaphy)
e. (hystero-) denoting the uterus (e.g. hysterectomy, hysterotomy)
f. (nephro-) referring to the kidney (e.g. nephrectomy)
g. (thoraco-) indicating the chest (e.g. thoracotomy, thoracentesis)
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2. Suffixes, when applied to medical terms would connote a procedure, condition, or disease
of the body part. These letters are situated at the end of words which changes the original
meaning.
a. (-centesis) to puncture a cavity to remove fluid (e.g. amniocentesis, arthrocentesis)
b. (-ectomy) to remove or excise (e.g. appendectomy, cholecystectomy)
c. (-ostomy) the surgical creation of an opening in an organ for the removal of
waste (e.g. colostomy, tracheostomy)
d. (-otomy) the cut or make an incision but without removal (e.g. craniotomy,
e. (-oorhaphy) to repair or suture (e.g. cystorrhaphy, herniorrhaphy)
f. (-opexy) surgical suspension or fixation (e.g. hysteropexy)
g. (-oplasty) surgical repair or remodel (e.g. angioplasty, rhinoplasty)
h. (-otripsy) crushing or destroying (e.g. lithotripsy)
i. (-scopy) examination often related to visual observation with an endoscope (e.g.
endoscopy)
B. What is surgery?
Also termed as operation, it is the branch of medicine performed for the purpose
of mechanically altering the human body by the incision or destruction of tissues.
(American College of Surgeons, lifted July 4, 2020)
C. Categories of Surgery
The classification of surgical procedures are grouped into according to their urgency, risk,
and purpose.
According to Urgency
Type of Surgery Description Examples
Removal of inflamed
appendix
Control of hemorrhage from
Performed immediately or as gunshot or stabbed wound
1. Emergent soon as possible Repair of severe accidental
Without delay trauma
Extensive burns
Bladder or intestinal
obstruction
Requires prompt attention Acute gallbladder infection
2. Urgent
Within 24-30 hours Kidney or ureteral stones
Prostatic hyperplasia without
Patient needs to undergo surgery bladder obstruction
3. Required
Within a few weeks or months Thyroid disorders
Cataracts
Performed for the patient’s well-
being but is not urgent Repair of keloid formation
4. Elective May be planned weeks or months Herniorrhaphy
ahead of the procedure Colporrhaphy
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According to Risk
Risk deals with the probability of morbidity or death from surgery.
The risk period covers the entire perioperative phase
Risk Factors Components Nursing Responsibility
Age Extremely young or old Detailed assessment
Obese or emaciated Initiate teaching
Nutrition
Nutritional deficits appropriate to patient’s
Fluid and Electrolyte Dehydration needs
Balance Electrolyte imbalance Involve family during
Problems with the: interview and health
Pulmonary teaching
Cardiovascular Verify completion of
General Health Status Liver preoperative diagnostic
Renal testing
Metabolic disorders Ensure patient and family
Infection understanding of surgeon’s
Anticoagulant preoperative orders
Tranquilizers Examine and review
Antibiotics advanced directive
Medications
Diuretics document
Anti-hypertensives Initiates
Long term steroid therapy discharge
planning
According to Purpose
Approach Rationale Example
This method is done by the
excision or incision of a
specimen for laboratory
1. Diagnostic Breast biopsy
analysis in order for
confirmation of the surgeon’s
diagnosis.
