Intra operative & Post operative Nursing NADEEKA JAYASINGHE

Objectives: At the end of this lab, the student must be able to: Discuss Duties of the Nurses in OR: Reception Nurse Anesthetic Nurse Circulating Nurse Scrub Nurse 4. Discuss immediate and later postoperative care. 5.Identify the postoperative complications

2.Intr – operative phase Reception Nurse Identified patient by asking him to say his name and checks and corresponds with his record and reporting list. Reassures patients , creates quiet , calm atmosphere to decrease patient apprehensiveness . Checks the preoperative assessment

Ctd… Reception Nuse 4. Confirms that the patient has signed the operating consent. 5. Checks the time of administrative order premedication and any adverse reaction is reported to anesthetist. 6. Uses the check list to complete the preparation for anesthesia and surgery. 7. Transfer patient to the anesthetic room.

Anesthetic Nurse Prepares safe environment for induction of anesthesia. Checks suction apparatus , gas supply , gas cylinder machine to be well prepared for use. Checks O2 supply and emergency tray in position. Checks and records all drugs required by the anesthetist .

Anesthetic Nurse Arranges for the scrub nurse to see the signed consent. Prepares inhalation trolley Assist in the transfer patient to recovery room Cleans used equipment

Circulating Nurse Managing the nursing care of the patient and coordinating the needs of surgical team members for each procedure, using critical thinking skills. Observes the procedure from a broad perspective and helps team members create. Assess the patient’s condition before, during, and after the procedure.

Circulating Nurse 4. Maintains a safe care environment. 5. Manages equipment use and delegates / directs care provided by OR technicians. 6. Performs the role of scrub nurse when necessary. 7. Is responsible for directing and coordinating all nursing care based on established clinical nursing practices . 8. Continuously evaluates patients outcomes during intra operative phase.

Scrub Nurse Before scrubbing: After scrubbing: Assists circulating nurse in preparation of operation theater. After scrubbing: Prepare the sterile instruments . Performs proper draping. Assess surgeons in wearing gowns and gloves. Prepare appropriate needles and sutures. Counts all swaps, sponges, and sterile instruments.

Scrub Nurse 3. Arranges sterile instruments in expected orders for use. 4. Hands instruments to the surgeons and helps to keep an eye on the patients condition. 5. Listens carefully to what the surgeon is saying. 6. Counts instruments before wound closure.

Immediate post operative period: Post operative care: Immediate post operative period: Initial assessment: Airway patency Effectiveness of respiration Presence of artificial airways Mechanical ventilation, or supplemental oxygen Circulatory status, vital signs Wound condition, including dressings and drains Fluid balance, including IV fluids, output from catheters and drains and ability to void Level of consciousness and pain

Later post operative period: Post operative care Later post operative period: Ongoing assessment: Respiratory function General condition Vital signs Cardiovascular function Fluid status Pain level Bowel and urinary elimination Dressings, tubes, drains, and IV lines

Nurse’s roles in the post-operative phase: Ensures a patent airway Helps maintain adequate circulation Prevents or assist with the treatment of shock Maintains proper position and function of drain tubes and IV infusion Monitor for potential complications

Post operative complication: Hemorrhage Shock Hypoxia Aspiration

Thank you for your attention