Download presentation
Presentation is loading. Please wait.
1
Perioperative Nursing Peg Trueman RN MSN Ed.D. CNE
2
Meet the Patient The experience of surgery is a routine event for everyone involved EXCEPT for the patient!
3
Nursing Management after Surgery
4
Postoperative Phase: Plan of Care
System Assessments and related nursing diagnoses
5
System Assessments Respiratory Cardiovascular Fluid Status Nutrition
Elimination Activity Wound Healing
6
The real reason dinosaurs
Respiratory Pulmonary assessment data TCDB C/I: CHI, eye sx O2 therapy IPPB I.S. The real reason dinosaurs became extinct.
7
Cardiovascular Cardiac assessment data Leg exercises
“Okay, Williams, we’ll vote… how many here say the heart has four chambers?” Cardiac assessment data Leg exercises Avoiding venous statsis ICD/hose
8
Fluid Status Hydration status data Drainage amts vital signs
daily weights! IV therapy Blood therapy
9
Nutrition NPO status Progression of diet check bowel sounds Feedings
TPN “The Nurse says a trip-o’-loomin’ cow-filler is feeding Grandma. It has three loops--one for breakfast, one for lunch, and one for dinner!”
10
Elimination Urinary output Bowel activity Ambulation!!!! retention?!!
Dehydration Catheter is the last resort! Bowel activity bowel sounds flatus Ambulation!!!!
11
Activity OOB ASAP!! Psychological impact Needs encouragement!
Usually within 24 hrs Psychological impact Needs encouragement!
12
Physiology of Wound Healing
Inflammatory Stage “insult” Proliferative Stage reinforcemen/framework Maturation Stage “settling in”
13
Wound Healing: First Intention
Scar formation is minimal Properly closed Heal with little tissue reaction
14
Wound Healing: Second Intention
Wound is left open to granulate Resultant in scar formation “Healing by granulation”
15
Wound Healing: Third Intention
Two opposing granulation surfaces are brought together Scar is deeper and wider “Delayed closure”
16
Factors Affecting Wound Healing
Age Hemorrhage Hypovolemia Local Factors Nutritional Deficits Oxygen deficit Drainage Medications Systemic Disorders Wound Stressors
17
Wound Care “Just a friendly suggestion…next time you do a dressing change, don’t say, OH MY GOD, WILL YOU LOOK AT THAT!”
18
Post-op Pain Control What is pain? Factors affecting pain
Administration Preventative Approach PRN vs ATC Routes of Administration Intramuscular Intravenous PCA pump/Epidural lines
19
Post-op Pain Control Common Pain Medication
Demerol Morphine Dilaudid Stadol NSAIDs Side Effects of Pain medication*
20
Managing Potential Complications
Shock/Hemorrhage Deep Vein Thrombosis (DVT) Pulmonary Embolism Respiratory Complications Urinary Retention Intestinal Obstruction Wound Complications
21
Surgery Specific Care Postoperative Uniquities and “worries”
22
Remember Mr. P? Case Study Review
23
Perioperative Nursing
"Dr. Trueman, can I be excused? My brain is full."
Similar presentations