Opening into the
Performed to confirm the abdominal cavity to
2. Exploratory extent or to make or confirm a assess abnormal tissue
diagnosis growth or trauma
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A surgical intervention to
repair or remove an organ or a
portion of it for the described
as the following:
Reconstructive - repair of Plastic surgery for
tissues or organs whose considerable area of
4. Corrective or appearance or function was scarring due to burn
curative damaged
Constructive - refers to the Cleft lip or palate
repair of congenitally
malformed organs
Ablative – (to take away or Gallbladder or appendix
cut off) refers to the
removal of diseased organs
D. Pre-Admission Practices
Total analysis of the blood, organ functions, and medical routines are started in the
preop period
Nursing care plan is based on the data and evidences gathered
Procedures Rationale Nursing Responsibility
1. Medical history and physical Allergies and sensitivities Establishes the baseline vital
examination should be noted signs
3. Blood type and cross In events of blood Ascertains that the required
matching transfusion (BT) laboratory and diagnostic
Appropriate examinations are carried out
documentation should be with the patient’s safety in
completed for patients mind through:
who refuse BT Confirming that the
patient understands the
procedure to be done
Clarifying
uncertainties
Ensure the patient’s’
comfort during the
procedures
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E. Pre-Operative Preparations
Before transporting patient to the Operating Room
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JDC is a 46-year-old woman who was admitted a day before to the surgical ward for
laparoscopic cholecystectomy under general anesthesia. On physical examination, her vital
signs are the following:
Temperature is 36.6°C (97.88°F),
Blood Pressure is 120/ 76mmHg.
Pulse is 82 beats per minute
Respiration is 21 breaths per minute
Weight is 72 kgs
Height is 5’0
Upon admission, her medical record presented with a 24-hour history of abdominal pain
that began approximately 1 hour after a large dinner. The pain initially began as a dull ache in the
epigastrium but then localized in the right upper quadrant (RUQ). She described some nausea but
no vomiting.
Since her consultation in the emergency department, the pain has improved significantly to
the point of her being nearly pain free. She describes having had similar pain in the past that would
resolve after a few hours.
Physical examination showed that the abdomen is nondistended with minimal tenderness in
the Right Upper Quadrant (RUQ). Findings from the liver examination appear normal. The rectal
and pelvic examinations reveal no abnormalities.
Her complete blood count reveals a white blood cell (WBC) count of 13,000/mm 3. Serum
chemistry studies demonstrate total bilirubin 0.8 mg/dL, direct bilirubin 0.6 mg/dL, alkaline
phosphatase 100 U/L, aspartate transaminase (AST) 45 U/L, and alanine transaminase (ALT) 30
U/L. Ultrasonography of the RUQ demonstrates stones in the gallbladder, a thickened gallbladder
wall, and a common bile duct (CBD) diameter of 4.0 mm.
Today is your patient’s day for surgery. As JDC’s preop nurse, you need to
complete the following task to ensure a safe and successful operation.
b. Risk- Nutrition- the BMI of the patient is 30.1 which falls on the obesity category.
c. Purpose- Exploratory- Finding out the extent of diagnosis.
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3. Create your preoperative plans in preparing the patient for surgery and give the rationale
Preoperative Preparations
Nursing Care Rationale
1. Correcting any dietary deficiencies. The body needs a variety of vitamins and minerals to
function properly. It can't produce these nutrients on its
own, however, so it needs to get them from your diet.
2. Reducing an obese person’s weight as Preventing obesity helps you reduce your risk of a host
time permits. of associated health issues, from heart disease to
diabetes to some cancers and much more. Like many
chronic conditions, obesity is preventable with a
healthy lifestyle—staying active, following a healthy
diet, getting adequate sleep, and so on.
3. Correcting fluid and electrolyte imbalances. Electrolytes are minerals in your body that have an
electric charge. They are in your blood, urine and body
fluids. Maintaining the right balance of electrolytes
helps your body's blood chemistry, muscle action and
other processes.
4. Treating any infectious process. Infection control prevents or stops the spread of
infections in healthcare settings.
5. Restoring adequate blood volume/transfusion. This potentially life-saving procedure can help replace
blood lost due to surgery or injury. A blood transfusion
also can help if an illness prevents your body from
making blood or some of your blood's components
correctly.
Good job! You are now ready to move into the next phase.
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INTRODUCTION
The Intraop phase begins with positioning of the patient on the operating room bed
and continues until the patient is admitted to the post anesthesia care unit (PACU).
Implementation of the plan and evaluation of care continue during this phase. The
perioperative nurse either functions as a scrub or circulating nurse who applies the patient’s
plan of care efficiently and effectively, with the patient’s safety being taken into
consideration. In some instances, modifications of the care plan can occur when essential.
The patient is the most important person inside the operating room. This is
because the patient is at their most vulnerable, WHY the helplessness? This is because of
their reduced or absence of sensations of pain and depressed reflexes. You will observe a
patient who is:
unable to act or make personal care decisions
incapable of communicating
defenseless against injury.
These weaknesses increase patients’ surgical risks, thus health care workers should ensure
that patent is safe all throughout the intraoperative phase.
LEARNING OUTCOMES
At the end of this session, you should be able to:
Topic Outline:
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TRY THIS!
You are the circulating nurse of patient JDC whom you met a day prior for a preop
visit. As the intraop nurse, determine the initial measures that you should observe as you
receive the patient from the preop nurse to ensure a safe and successful surgery.
For lesson 2, the Circulating Nurse’s responsibilities are enumerated, you are now
tasked to do the following:
1. Analyze their expected role and give the rationale for each intervention.
2. Compare your assumptions to the answers in page 16.
THINK AHEAD!
Circulating Nurse Responsibility Rationale
1. Greets and introduces self To establish rapport and to verify identity to the
patient as well as to the doctors and nurses in the
operating field. It is a form of treating the patient as an
individual, not a faceless
part of the job.
2. Covers patient with a warm blanket To prevent hypothermia and to keep the patient warm
and comfortable.
3. Compares patient’s identification by name To verify and assure patient’s identification.
and date of birth
4. Inspects the side rails, restraining straps, To provide patient’s safety.
IV infusions, indwelling catheter if secured
5. Observes for reaction to medications Monitoring the patient’s status will aid to the success of
procedure to also minimize any medical error.
6. Observes patient’s level of anxiety Talk to the patient regarding his/her feelings regarding
to the procedure. Report any inappropriate response to
the physician in-charge.
Consent is necessary in every medical procedure
7. Checks for: because it serves as an agreement between the
Consent patient and the physician, as well as the patient
and the hospital. In addition, laboratory, medical
Laboratory and diagnostic results
record and diagnostic results should be reviewed
Medical record before the procedure to minimize error during the
procedure.
Assessing the patient is necessary. Monitoring the
8. Reviews the plan of care and the surgical patient and providing the needs of the patient will
checklist regarding: aid to a successful procedure and it will also
Allergies minimize medical malpractice, negligence and
errors.
Previous reactions to anesthesia, blood
transfusion
Patient’s unique and individual needs
9. Cover the patient’s head with a cap Covering the patient’s head with a cap will aid to
prevent cross contamination.
3. Were you able to correctly guess the reasons for the interventions? fall Check the
box corresponding to your result. Remember, this is a self-evaluation, your score
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Scrubs
Dons s
Enters
Handle
patient
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Circulating Nurse – holding patient’s chart, with blue-colored, clean surgical gloves
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II. Anesthesia
I. Definition:
A loss of feeling, sensation of pain and protective reflexes
Analgesia – absence of sensibility to pain without loss of consciousness
Anesthesiology – branch of medicine, it is the administration of medication or
anesthetic agents for the purpose relieving pain while supporting physiologic
functions
Anesthetics – drugs that produces local or general loss of sensibility
II. Choice of anesthesia is done by the:
Anesthesia provider (anesthesiologist)
Surgeon
Patient
III. Primary consideration in providing anesthesia
Low morbidity
Low mortality
Lowest concentration
IV. Types of Anesthesia
1. General
2. Spinal and epidural
3. Local
1. General Anesthesia
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3. Local Anesthesia
CIRCULATING NUR
(supervisor, adviser, teach
Applies the nursing process in directi coord
Creates and maintains a safe, and com envir
Provides assistance to any of the OR t that t
Identifies environmental danger or str invol
Maintains communication link betwee
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SCRUB NURSE
1. These practices are based on sound scientific principles and are carried out
primarily to prevent the transmission of microorganisms that can cause infection
2. An object can be aseptic without being sterile
3. It is impossible to remove all microorganisms from the environment, nevertheless,
every effort is made to maximize and control the organisms.
