Chapter 27 Perioperative Care Copyright 2009 Wolters Kluwer

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Introduction to Operative Care • Perioperative care is care that clients receive before, during,

Preoperative Period • Starts when client, or his family in an emergency situation, learn

Types of Surgery According to Urgency Copyright © 2009 Wolters Kluwer Health | Lippincott

Preoperative Period (cont’d) • Inpatient surgery – Term used for procedures performed on a

Preoperative Period (cont’d) • Outpatient surgery – Term used for operative procedures performed on

Preoperative Period (cont’d) • Informed consent – Permission for a procedure that a client

Preoperative Period (cont’d) • Immediate preoperative care – Nursing assessment o Surgical risk factors

Preoperative Period (cont’d) • Immediate preoperative care (cont’d) – Preoperative teaching o Deep breathing

Preoperative Period (cont’d) • Immediate preoperative care (cont’d) – Physical preparation o Skin preparation

Preoperative Period (cont’d) • Immediate preoperative care (cont’d) – Physical preparation (cont’d) o Care

Preoperative Period (cont’d) • Immediate preoperative care (cont’d) – Preoperative medications – Psychosocial preparation

Preoperative Checklist Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Postoperative Period • Immediate postoperative care – Initial postoperative assessments – Preparing the room

Postoperative Period (cont’d) • Continuing postoperative care (cont’d) – Promoting venous circulation – Wound

Postoperative Period (cont’d) • Continuing postoperative care (cont’d) – Discharge instructions o How to

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Introduction to Operative Care • Perioperative care is care that clients receive before, during, and after surgery • Nurses assume general responsibilities when caring for clients during the preoperative, intraoperative, and postoperative periods of perioperative care Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Preoperative Period • Starts when client, or his family in an emergency situation, learn that surgery is necessary • Ends when client is transported to the operating room Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Preoperative Period (cont’d) • Inpatient surgery – Term used for procedures performed on a client who is admitted to the hospital, expected to remain at least overnight, and needs nursing care for more than 1 day after surgery – Clients who have inpatient surgery undergo prior laboratory and diagnostic tests Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Preoperative Period (cont’d) • Outpatient surgery – Term used for operative procedures performed on clients who return home the same day Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Preoperative Period (cont’d) • Informed consent – Permission for a procedure that a client gives after an explanation of the risks, benefits, and alternatives Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Preoperative Period (cont’d) • Immediate preoperative care – Nursing assessment o Surgical risk factors § Low hemoglobin and red cells § Cardiopulmonary disease § Malnutrition § Dehydration Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Preoperative Period (cont’d) • Immediate preoperative care (cont’d) – Preoperative teaching o Deep breathing o Coughing o Leg exercises o Postoperative pain management Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Preoperative Period (cont’d) • Immediate preoperative care (cont’d) – Physical preparation o Skin preparation o Elimination o Food and fluid restrictions Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Preoperative Period (cont’d) • Immediate preoperative care (cont’d) – Physical preparation (cont’d) o Care of valuables o Surgical attire o Removal of dentures and prostheses Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Preoperative Period (cont’d) • Immediate preoperative care (cont’d) – Preoperative medications – Psychosocial preparation – Preoperative checklist Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Postoperative Period • Immediate postoperative care – Initial postoperative assessments – Preparing the room – Monitoring for complications • Continuing postoperative care – Food and oral fluid intake Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Postoperative Period (cont’d) • Continuing postoperative care (cont’d) – Promoting venous circulation – Wound management – Elimination Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Postoperative Period (cont’d) • Continuing postoperative care (cont’d) – Discharge instructions o How to care for the incision site o Signs of complications to report o Which foods to consume or avoid o When and where to return for a medical appointment Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins