Gen. Pre & Post-Opt

Introduction to Surgical
Nursing
AMOOBA Philemon A.
Department of Nursing
KNUST
Learning Objectives
At the end of this lecture each student should be
able to:
Understand the basics of general surgery and
surgical nursing
Describe the various classifications of
surgical procedures
Provide appropriate nursing care for the client
in the preoperative and postoperative phases
of surgery.
Surgery
Surgery is any procedure performed on the
human body that uses instruments to alter
tissue or organ integrity
Type of Surgery
Purpose/reasons
Degree of urgency – necessity to preserve the

client’s life, body part, or body function
Degree of risk – involved in surgical procedure is

affected by the client’s age, general health, nutritional
status, use of medications, and mental status
Extent of surgery – Simple and radical

Type of Surgery (Purpose)
Diagnostic- Allows to confirm or establishes diagnosis.
Corrective- Excision or removal of diseased body part.
Reconstructive- Restore function or appearance to
traumatized or malfunctioning tissues.
Ablative – Removes a diseased body parts
Palliative – Relieves or reduces pain or symptoms of a
disease; it does not cure
Transplant – Replaces malfunctioning structures
Cosmetic- Performed to improve personal appearance.
Types of Surgery (Urgency)
Emergency- performed immediately to preserve
function or the life of the client
Elective – is performed when surgical intervention is

the preferred treatment for a condition that is not
imminently life threatening or to improve the client’s
life
Urgent – Necessary for client’ health to prevent

additional problem from developing; not necessarily
an emergency
Required – has to be performed at some point; can be

pre-scheduled
Type of Surgery (Degree of Risk)
Major – involves a high degree of risk
Minor – normally involves little risk
Age – very young and elder clients are greater
surgical risks than children and adult
General health- surgery is least risky when the
client’s general health is good
Nutritional Status – required for normal tissue
repair
Medications – regular use of certain medications
can increase surgical risk
Mental status – disorder that affect cognitive
function
Introduction to Perioperative Nursing
Phases of Perioperative Care
Perioperative period – extends from the time of
hospitalisation for surgery to the time of discharge
Pre Operative - begins with the patient’s decision to have

surgery, ends with entry into the operating room
Intra Operative - begins with entry into the operating

room and ends with admission to the recovery room
Post Operative - begins with admission to recovery

room, and ends with discharge from care by physician
Phases of Perioperative Care
Preoperative Nursing Care
Psychological preparation
Physical and physiological preparation
Spiritual preparation
Psychological preparation
Informed Consent
Nature and intention of the surgery
Name and qualifications of the person performing
the surgery
Risks, including tissue damage, disfigurement, or
even death
Chances of success
Possible alternative measures
The right of the client to refuse consent or later
withdraw consent
Psychosocial considerations
Level of anxiety
Coping ability
Support systems
Pre-opt. teaching
The education plan should begin with assessment,
including baseline knowledge of the patient and
family, readiness to learn, barriers to learning,
patient and family concern and learning styles and
preferences
The content focuses on information that will

increase patient’s familiarity with procedural events.
This includes surgical experience (procedural), what
the pt. may experience (sensory) and what actions
may help decrease anxiety (behavioral)
Anxiety
The nurse must consider the patient’s
family and friends when planning
psychological support
Empowering their sense of control.

Activities that decreasing anxiety are deep
breathing, relaxation exercises, music
therapy, massage and animal-assisted
therapy
Use of medication to relieve anxiety.

Common nursing diagnosis
Knowledge deficit
Anxiety
Fear related to
Disturbed sleep pattern
Anticipatory grieving related to
Physical and physiological pre
COMPLETE PHYSICAL
ASSESSMENT
Physical & psychological needs
Medical & surgical history
Completion of required documents
Assessment (Nursing History)
Current health status-
Allergies
Medications- list all current medications
Previous surgeries
Understanding of the surgical procedure and
anesthesia
Smoking
Alcohol and other-altering substances
Coping
Social resources
Cultural considerations
Physical assessment
Cardiovascular system
Respiratory system
Renal system
Neurological system
Musculoskeletal system
Nutritional status
Gerontological considerations
Laboratory and diagnostic studies
Screening tests depend on the condition of
the client and the nature of the surgery. If
test reveals severe problems the surgery may
be cancel until the condition is stabilized
Routine screening test-FBC, Blood

grouping and X-match, fasting blood sugar,
BUN & Creatinine, ALT,AST, and
bilirubin,Serum albumin, and Total protein,
Urinalysis, Chest X-ray, ECG
PRE-OP NURSING DIAGNOSES
Knowledge Deficit R/T Unfamiliar Planned or
Unplanned Surgery
Ineffective individual or family coping R/T