ASEPSIS – the absence of pathogenic (viruses, bacteria, fungi, protozoa, and worms) microorganisms that c
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Guidelines Practice
Unsterile gloves are used handle
1. Items in use may be sterile or contaminated or dirty items
unsterile Sterile gloves are used within the sterile
field
2. Items are used for individual patient A disposable item should not be washed
only and reused for another patient
The brush used in surgical scrub is not
considered sterile at any time during its
3. Items are not always used within a
use, yet aseptic practice in surgery requires
sterile field
the hands to be cleaned before donning
sterile gown and gloves.
An oral suction tip that fell on the floor is
discarded and a new one is obtained even
4. Contamination is contained
though the mouth is not considered part of
the sterile field
5. Reusable items must be terminally Instruments and accessories are either gas
sterilized or high-level disinfected or steam sterilized before usage
A reusable item may be stored in opened
6. Items are not necessarily stored in
state if it is not to be used within a sterile
sterile condition
field
STERILE TECHNIQUE
The patient is the center of the sterile field to include the surgical team, the OR
bed, and the furniture to be used
Guidelines Practice
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during: glove
a) Setting up for an invasive procedure Patient’s skin is prepped (painted with
b) Preparation of the sterile team to skin antiseptic) and draped (covered
handle the sterile supplies and come with sterile drapes
in contact with the surgical site Breaks in sterility are immediately
c) Creation of the sterile field corrected
d) Maintenance of the sterile field
Ster
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1. As the circulating nurse, create a care plan to ensure your patient JDC is safe and
comfortable inside the operating while she is being prepared for anesthesia induction.
Remember to include the rationale.
2. As the CN for this surgery, organize your plan of care based on the Principles of
Aseptic and Sterile Techniques, your responsibilities to ensure that sterility is observed
all throughout the procedure. Select only the principles that are applicable to your role.
As always, include the rationale. (I have identified 9, are we in the same page?)
Principle Rationale
1. Only sterile items are used within the • If in doubt, consider it unsterile
sterile field. • Contaminated items must not be placed in the
sterile field
2. Sterile persons are gowned and gloved. • Scrubbed persons should remember that:
- Anything outside of the yellow frame is
considered unsterile
3. Sterile persons touch only sterile items • Maintain contact with the sterile field by
or areas. means of gowns and gloves
• Avoid leaning over or against a nonsterile field
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4. Unsterile persons avoid reaching over • Circulating nurse does not come into contact
the sterile field. with the sterile field and should remember to:
- Stand at a distance when pouring solution into
sterile receptacles.
5. The sterile field is created as close as possible • Contamination is imminent when sterile items
to the time of use. that are unnecessarily exposed to the environment.
6. Sterile areas are continuously kept in • Sterile persons face the sterile areas
• A staff must remain in the room once sterile
view. packs are opened, to ensure that sterility is not
compromised
7. Sterile persons keep contact with • Avoid leaning on sterile tables or on the
sterile areas to a minimum. draped patient – leaning on the patient can cause injury
to tissues and structures
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INTRODUCTION
LEARNING OUTCOMES
At the end of this session, you should be able to:
1. Categorize patient’s condition according to the immediate postop and post anesthesia
assessment
2. Arrange in order of priority care of the patient upon admission to the PACU
3. Validate patient’s data and needs postoperatively before endorsement to the
surgical ward
4. Develop the immediate postop nursing care and rationale
Topic Outline
I. Post anesthesia care
II. Admission to the PACU
III. Postoperative observation in the PACU
IV. Discharge from the PACU
Try this!
Consider the image below. This picture depicts the care of an immediate postoperative patient. You
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THINK AHEAD!
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10
9 Excruciating Pain Cannot function. Unable to move
8
7 Very Severe Pain Intense cramping pain. Interferes with basic need
6
5 Severe Pain Distressing. Interferes with concentration
4
3 Moderate Pain Interferes with tasks. Uncomfortable
2
1 Mild Pain Bearable pain. Can be ignored
0 No Pain
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11. Location and contact information for The presence of family or significant
significant other or caregiver others is important in providing
Social information effective psychological and emotional
Communication barriers support.
