OR SKILLS

Subdecks (1)

Cards (199)

  • Perioperative nursing
    A registered nurse's planned patient-centered approach in providing care to patients preoperatively, intraoperatively and postoperatively
  • Nursing goals
    • Quality improvement
    • Patient safety
    • Teamwork and collaboration
    • Effective communication
    • Timely assessment and deliver intervention
    • Patient advocate
    • Cost containment
  • Perioperative nursing
    A registered nurse's planned patient-centered approach in providing care to patients preoperatively, intraoperatively and postoperatively
  • Nursing goals
    • Quality improvement
    • Patient safety
    • Teamwork and collaboration
    • Effective communication
    • Timely assessment and deliver intervention
    • Patient advocate
    • Cost containment
  • Classification of surgery
    • Seriousness: Major, Minor
    • Urgency: Elective, Urgent, Emergency
    • Purpose: Diagnostic, Ablative, Palliative, Reconstructive/Restorative, Procurement of Transplant, Constructive, Cosmetic
  • Surgical risk factors
    • Smoking
    • Age
    • Nutrition
    • Obesity
    • Obstructive Sleep Apnea (OSA)
    • Immunosuppression
    • Fluid and Electrolyte Imbalance
    • Postoperative Nausea and Vomiting
    • Post Operative Urinary Retention
    • Venous Thromboembolism
  • Nursing knowledge base
    • Perioperative communication
    • Hand-off communication
    • Glycemic control and infection prevention
    • Pressure ulcer prevention
  • Phases of perioperative nursing
    1. Preoperative phase
    2. Intraoperative phase
    3. Postoperative phase
  • Preoperative surgical phase: Nursing process and assessment

    • Determine the patient's expectations of surgery and the road to recovery
    • Include information about advance directives
    • Screen for conditions that increase surgical risks
    • Check for complications in prior surgeries
    • Maintain normal baseline function
  • Preoperative surgical phase: Risk factors

    • Obstructive sleep apnea
    • Malnourishment
    • Smoking
  • Preoperative surgical phase: Assessment
    • Medications
    • Allergies
    • Smoking habits
    • Alcohol ingestion and substance abuse and use
    • Pregnancy
    • Perceptions and knowledge regarding surgery
    • Support sources
    • Occupation
    • Preoperative pain assessment
    • Review of emotional health
    • Cultural and spiritual factors
  • Diagnostic & laboratory tests
    • Hgb (Hemoglobin)
    • Hct (Hematocrit)
    • Platelet Count
    • WBC count
    • PT
    • PTT
    • Glucose
  • Preoperative surgical phase: Nursing diagnosis
    • Ineffective airway clearance
    • Anxiety
    • Ineffective Coping
    • Impaired skin integrity
    • Risk for aspiration
    • Risk for perioperative positioning injury
    • Risk for infection
    • Deficient knowledge
    • Impaired physical mobility
    • Ineffective thermoregulation
    • Nausea
    • Acute pain
    • Delayed surgical recovery
  • Preoperative surgical phase: Planning
    • Review and modify the plan during the intraoperative and postoperative periods
    • Setting priorities
    • Teamwork and collaboration
    • Preoperative instruction gives patients time to make necessary preparations
  • Informed consent
    Surgical procedures require documentation of consent
  • Privacy and social media
    Do not discuss confidential patient information in public areas or use social media to convey patient information; posting patient information and photos on websites is prohibited
  • Preoperative surgical phase: Implementation
    1. Minimize risk for surgical wound infection
    2. Maintaining normal fluid and electrolyte balance
    3. Preventing bowel incontinence and contamination
    4. Preparation on the day of surgery
    5. Eliminating wrong site and wrong procedure surgery
  • Preoperative surgical phase: Evaluation
    • Evaluate whether the patient's expectations were met with respect to surgical preparation
    • Deficient knowledge
    • Anxiety
  • Transport to the Operating Room

    1. Notification
    2. Transportation
    3. Verify patient's identity
    4. Family
    5. Prepare room for patient's return
  • Surgical risk factors
    • Smoking
    • Age
    • Nutrition
    • Obesity
    • Obstructive Sleep Apnea (OSA)
    • Immunosuppression
    • Fluid and Electrolyte Imbalance
    • Postoperative Nausea and Vomiting
    • Post Operative Urinary Retention
    • Venous Thromboembolism
  • Preanesthesia Care Unit
    1. Inserts IV catheter
    2. Administers preoperative medications
    3. Monitors vital signs
    4. Performs patient assessment
  • Nursing roles during surgery
    • Circulating nurse
    • Scrub nurse
    • Registered nurse first assistant
  • Intraoperative Surgical Phase: Implementation
    1. Introduction of anesthesia
    2. Positioning the patient for surgery
    3. Documentation of intraoperative care
  • Intraoperative Surgical Phase: Evaluation
    • Keep the family informed
    • Evaluate a patient's ongoing clinical status during surgery
  • Principles of sterile technique
    • All objects used in a sterile field must be sterile
    • A sterile object becomes non-sterile when touched by a non-sterile object
    • Sterile items that are below the waist level, or items held below waist level, are considered to be non-sterile
    • Sterile fields must always be kept in sight to be considered sterile
    • When opening sterile equipment and adding supplies to a sterile field, take care to avoid contamination
    • Any puncture, moisture, or tear that passes through a sterile barrier must be considered contaminated
    • Once a sterile field is set up, the border of one inch at the edge of the sterile drape is considered non-sterile
    • If there is any doubt about the sterility of an object, it is considered non-sterile
    • Sterile persons or sterile objects may only contact sterile areas; non-sterile persons or items contact only non-sterile areas
    • Movement around and in the sterile field must not compromise or contaminate the sterile field
  • Sterile items
    • Items that are below the waist level, or items held below waist level, are considered to be non-sterile
    • Sterile fields must always be kept in sight to be considered sterile
  • Opening sterile equipment and adding supplies to a sterile field
    Take care to avoid contamination
  • Sterile barrier
    Any puncture, moisture, or tear that passes through it must be considered contaminated
  • Nursing knowledge base
    • Perioperative communication
    • Hand-off communication
    • Glycemic control and infection prevention
    • Pressure ulcer prevention
  • Sterile field
    The border of one inch at the edge of the sterile drape is considered non-sterile
  • If there is any doubt about the sterility of an object, it is considered non-sterile
  • Sterile persons or sterile objects

    May only contact sterile areas
  • Phases of perioperative nursing
    • Preoperative phase
    • Intraoperative phase
    • Postoperative phase
  • Non-sterile persons or items

    Contact only non-sterile areas
  • Movement around and in the sterile field must not compromise or contaminate the sterile field
  • Postoperative recovery phases
    • Immediate postoperative recovery (Phase I)
    • Recovery in ambulatory surgery (Phase II)
    • Postoperative convalescence
  • Immediate postoperative recovery (Phase I)

    1. Notification and arrival
    2. Hand-off: OR to PACU
    3. Patient monitoring and assessment
    4. Discharge and hand-off: PACU to Acute Care
  • Preoperative surgical phase: Nursing process and assessment
    1. Determine the patient's expectations of surgery and the road to recovery
    2. Nursing history including information about advance directives
    3. Medical history screening for conditions that increase surgical risks
    4. Surgical history checking for complications in prior surgeries
    5. Maintain normal baseline function
  • Modified Aldrete score
    Tool for patient monitoring and assessment
  • Modified postanesthesia recovery score (PARS)

    Tool for patient monitoring and assessment