Unfamiliar Planned or Unplanned Surgery
Anticipatory Grieving R/T Potential for Loss of

Life or Body Part
Preanesthesia Management Physical Status Categories
ASA 1: Healthy patient with no disease
ASA 11: Mild systemic ds without fx limitations
ASA 111:Severe systemic ds associated with definite fx
limitations
ASA 1V: Severe systemic ds that is a constant threat to
life.
ASA V: Moribund pt. Who is not expected to survive
without the operation.
ASA V1: A declared brain-death whose organ are being
recovered for donor.
E: Emergency
Final Preparation for surgery
All personal belongings are identified and
secured
Jewelry is usually removed
Dentures are removed, labeled and placed
in a denture cup
Pt. to verbally confirm the surgical
procedures and the surgical site. This
verification process is documented in the
medical record on the preop checklist.
Pre-op. medications
Prior to administering – check permits
Purpose: Allay anxiety
Decrease pharyngeal secretions
Decrease gastric secretion.
Decrease side effects of anesthesia
Induce amnesia
Medications
Sedatives/hypnotics- Nembutal
Tranquilizers-Ativan, versed, valium
Opiate analgesics- Demerol, morphine
Anticholinergics-Atropine sulfate,atarax
H2 blockers.- Tagamet, Zantac
Antiemetic- Reglan, Phenergan
Nursing assessment in the PACU
Vital signs- presence of artificial airway, 02 sat,
BP, pulse, temperature.
LOC- ability to follow command, pupillary
response
Urinary output
Skin integrity
Pain
Condition of surgical wound
Presence of IV lines
Position of patient
Nursing Diagnosis
Ineffective airway clearance- increased
secretions 2 to anesthesia, ineffective
cough, pain
Ineffective breathing pattern- anesthetic
and drug effects, incisional pain
Acute pain
Urinary retention
Risk for infection
Postoperative Phase
Assessment of the Postanesthesia Client
 Airway
 Vital signs
 Cardiac monitoring
 Peripheral vascular assessment
 Level of consciousness (LOC)
 Fluid and electrolytes
 GI system
 Integumentary system
 Discomfort/pain
Postoperative Management
Maintain a patent airway
Stabilize vital signs
Ensure patient safety
Provide pain
Recognize & manage complications
When caring for post-surgical patient, think of the “4 W’s”
Wind: prevent respiratory complications

Wound: prevent infection
Water: monitor I & O
Walk: prevent thrombophlebitis
Complications
Respiratory- atelectasis, pulm. Embolus
Cardiovascular- venous thrombosis
Gastrointestinal-Hiccoughs, N/V, abd. Distention,
paralytic ileus, stress ulcer.
GU- urinary retention
Hemorrhage-slipping of a ligature(suture)
Wound infection-
Wound dehiscence and evisceration-
Questions ????
05/29/2024
31

Gen. Pre & Post-Opt

Uploaded by

Copyright:

Available Formats

Gen. Pre & Post-Opt

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Gen. Pre & Post-Opt

Uploaded by

Copyright:

Available Formats

Introduction to Surgical

Degree of urgency – necessity to preserve the

Degree of risk – involved in surgical procedure is

Extent of surgery – Simple and radical

Elective – is performed when surgical intervention is

Urgent – Necessary for client’ health to prevent

Required – has to be performed at some point; can be

Pre Operative - begins with the patient’s decision to have

Intra Operative - begins with entry into the operating

Post Operative - begins with admission to recovery

The content focuses on information that will

Empowering their sense of control.

Use of medication to relieve anxiety.

Routine screening test-FBC, Blood

Ineffective individual or family coping R/T

Anticipatory Grieving R/T Potential for Loss of

Wind: prevent respiratory complications

You might also like

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.