Language Knowledge of cognitive and
Cognition communication challenges will enable
the nurse to counter them accordingly
1. After going through the three phases of perioperative nursing care, you are now familiar
with the interventions that are needed to render effective care. You are therefore tasked to
synthesize the nursing care from pre to intra to postop care with their rationale.
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12.Continue to support the patient emotionally. Anxiety level may be high at this time.
Accomplish the Preop checklist as provided by Accomplishing preop checklist will serve as a
the institution/hospital. documentation of preoperative care.
Receiving Patient in The Pre-Surgical Area
1. Greet patient. Introduces self Introducing self is the first, integral part of the
treatment process. It is a form of treating the patient
as an individual, not a faceless
part of the job.
2. Cover patient with a warm blanket • To keep patient warm and prevent
hypothermia
3. Verify patient identification • To decrease the instances of performing the
• By name and date of birth wrong procedure on the wrong patient
• The use of two patient identifiers improves
• Ask the patient to state and or spell their the reliability of the patient identification process
name
• Check identification against patient’s
chart, surgical procedure, site, and surgeon
verbally with the patient and/or family as
appropriate
4. Check: rails, straps, IVF, catheters • To ensure patient’s safety
5. Observe level of anxiety. • An anxious patient can cause the delay or
postponement of the procedure
6. Check the patient’s medical records for: • Consent forms authorizes the attending
Consent physician and the health care staff to render
Laboratory results treatment
Medical history and physical exam • Patient’s records will serve as the baseline
Verify allergies and medication history for treatment and interventions
7. Check skin tone and integrity • Assessment of patient is a continuous
process in all perioperative phases. The surgeon
should be notified of any
remarkable changes
8. Verify physical limitation • To enable the intraoperative team to assist
patient during positioning and transfer
9. Cover the head with a cap • To protect hair in case patient vomits
• Prevent cross contamination
• Prevent hypothermia
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findings o Medications
6. Blood loss and fluid replacement o Fluid and electrolyte
Includes intake and output imbalances
7. All medications given in PACU o Cross contamination
Pain o Coordinated care with other
Postop nausea and vomiting allied health care workers
IV Fluids
8. Dressings and drains
Foley catheter
9. Tests and treatments performed in PACU
and any postop orders
11. 10. Valuables and their quality Removable prostheses are
Prosthetics safeguarded by the PACU nurse then
Eyeglasses properly endorsed to the postop nurse
Hearing aids for any changes in the usage
Others
2. Recall your preop activity. Remember your perioperative learning partner and his/her
journey through the surgical experience. Your task is to:
a) Determine the perioperative nurses’ responsibilities that were missed. Use the
given table below. Enter only those that were not carried out regardless of the
quantity.
b) Write a reflective journal based on the enumerated missed nursing care.
c) You will be evaluated according to the Rubric on Reflective Journal (See
Appendix A. You will find the write-up about this method (reflective journaling)
in the Appendices.
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the patient.
2.Position the client to promote patent airway This will aid to comfortable status of the patient.
and prevent aspiration.
3.Avoid exposure of the client. This is to protect privacy and prevent chills.
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REFLECTIVE JOURNAL
Within the nursing profession, perioperative nursing is a fascinating specialty. In this area of nursing,
patients are cared for at three separate stages. Preoperative, intraoperative, and postoperative care are provided
during these phases. This topic interests a lot of nurses and nursing students, and some even decide to specialize in it
for a variety of reasons. Most frequently, it's because they want to work in a fast-paced atmosphere, enjoy staff
camaraderie, help those in need, and concentrate on the surgical patient at hand. All nurses and nursing students
should aspire to excel in this specialist field and deliver the best, most effective treatment possible.
The road to surgery for a patient is essential for getting them ready. This is the pre-admission preparations.
