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BHARATI VIDYAPEETH DEEMED
UNIVERSITY COLLEGE OF
NURSING SANGLI
SEMINAR
SUBMITTED BY :
MR.MAHESH CHAND
MSC.NURSING
PREOPERATIVE
PREPARATION AND
POSTOPERATIVE
CARE
INTRODUCTION
Patient education is a vital component
of a surgical experiences pre-operative
patient education may be offer...
Definitions.
 Preoperative nursing is a term used to
describe the nursing functions in the total
surgical experience of t...
CLASSIFICATION OF SURGERY:
The type of surgical procedure are classified
according to
1] Seriousness
2] Urgency
3] Purpose
1] Seriousness:
I] Major
II] Minor
I] Major surgery
Involves expensive reconstruction or
alternation in body parts . Poses...
2) URGENCY:
1) ELECTIVE
2)URGENT
3)EMERGENCY
1)ELECTIVE:-
It performed on basis of Clients choice,
is not essential and ma...
2)URGENT:
Is necessary for client health, may
prevent additional problem from developing
(e.g. tissue destruction or impai...
Purpose:
1)Diagnostic :- Is surgical exploration that
allow physician to confirm diagnosis. May involve
removal of tissue ...
The nursing process in the pre
operative surgical phase:
The surgical client may undergo test of
procedures to confirm or ...
ASSESSMENT
 The aim of assessment of surgical client is
to establish the clients normal pre-
operative function to assist...
 MEDICAL HISTORY
 NUTRITION
 PAST HISTORY
 ALLERGIES
 HABITS
 FAMILY HISTORY
 AGE
 OBESITY
 FLUID AND ELECTROLYTE...
PHYSICAL EXAMINATION
 General assessment
 head to toe examination
DIAGNOSTIC SCREENING
 BLOOD INVESTIGATION
 RADIOLOGICAL INVESTIGATION
 ECG

Implementation :
Pre-operative nursing intervention provide
the client with a complete understanding of the
surgical inter...
2)Health Promotion:-
Health problem activity during the
pre-operative phase focus on health
maintenance, prevention or com...
3)Pre –operative teaching
The client education is an important
aspect of the client surgical experiences.
The nurse should...
4)Deep breathing:
One goal of pre – operative nursing
care is to teach the patient how to promote
optimal lung expansion a...
5. INCENTIVE SPIRMETER
 Pre – operative the patient was a spirometer to
measure deep breath expiring maximum effort.
 Th...
THE FOLLOWING STANDARDS HAVE BEEN
ESTABLISHMENT BY ANA TO
DEMONSTRATE CLIENT UNDERSTANDING
OF THE SURGICAL EXPERIENCE
PHYSICAL PREPARATION
1) Maintenances of normal fluid and
electrolyte balance
 The surgical client is vulnerable to fluid ...
2)Promotional of rest and comfort :-
 Rest is essential for normal healing.
 Anxiety about the impending surgery can
eas...
PRE PARATHION ON THE DAY OF SURGERY
The nurse complete a number of routine procedures
before releasing the client for surg...
 Vital signs:-
The nurse measure a final pre operative
vital signs
If pre operative vital signs are abnormal
surgery need...
INTRA OPERATIVE SURGICAL
PHASE
 The nurse conduct a focused pre
operative assessment to verify client is
ready for surger...
ACUTE CARE :-
 Physical preparation :
After safety securing the client on the
orating room table the nurse applies
monito...
 INTRODUCTION OF ANESTHESIA:-
Client undergoing surgical procedure
reduces one of four type or anesthesia,
general, regio...
2)REGIONAL ANESTHESIA
 Regional anesthesia resulting of sensation
in an area of the body
 The method of induction influe...
 POSITIONING THE CLIENT FOR SURGERY
 The choices or position is usually determine by
surgical approach
 Ideally the cli...
THE NURSING PROCESSING IN
POST OPERATIVE CARE :
 The nurse thoroughly documents
the assessment including vital
sciences, ...
