NSB231 Lecture Notes - Lecture 6: Clinical Urine Tests, Vital Signs, Comorbidity
Week 6: Peri, Intra & Postoperative Care Lecture
Classification of surgical procedures
• Emergency = immediate intervention to save life
• Urgent = prompt intervention 24-48 hours
• Diagnostic = intervention to determine origin/cause
• Elective = planned correction of non-acute problem
• Palliative = relieve symptoms of a disease
• Cosmetic = alteration of persona appearance
ALL ARE ANXIOUS
Perioperative Journey
• Starts at home
• GP or ED visit -> referral to surgeon -> consultation -> wait listed for routine surgery
• Pre-admission clinic
• Hospital admission -> pre-op check -> holding bay -> anaesthetic induction room -> procedure
• Post-operative care on ward
• Post-operative assessment and education
• Discharge home
Risk Factors
• Age = comorbidities
• Smoking = decrease lung expansion
• Alcohol = impair liver metabolism, can't detox the anaesthetic
• Nutritional status = impaired wound healing
• Pre-existing disease/comorbidities
• Regular medication = anticoagulants?
Pre-operative nursing care: Patient Assessment
• Health History
o Potential psychosocial problems/needs
• Situational changes
• Common fears/concerns with the unknown
• Concerns with body image
• Past experiences
• Physiological assessment
o Body system approach - cardiac, respiratory, neurologic, GIT, renal, integument
o Vital signs, urinalysis, weight, head-to-toe
• Knowledge deficits
• Past medical/surgical history
• Medications
• Allergies
• Herbs/vitamins/health supplements = St John's Wort p. 298
• Focused assessment
Preoperative Considerations
• Teaching:
o Inform patient about preoperative procedure
o Time of surgery
o Food and fluid restrictions
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