1. Chapter 27 Perioperative Care

3. Introduction to Operative Care
Perioperative care is care that clients receive before, during, and after surgery
Nurses assume general responsibilities when caring for clients during the preoperative, intraoperative, and postoperative periods of perioperative care

4. Preoperative Period
Starts when client, or his family in an emergency situation, learn that surgery is necessary
Ends when client is transported to the operating room

5. Types of Surgery According to Urgency

7. Preoperative Period (cont’d)
Informed consent
Permission for a procedure that a client gives after an explanation of the risks, benefits, and alternatives

8. Surgical Consent Form

9. Preoperative Period (cont’d)
Preoperative blood donation
Autologous transfusion: self-donated blood
Directed donors: blood donors chosen from among the client’s relatives and friends
If directed donation not used, it is available for use by other clients

10. Preoperative Period (cont’d)
Immediate preoperative care
Nursing assessment
Surgical risk factors
Low hemoglobin and red cells
Cardiopulmonary disease
Malnutrition
Dehydration

11. Preoperative Period (cont’d)
Immediate preoperative care (cont’d)
Preoperative teaching
Deep breathing
Coughing
Leg exercises
Postoperative pain management

12. Preoperative Period (cont’d)
Immediate preoperative care (cont’d)
Physical preparation
Skin preparation
Elimination
Food and fluid restrictions

13. Preoperative Period (cont’d)
Immediate preoperative care (cont’d)
Physical preparation (cont’d)
Care of valuables
Surgical attire
Disposition of dentures and prostheses

14. Preoperative Period (cont’d)
Immediate preoperative care (cont’d)
Preoperative medications
Psychosocial preparation
Preoperative checklist

15. Preoperative Checklist

17. Postoperative Period Immediate postoperative care
Initial postoperative assessments
Preparing the room
Monitoring for complications
Continuing postoperative care
Food and oral fluid intake

18. Postoperative Period (cont’d)
Continuing postoperative care (cont’d)
Promoting venous circulation
Pneumatic compression device
Antiembolism hose
Wound management
Elimination

19. Pneumatic Compression Device

21. Postoperative Period (cont’d)
Continuing postoperative care (cont’d)
Discharge instructions
How to care for the incision site
Signs of complications to report
Which foods to consume or avoid
When and where to return for a medical appointment

22. Nursing Implications Applicable nursing diagnoses
Deficient knowledge, fear, acute pain
Risk for ineffective therapeutic regimen management, infection, impaired gas exchange, deficient fluid volume
Ineffective breathing pattern, airway clearance
Impaired skin integrity, disturbed body image