1. Respiration
 Certain anesthetic agent may cause
respiratory dispersion
 The nurse a specially alert for shallow,
slow...
2) CIRCULATION
 The client is risk for cardio vascular complication
resulting of actual or potential blood loss form surg...
3)TEMPERATURE CONTROL
 Temperature regulation is important in the
post operative period
 Client are offend cool after su...
4)MAINTAIN NEUROLOGICAL
FUNCTION
 Orientation to environment is important in
maintain the clients mental status the nurse...
6)PROMOTING WOUND HEALING
7) ACHIEVING REST AND COMFORT
THANK
YOU
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Pre operative and post operative care

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CAAR OF PATIENT BEFORE AND AFTER SURGERY

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Pre operative and post operative care

  1. 1. BHARATI VIDYAPEETH DEEMED UNIVERSITY COLLEGE OF NURSING SANGLI SEMINAR SUBMITTED BY : MR.MAHESH CHAND MSC.NURSING
  2. 2. PREOPERATIVE PREPARATION AND POSTOPERATIVE CARE
  3. 3. INTRODUCTION Patient education is a vital component of a surgical experiences pre-operative patient education may be offered through conversation , discussion. The pre-operative nurse can assess the patient knowledge and use this information in developing a plan for an event full pre-operative course. The use of audio-visual aids demonstration and return demonstration.
  4. 4. Definitions.  Preoperative nursing is a term used to describe the nursing functions in the total surgical experience of the patient, pre operative, intra operative, and post operative (Lipincott Manual of Nursing Practice 6th edition)
  5. 5. CLASSIFICATION OF SURGERY: The type of surgical procedure are classified according to 1] Seriousness 2] Urgency 3] Purpose
  6. 6. 1] Seriousness: I] Major II] Minor I] Major surgery Involves expensive reconstruction or alternation in body parts . Poses great risk to well-being . II] Minor Involves minimal alternative in body parts often designed to correct deformities involves minimal risk compared with major procedure. e.g. Cataract extraction, facial plastic surgery, tooth extraction
  7. 7. 2) URGENCY: 1) ELECTIVE 2)URGENT 3)EMERGENCY 1)ELECTIVE:- It performed on basis of Clients choice, is not essential and may not be necessary for health . e.g.-facial plastic surgery , breast reconstruction
  8. 8. 2)URGENT: Is necessary for client health, may prevent additional problem from developing (e.g. tissue destruction or impaired organ function e.g.:- excision of cancerous famour, removal of gall bladder for stone 3}EMERGENCY:- Must be done immediately for save life or preserve function of body part. e.g. Repair of perforated appendix, Repair of traumatic amputation, Control of internal hemorrhaging.
  9. 9. Purpose: 1)Diagnostic :- Is surgical exploration that allow physician to confirm diagnosis. May involve removal of tissue for further diagnostic testing e.g. Breast mass biopsy 2)Cosmetic :- Perform to improve personal appearances e.g.Rhinoplasty to reshape nose 3)Constructive :- Restore function lost or reduced as result congenital abnormalities e.g. Repair of cleft palate , closure of arterial septal defect in heart 4)Palliative:- Relieves or reduces intensity of arterial symptoms will not produce care. e.g. colostomy, debridement of necrotic tissue
  10. 10. The nursing process in the pre operative surgical phase: The surgical client may undergo test of procedures to confirm or rule out alteration requiring surgery. The client meets many health care personal including surgeons, nurse, anesthesiologist, therapist all play a role in the client care and recovery. The nurse must effectively communication with the client and family because the nurse client ralationship is the foundation of care. The nurse assess the client physical, emotional and spiritual well being and cultural heritage, recognizes the degree of surgical risk, coordinates diagnostic test, identifies nursing diagnosis and nursing interventions and establishes outcome in collaboration with the client and with family.