The need for patients to be completely prepared has been established in order to limit the possibility of cancellations
or delays and maximize the number of patients having surgery (maximizing theatre utilization). In addition,
preadmission treatments' efficacy is shown by the accompanying drop in case cancellations, shorter hospital stays
linked to better patient wellbeing, and raised patient satisfaction. By having the patient properly assessed,
investigated, and prepared for the surgery, the pre-assessment preparation plays a crucial role in minimizing
cancellations.
Moving forward, preoperative assessment is the clinical inquiry that comes before receiving anesthesia for
either surgical or non-surgical procedures and that collects information to help choose the best anesthetic plan.
Preoperative evaluation may be necessary for surgery performed in a variety of clinical settings, including hospitals,
clinics, medical offices, dental offices, and other private and public settings. Furthermore, the day before surgery,
the anesthetist used to visit patients in the wards. However, if there were serious comorbidities, surgery could need
to be postponed. A late cancellation is upsetting for the patient and causes the operating room to be underutilized
because it might not be able to book another patient. Preoperative and readmission clinics have made it possible to
control comorbidities, deliver high-quality, secure perioperative care, and decrease cancellations. Various
assessment concepts include making sure that the consultation takes place at the proper time and location. The
setting should give the patient enough privacy, such as a consulting room with just one bed, and the consultation
should go on without being interrupted. The consultation ought to take place a few weeks before the procedure. This
is crucial in order to give time for patient education, especially if there are substantial comorbidities that need to be
managed, special laboratory tests or procedures that need to be ordered, or planning or management of any
anesthetic issues.
Following surgery, a surgical nurse is in charge of keeping an eye on the patient and making sure they
receive high-quality care. A successful recovery for the patient is the primary goal of the postoperative nurse's job,
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which includes assessment, diagnosis, planning, intervention, and outcome evaluation. The proper delivery of care is
essential for preventing the potential side effects of anesthesia or surgical operation. Even though difficulties are
common, at least half of them can be avoided.
In conclusion, I have realized that since we will learn about the true nature and structure of the human
anatomy, perioperative nursing is a fast-paced, dynamic, and educational field. It is also rewarding since we
frequently witness the patient's quality of life improving as a result of the knowledgeable, sympathetic care provided
by the medical staff. The perioperative nurse and the rest of the team are responsible for meeting the patient's
physical and psychological demands while also ensuring their safety and wellbeing.
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REFERENCES
https://www.facs.org/~/media/files/advocacy/state/definition
https://doi.org/10.1016/j.aorn.2017.03.002
John Hopkins University School of Nursing. The B.U.R.P.S. list. Retrieved from
https://nursing.jhu.edu/academics/documents/burps.pdf
Phillips, N. (2017). Berry & Kohn’s operating room technique. 13th edition. Elsevier. eBook.
Rothrock, J.C. (2019). Alexander’s care od the patient in surgery. 16th edition. Elsevier.
eBook.
Smeltzer, S.C., Bare, B.G., Hinkle, J.L., Cheever, K.H. (2010). Brunner & Suddarth’s
Wicker, P. (2015). Perioperative practice at a glance. John Wiley & Sons, Ltd. eBook
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APPENDICES
Appendix A. Rubric on Reflective Journal
CATEGORY 4 3 2 1
SCORE
Intellectual skills
Rich in Substantial Information Rudimentary
content, information is thin and and
Clear General commonplac superficial
1. Critical connections connections e No
thinking made to the are made to Connections connections,
given the given are limited to the given
situation situation to the given situation
situation
High quality Some Little No evidence
relationship evidence of evidence of of
between the relationship relationship relationship
2. Depth of patient between the between the between the
interview, patient patient patient
reflection learning, and interview, interview, interview,
reading learning, and learning, and learning, and
reading reading reading
TOTAL SCORE
19 – 20 = 1.0 10 = 3.25
18 = 1.25 9 = 3.5
17 = 1.5 8 = 3.75
16 = 1.75 7 = 4.0 Final Rating
15 = 2.0 6 = 4.25
14 = 2.25 5 = 4.5
13 = 2.5 4 = 4.75
12 = 2.75 3↓ = 5.0
11 = 3.0 Date
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