Nursing Care of Surgical Patient
Presented by
Lt. Col / Sherihan Aboelkhir
-:Out Lines
Definition of perioperative
Perioperative phases (pre – intra – post )
Patient needs before surgery
Preoperative preparation &check list
Operative forms
Post operative plan of care
?What is meant by perioperative
Perioperative is a term used to describe the entire span
of surgery, including what occurs before, during, and
.after the actual operation
Phases of perioperative
The Perioperative period is used to describe the
three phases of any surgery which includes:
Preoperative phase
Intraoperative phase
Postoperative phase
Phases of Perioperative Period
care
Preoperative phase: period of time from decision for surgery until
patient is transferred into operating room
Intraoperative phase: period of time from when patient is
transferred into operating room to admission to post anesthesia
care unit (PACU)
Postoperative phase: period of time from when patient is admitted
to PACU to follow-up evaluation in clinical setting or at home
Types of Surgery
Preoperative Assessment
Physical
Psychological
Cultural
Assessment of Preoperative physical needs
Review laboratory and diagnostic study
Blood type and cross match
Past medical history
Past problem with anesthesia
Previous hospitalization and history
Allergies
Present medication
Body systems examination
Assessment of Preoperative Psychological Needs
Fear of:
The unknown
Pain and discomfort
Mutilation and disfigurement
Anesthesia.
Disruption of life patterns
Death/not waking up.
Not being in control.
Assessment of Preoperative Cultural needs
Beliefs
Language
Preoperative check list (sign in )
Surgery consent
Patient identification
Vital signs – allergy
Types of isolation
Fasting - Preoperative medication
Radiological , lab and other studies reports
Teeth / denture –contact lenses
–make up –jewelry- connections
Preoperative check list (sign in )
Pre operative clothes
Operation side
Site mark
Types of isolation
Skin preparation
Special medical equipment
Intraoperative check list (Time out)
Just before procedure/surgery inside the operating theater
Team member
surgeon-assistant- anesthesiologist -scrub nurse –circulating nurse
They check for
Name of patient
Medical record number
Date of birth
Diagnosis
Procedure name
Procedure side and site
Operating Room Nurses
Scrub nurse Circulating nurse
a registered nurse who manages
a nurse who assists doctors
the flow of patients and materials
,and patients during surgery .in an operating room nurse
Postoperative check list (sign out )
Before patient leaves OR Nurse confirm with the surgeon :
Name of procedure done
Sponge/needle/dressing/gauze counts
are correct before incision /Closure
The specimen is labeled and handed over
Operation report is written
Anesthesia forms are complete
Drains ,connections
Medical devices
Postoperative Operative Plan of Care
Transfer (ward-ICU)
Position (supine-lateral-semi sitting-limb elevation )
Mobility (as soon as possible –strict to bed-physiotherapy)
Nutrition (NPO-NGT-feeding specify )
Monitoring (vital signs –RBS-CBC …)
Fluid chart (intake –output )
Postoperative Operative Plan of Care
Wound (covered-exposed –frequency of care )
Drain (color-volume-patency-position )
Urine output (voiding –catheter)
Other connections
Other instructions