  11. 11. ASSESSMENT  The aim of assessment of surgical client is to establish the clients normal pre- operative function to assist the nurse in prevention and recognizing possible post operative complications.
  12. 12.  MEDICAL HISTORY  NUTRITION  PAST HISTORY  ALLERGIES  HABITS  FAMILY HISTORY  AGE  OBESITY  FLUID AND ELECTROLYTE IMBALANCE  PREGANACY
  13. 13. PHYSICAL EXAMINATION  General assessment  head to toe examination
  14. 14. DIAGNOSTIC SCREENING  BLOOD INVESTIGATION  RADIOLOGICAL INVESTIGATION  ECG 
  15. 15. Implementation : Pre-operative nursing intervention provide the client with a complete understanding of the surgical intervention. 1) Informed consent: Surgery cannot be legally or ethically performed until client understand the need for a procedure the steps involving, risk, expected resources and alternative treatment. It is surgeons responsible to explain the procedure and obtain the informed content. After the consent form has been completed the nurse ensure that the form is placed in the client medical record.
  16. 16. 2)Health Promotion:- Health problem activity during the pre-operative phase focus on health maintenance, prevention or complication and support of possible rehabilitation need post operatively.
  17. 17. 3)Pre –operative teaching The client education is an important aspect of the client surgical experiences. The nurse should provide client with information about sensation typically experienced after surgery.
  18. 18. 4)Deep breathing: One goal of pre – operative nursing care is to teach the patient how to promote optimal lung expansion and resulting blood oxygen after anesthesia. Asset client to comfortable sitting position on side of bed or in chair standing position. The nurse then demonstrates how to take a deep slow breath and now exhale slowly.
  19. 19. 5. INCENTIVE SPIRMETER  Pre – operative the patient was a spirometer to measure deep breath expiring maximum effort.  The pre-operative measurement because the goal of be achieve as soon as possible after the operation Post operatively the patient is encouraged to use the incentive spirometer about 10 to 12 time per hours. 6. COUGHING:-  If thoracic or abdominal incision is anticipated nurse demonstrate now to splint the incision to minimize pressure and control pain.  The patient should put the palm of both hand across the incision site acts as an effective splint when coughing.
  20. 20. THE FOLLOWING STANDARDS HAVE BEEN ESTABLISHMENT BY ANA TO DEMONSTRATE CLIENT UNDERSTANDING OF THE SURGICAL EXPERIENCE
  21. 21. PHYSICAL PREPARATION 1) Maintenances of normal fluid and electrolyte balance  The surgical client is vulnerable to fluid and electrolyte imbalance as a result or in adequate pre operative intake or excessive fluids losses during surgery.  A client traditionally took nothing by mouth (NBM) after midnight on the morning of surgery of keep stomach empty and thus reduce the risk of vomiting and aspiration.  The physician assess serum electrolyte level to determine the type of full fluid electrolyte additives to administer.
  22. 22. 2)Promotional of rest and comfort :-  Rest is essential for normal healing.  Anxiety about the impending surgery can easily interfere with ability to relax or sleep.  The nurse should attempts to make the client environment quite and comfortable.
  23. 23. PRE PARATHION ON THE DAY OF SURGERY The nurse complete a number of routine procedures before releasing the client for surgery .  Hygiene:- basic hygiene measure provide additional comfort before surgery e.g. bath, provide clean hospital gown  Removal of prostheses: the client must remorse all presence. Including denture artificial limb raring aids or contact lens  Safeguarding valuables :- If client has any valuables the nurse should give them to family members of secure them for safekeeping  Preparing the bowel and bladder :- The client may required an enema or catheter the morning of surgery to ensure that the colon is empty.
  24. 24.  Vital signs:- The nurse measure a final pre operative vital signs If pre operative vital signs are abnormal surgery need to be pond  Documentation: Before the client goes to surgery the nurse choice the contents of the medical record laboratory reports and consent from cy choice list  Administering preoperative medication Typically the physician order operative medication to be administered when the client values for the operating room or at an earlier prescribe time
  25. 25. INTRA OPERATIVE SURGICAL PHASE  The nurse conduct a focused pre operative assessment to verify client is ready for surgery and plan.
