1. Unit 32 Care of the Client with Surgery
Ren Jianhua
West China second university hospital

2. vocabulary ambulatory -- move hernia
ambulance
ambulatory nurse
hernia
a medical condition in which an organ pushes through the muscles that are supposed to contain it
anesthetist -- anesthesia

3. How to define” Surgery”
Surgery is the use of instruments during an operation to treat injuries, diseases, and deformities
(p129,para 1 ,L1~2)
Surgery is usually Invasive
“A chance to cut is a chance to cure”

4. Reading exercises (p129,para 2) 1.To state the category of surgery
3.To articulate the purpose of each type of surgery 4

5. Category of Surgery (Ⅰ)
immediate
Emergent
Urgent
Elective
Optional
needed within hours
planned; no time requirements
done at the request of the client 5

6. Category of Surgery (Ⅱ)
Diagnostic- tissue samples or biopsy
Exploratory- confirmation of extent of condition
Preventive- removal before it causes a problem
Curative- removal of diseased tissue
Reconstructive- correction of body parts
Palliative- alleviation of symptoms without curing disease 6

7. The Purpose of Surgery are……
To cure pathologies
To diagnose
To slow the progress of pathologic process
To relieve the undesirable symptoms
To reconstruct

8. There are three phases in the surgical process (p130,para 1,Line 1)
preoperative, intraoperative, and postoperative
术前的、术中的、术后的
These three phases are referred to collectively by the word perioperative,
which is defined as the time surrounding and during surgery
围手术期的

9. Perio-/pre-/intra-/postoperative
peri- pref.
around; about; enclosing
near
eg. pericardium
periodontal
perinatal
心包；心包膜
牙周的
围产期的
of or relating to a surgical operation 9

10. Perio-/pre-/intra-/postoperative
pre- pref.
Earlier; before; prior to:
prehistoric
Preparatory; preliminary:
premedical
In advance
prepay.
Anterior; in front of
preaxial
史前的
医学预科的
premedical
词性及解释
a. 医学预科的
【医】 医预科的
preaxial
a 身体前方的
a. 躯体前的, 上肢(或下肢)内侧的
【医】 轴前的 预支
身体前方的,轴前的 10

11. How to differentiate the three phages
Reading Exercises
How to differentiate the three phages
(The time range of each phage)
Describe the nurse’s tasks in the preoperative phases.
P130,para2~p131,para1 11

12. Perioperative Phases Preoperative
The medicine will induce sleep
Her illness was induced by overwork
Perioperative Phases
Preoperative
Begins when client /be apprised of the need for surgery
Ends when client be transferred to O.R（手术室）/anesthesia is induced.
Intraoperative
Begins with transfer to O.R
Ends with admission to PACU/completion of surgery
Postoperative
Begins with admission to PACU/completion of surgery
Ends when recovery is complete.
post anesthesia care unit (PACU) （麻醉复苏室） 12

13. Nurse’s task in Preoperative Phase
To identify /implement actions to decrease surgical risk factors
Patient Interview
Physical examination
Lab Work/Diagnostic tests
Nursing Diagnoses
Nursing Interventions
Informed Consent
知情同意书 13

14. Key sentences
This consent not only gives the surgeon permission to perform surgery but also states that the client has been informed of exactly what procedure is being done, its outcomes, and the possible complications.(p130,para 3)
委托书，授权书?
Power of attorney（POA） 14

15. What will be generally covered in informed consent?
Description of procedure and alternative therapies
Underlying disease process and its natural course
Explanation of risks and how often they occur
Explanation that patient has the right to refuse treatment or withdraw consent
Name and qualifications of person performing procedure
who have the right to sign informed consent ? 15

16. The purpose for all clients to sign an informed consent before any surgical processes are
to prevent the surgical infection
to give the surgeon permission to perform surgery
to state that the client has been informed of exactly what procedure is being done and its outcomes
to avoid complications
to avoid communication

17. Preoperative nursing intervention
Preoperative teaching
Preoperative preparations
Sleep medications
Final safety and
preparatory checks

18. Preoperative teaching
What should be taught before operation?
Preoperative teaching
Preoperative teaching serves to
help relieve the fears and anxieties /
provide the client with the basic skills needed during the postoperative period.
General areas of preoperative teaching include methods and rationale for
coughing
deep breathing
incision splinting
turning
ambulating
exercising
下床活动
P130,para 4,L3

19. Other preparations 备皮 灌 肠
Some preparations are carried out the day before surgery, such as laxatives or enemas, and skin shaves and cleanness. 备皮
灌 肠

20. Operating/surgical team
Intraoperative Phase
巡回护士
洗手护士
Operating/surgical team 20

21. What are the nurse’s tasks in Intraoperative Phase (P131,para2)
Acts as bridge
The nurse advocates for the patient, maintains safety and continuously assesses the needs of the patient and the surgical team
Creates and maintains a safe and therapeutic environment for both the patient and the OR team 21

22. Scrub nurse or circulating nurse?
Scrub nurse
Circulating nurse 22

23. Postoperative recovery room
Translation P131, Para 3

24. The nurses’ task in different phases of postoperative period
Reading (P131, Para 4-p132,para2)
The nurses’ task in different phases of postoperative period

25. Postoperative Phase (1)
Initial/early stage of postoperative period
Assess and maintain the function of all drainage tubes
Assess the condition of the client and maintain the vital signs and prevent early complications
Pain control
Decrease the client and his family’s anxiety and fear

26. Words（p131,para4） 定向力 Orientation 意识 Consciousness 引流管 Drainage tube
床挡；床栏
呼叫器
Orientation
Consciousness
Drainage tube
Side rail
Call bell

27. Postoperative Phase (2)
In the middle of postoperative period
To maximize the clients recovery
To assist the client to attain the highest level of well-being
Before discharging from the hospital
teaching plan

28. Nurse’s task in Postoperative Phase
The Nurse:
1. Assess the patient’s condition and response to surgery
2. Facilitate healing
3. Prevent complications
4. Teach
5. Support
6. Plan for home care 28

29. Key words 围手术期的 术前的 术后的 术中的 知情同意 洗手护士 巡回护士 perioperative preoperative
postoperative
intraoperative
Informed consent
Scrub nurse
Circulating nurse 29