Peri operative Care Nursing: CARING is the essence of NURSING

Surgery is a process implemented on the human body that uses instruments to alter tissue or organ integrity. Perioperative is a term used to designate the entire span of operation including what occurs before, during and after the actual operation.

Phases of perioperative care

       I.            Preoperative: It begins with the resolution to perform surgery and continues until the client has reached the operating area.

    II.            Intraoperative: It includes the entire duration of the surgical procedure until transmission of the client to the regaining area.

 III.            Postoperative: It begins with the admission to the retrieval area and remains the client receives a follow up evaluation at home or is discharged to a recuperation unit.

Types of Surgery

·         Diagnostic: Elimination and study of tissue to make  the tissue identification (Pathology)

·         Exploratory: It is most extensive to involve the exploration and examination of a body cavity or use of scopes inserted though small incision.

·         Curative: Replacement or elimination of defective tissue to restore function.(Joint)

·         Palliative: Release of symptoms or enhancement of function without cure. (Thyroidectomy)

·         Cosmetic: Rectification of deficiencies, development of appearance or change to a physical feature. 

Categories of Surgical Nursing Care

1.      Emergency

·         It performs immediately to preserve the function or the life of the patient.

·         Elective - It is performed when the surgical intervention is the favored handling and treatment for a condition that is not imminently life threatening or to improve the patient’s life.

·         Urgent –It is essential for patients health to prevent additional problem from developing, not necessarily a reserve.

·         Required – has to be performed at some point; can be pre-scheduled.

2.      Degree of risk

·         Major –It includes a high degree of risk.

·         Minor – In this normally involves little risk.

·         Age – It contains both very young and elder clients are greater surgical risks than children and adult.

·         General health- The surgery is least risky when the client’s general health is good.

·         Nutritional Status –It is required for normal tissue repair.

·         Medications – It contains the regular use of certain medications can increase surgical risk.

·         Mental status – disorder that affect cognitive function

3.      Diagnostic

·         It allows settling or establishes the diagnosis.

·         Corrective - It includes Excision or removal of diseased body part.

·         Reconstructive - It restore function or appearance to traumatized or malfunctioning tissues.

·         Ablative – This  means eliminates a unhealthy body parts

·         Palliative – it relieves or reduces aching or symptoms of a disease which will not be a curable.

·         Transplant – it can replace the malfunctioning of  structures

·         Cosmetic – Increased to improve personal appearance.

4.      Purpose

                               I.            Review of preoperative laboratory and diagnostic studies:

·         Complete blood count.

·         Blood type and cross match.

·         Serum electrolytes

·         Urinalysis

·         Chest X-rays

·         Electrocardiogram.

·         Other tests related to procedure or persevering person medical conditions such as: prothrombin time, partial thromboplastic time, blood urea nitrogen, creatinine, and other radiographic studies.

                            II.            Review the client’s health history and preparation for surgery

·         History of present illness and reason for surgery

·         Past medical history •Medical conditions (acute and chronic)

·         Previous hospitalization and surgeries

·         History of any past problem with anesthesia

·         Allergies

·         Present medications

·         Substance use: alcohol, tobacco, street drugs

·         Review of system

                         III.            Assess physical needs

·         Ability to communicate

·         Vital signs

·         Level of consciousness Confusion Drowsiness Unresponsiveness

·         Weight and height

·         Skin integrity

·         Ability to move/ ambulate

·         Level of exercise

·         Prostheses

·         Circulatory status

                         IV.            Assess psychological needs

·         Assess psychological needs

·         Emotional state

·         Level of understanding of surgical procedure, preoperative and postoperative instruction

·         Coping strategies

·         Support system

·         Roles and responsibilities

                            V.            Assess cultural needs

·         Language-need for an interpreter

Surgical Risk Factors:

· Age: Very young – Elderly

·         Nutritional Status: Malnourished – Low weight – Obese

·         Medical Problems:

Acute and chronic respiratory problems – Hypertension – Liver dysfunction – Renal failure – Diabetes

Nursing in Health care in preoperative assessment care can be useful in identifying and defining patients’ risk factors and vulnerabilities not just for operation but for the entire perioperative care trajectory. The assumption that communication gaps exist was supported by the research findings. Announcement of patient risk factors and vulnerabilities to the entire perioperative team is critical for a successful transition through the perioperative environment to occur. If patients’ susceptibilities or risks cannot be lessened, they need to at least be recognized so they can be managed as they shift within the complexity of the perioperative atmosphere.