NUR 104 
Nursing Care Concepts
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UNIT 1D - PERIOPERATIVE NURSING
 
Theory schedule
   Unit 1-A
   Unit 1-B
   Unit 1-C
   Unit 1-D
   Unit 1-E
   Unit 1-F

   Unit 2-A
   Unit 2-B
   Unit 2-C

Appendix A

Lab

Clinical

 

 Objectives:
1. Utilize the nursing process in implementing nursing care to the perioperative client.
2. Communicate therapeutically with the client and significant others to reduce stress throughout the perioperative period.
3.  Identify teaching/learning needs of the preoperative and postoperative client.
4. Demonstrate selected nursing skills related to the care of the preoperative and postoperative client.
5. Identify the roles of health team members in the intraoperative setting.
6. Discuss legal implications of the surgical consent.
7. Describe integrative therapies used in the perioperative period
8. List community resources for surgical clients after discharge from the hospital.
9.Identify the role of the nurse in the operating room, post anesthesia recovery area, and out patient surgery area.
 
 
 
Theory
Content
Lab
Assignment
Clinical
Clinical Assignment

A.  Nursing process for 
      preoperative clients
     1.  emotional and physical 
          assessment of the preoperative 
          client
          a.   health history/risk factors
          b.  emotional coping and support 
               systems
          c.  baseline physical
          d.  social/cultural
     2.  nursing diagnosis (examples)
          a.  knowledge deficits
          b.  anxiety and stress
          c.  potential for complications
     3.  Planning and nursing 
          intervention
          a.  communication techniques 
               and emotional support
          b.  informed consent for surgery
          c.  preoperative teaching
          d.  physical preparation 
               for surgery
          e.  preoperative checklist
          f.  preoperative medications
     4.  Evaluation
          - expected outcomes of 
             preoperative nursing  care
B.  Intraoperative Nursing Role
     1.  intraoperative setting
          a.  surgical team
          b.  physical environment
          c.  surgical asepsis
     2.  nursing implications of 
          anesthesia
          a.  general
          b.  regional
          c.  local
C.  Nursing process for post-operative 
     clients
     1.  physical and emotional 
          assessment of the postoperative 
          client
          a.  assessment in the post-
               anesthesia recovery (PAR) period
          b.  assessment of the postoperative 
               client on the clinical unit
     2.  nursing diagnosis (examples)
          a.  anxiety
          b.  pain
          c.  alterations in breathing patterns 
               and ineffective gas exchange 
          d.  fluid deficit and excess
          e.  alteration in nutrition
          f.  alteration in urinary and 
               bowel elimination
          g.  alteration in family processes
          h.  high risk for postoperative 
               complications
     3.  planning and nursing interventions
          a.  prevention of complications
          b.  pain management
          c.  emotional support
          d.  wound care
          e.  fluid management
           f.  promoting mobility
          g.  discharge teaching
     4.  evaluation - expected outcomes 
          of  postoperative nursing care
D.  Ambulatory surgery
     1.  advantages
     2.  discharge criteria

Readings:
Lewis: p. 360-413
Winningham & Preusser
Chapter 3: Case Study #2
35-1 Preoperative teaching: Postoperative exercises
  • deep breathing
  • coughing
  • leg exercises
  • moving
  • (p. 1304) incentive spirometer

    • 35-2 Applying Antiembolic Stockings
    Surgical Aseptic Techniques
  • 29-5 gown and gloves
  • 29-1 hand washing before sterile techniques

    • Drainage Tubes (p. 928-929)
  • Jackson-Pratt (SDLP)
  • penrose drains
  • Hemovac (SDLP)


    • Readings:
    Kozier: pp. 902-905, 908-909, 915-917, 919-920, 928-930, 644-645, 662-664, 1303-1304

    Videos: 
    Preoperative and Postoperative Care

    Computer Programs:
    Nursing Software IV: Perioperative Nursing: 
    Part I- OR, Part II- PACU
                 Pre surgical Care
                 Post surgical Care

    Web Sites for Further Study:

    http://www.aorn.org/

    http://www.anesthesiapatientsafety.com/
     
    Assess a perioperative client for surgical risk factors.

    Assess a surgical client's support systems and cultural background. Review a surgical client's baseline physical assessment.

    In conference:
    Explain your client's surgery in non-medical terms. Identify sources of anxiety and supportive interventions. Identify surgical risk factors.

    Review the surgical consent of your client.

    Design a preoperative teaching plan. Review the preoperative checklist of your client.

    Observe the roles of the circulating and scrub nurses as part of the surgical team.

    Observe ways the surgical team establishes a caring environment for the client.

         Student Activities:
    Attend selected support groups/ Community education program related to surgery such as group preoperative teaching sessions or a support group for people who have had cardiac bypass surgery etc (option)

    Observe the care of a client in the PAR area. Identify 
    nursing actions to help prevent and detect post-anesthesia complications.

    In conference:
    Discuss benefits and potential complications associated with your client's anesthesia and adjunctive medications.

    Assess yours postoperative client for postoperative complications.

    Implement interventions to prevent postoperative complications.

    Write a nursing care plan for a surgical patient.

    Demonstrate nursing skills related to pain management, wound care, I.V. fluids, and emotional support. Implement some postoperative and/or discharge teaching.

    Compare the preoperative teaching, care, and discharge teaching of the ambulatory client to that of the hospitalized client.

    Discuss community resources used by your client after discharge from the hospital.

    Investigate opportunities for service learning in related agencies.
     

     
    ........
    Please direct general questions or comments about this page to its author: Kim Lubesnick, mikey@oakton.edu.
    Last update 10/04/02