  26. 26. ACUTE CARE :-  Physical preparation : After safety securing the client on the orating room table the nurse applies monitoring devices to the client before surgery Client reducing general and regional anesthesia under go continues ECG monitoring during surgery Pulse oximetry will be used to monitor oxygen saturation
  27. 27.  INTRODUCTION OF ANESTHESIA:- Client undergoing surgical procedure reduces one of four type or anesthesia, general, regional local or conscious sedation 1) General anesthesia It result in an immobile, acute, client does not recall the surgical procedure The client amnesia acts as a protective measure from the unpleasant client of the procedure Surgical requiring general anesthesia involve major procedure
  28. 28. 2)REGIONAL ANESTHESIA  Regional anesthesia resulting of sensation in an area of the body  The method of induction influences the potion of sensory path way that are anesthetized  No loss of sensation of conciseness occures with regional anesthesia  Administration technique include nerve block and spinal or epidural 3)LOCAL ANESTHESIA  Local anesthesia involve loss of sensatinal at desired site E.g. (growth on skin or the cornea of the eyes )
  29. 29.  POSITIONING THE CLIENT FOR SURGERY  The choices or position is usually determine by surgical approach  Ideally the client position provide good asses to the operative site and sustain adequate circulatory respiratory function  The client comfort and safety must be consider  DOCUMENTATION OF INTRA OPERATIVE CARE  During intra operative face the nursing staff countinues pre operative plan e.g. strict asepsis must be follow minimize the risk surgical wound infection.  Full fluid infusion and monitoring of urinary output are action the nurse takes to maintain fluid balance.
  30. 30. THE NURSING PROCESSING IN POST OPERATIVE CARE :  The nurse thoroughly documents the assessment including vital sciences, level consciousness, condition of dressing and drain, comfort level all fluids status, and urinary output measurement  Client data can be enter flow sheet and compute raised client record and written progress notes
  31. 31. 1. Respiration  Certain anesthetic agent may cause respiratory dispersion  The nurse a specially alert for shallow, slow breathing and weak cough  The nurse asses air patency, respiratory rate rhythm breath sound  The acute care area nurse continues to asses respiratory status and breath sound old clients smokes and client with history respiratory diseases are prone to developing complication such as atelectasis or pneumonia
  32. 32. 2) CIRCULATION  The client is risk for cardio vascular complication resulting of actual or potential blood loss form surgical site. Side effect of anesthesia, electrolyte imbalance and depression of normal circulatory regulating mechanism  Carefully assessment of heart rate and rhythm along with blood pressure reveal’s the client cardio vascular status  A common early circulatory problem is haemorrhage.  Blood loss may occur externally through a drain or incision or internally.  Either type of haemorrhage resulting a fall in blood pressure elevate heart and respiratory rate cool clubby pale skin and restlessness  The nurse maintain IV fluid infusion and many need to increase IV replacement fluid vital sciences every 15 minutes oxygen need to be continued medication may be consider  Blood counts and coagulation studies are drawn send to laboratory.
  33. 33. 3)TEMPERATURE CONTROL  Temperature regulation is important in the post operative period  Client are offend cool after surgery the nurse proved warmed blanket in the immediate post operative period
  34. 34. 4)MAINTAIN NEUROLOGICAL FUNCTION  Orientation to environment is important in maintain the clients mental status the nurse reorient the clients experience that surgery is completed and describe procedure by nursing measure 5)MAINTAIN FLUIDS AND ELECTROLYTE BALANCE :-  And important nursing responsibility is maintain patency of IV infusion in the post operative period
  35. 35. 6)PROMOTING WOUND HEALING 7) ACHIEVING REST AND COMFORT
  36. 36. THANK YOU
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CAAR OF PATIENT BEFORE AND AFTER SURGERY

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