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ppt on meeting and need of preoprative patient.pptx

Preoperative care involves a vital multidisciplinary assessment to ensure the patient is physically and psychologically fit for surgery. It includes gathering medical history, conducting physical and airway examinations, ordering targeted tests, managing medications, and providing education on fasting and recovery to minimize risks.

Education◦
MEETING AND NEEDS OF PRE OPERATIVE PATIENT Abhilasha NURSING LECTURER DIMS
“The term used to describe the wide variety of nursing function associated with the patient’s surgical experience.” The preoperative nursing are divided in to three phage  Preoperative  Intra operative  Post operative INTRODUCTION
 Preoperative :- From the time the decision is made for surgical intervention to the transfer of the patient to the operation room.  Intra operative :- From the time the patient received in the operative room until he is admitted in the recovery room.  Postoperative:- From the time the decision to the recovery room to the follow –up evaluation in the clinic or at home.
 To get the patient in the best possible physical and psychological condition for surgery.  To make every provision for the safe administration of anesthesia  To prevent or treat circulatory failure  To aid in the healing of the wound  To prevent or treat complication  To rapidly restore the function of body and mind. NURSING OBJECTIVE OF THE PREOPERATIVE PERIOD
 Surgery :- Treatment by operating procedures, that branch of medicine healing with manual or operating procedures of correction of deformities and defects, for repair of injuries and for diagnosis and cure of certain disease.  Emergency surgery:- Surgery which must be done immediately in order to prevent shock, hemorrhage, and others complication.
 Acute abdomen  Rupture uterus  Major bone fracture  Ruptured spleen Elective Surgery:- Surgery which can be done, as it is convenient and good for the patient , or when the doctors and accommodation is available.  Repair of scars  Removal of superficial cyst  Tonsillectomy
 Should have a good knowledge of microbiology, anatomy and surgical disease and conditions.  Should be alert and very observing in noting sign and symptoms indicating any complication or a change from normal.  Should understand the aim of the surgeon in order to give better assistance.  Should know how to give intelligent nursing care so that the patient may recover without comlication. Essential for surgical nurse
Major nursing goals  Assist the patient in understanding the physical and psychological aspects of the surgical experience.  Explain the patient and family members regarding hospital environment routine, and expectation of planned surgery.  To prepare the patient physically and psychologically for the anesthetic and operation. Preoperative management and nursing care
 To cooperate with the other members of the health teams in coordinating all the preoperative preparation Psychological Preparation :-  It is important that the patient be psychologically prepared for the operation in and attempt to reduced anxiety and emotional reaction caused by:  Fear of anesthesia  Fear of death  Fear of pain  Fear of poor prognosis  Fear of destruction of body images
Nursing approach:-  The nurse should show kindness  Maintain I.P.R with the patient and family members  Treat the patient as an individual  Listen the patient carefully  Provide the psychological support to the patient  Attempt to build patient confidence
Benefits of psychological support:-  Patient will sleep better  Patient will less experience of urinary retention  Need less anesthetic and pain medicine Spiritual therapy:- Help the patient to obtain full spiritual help
Physical Assessment:- This is done chiefly by the doctors, but the nurse has responsibility in understanding it and it importance, and the need to report to the doctors any observation makes while caring of patient.  Diagnosis tests:  Chest X- ray  Blood test  MRI  USG
 Assessment of nutritional status:- for finding out the deficiencies of nutritional status like, protein, calories, minerals and vitamins.  Assessment of hydration status:- maintain the hydration status of the patient before going for surgery  Assessment of respiratory status:-  Patient should stop smoking 4- 6 week of surgery  Teach the patient regarding deep breathing exercise or used incentive spiromataty
 Assessment of cardiovascular status:-the patient for surgery should have a well functioning cardiovascular system to meet the oxygen, fluid and nutritional needs throughout the preoperative period.  Assessment of hepatic function:- acute liver disease is associated with high surgical death rate, so preoperative improvement in liver function is desired.
 Assessment of endocrine function:- a patient with uncontrolled diabetic mellitus have surgical risk especially from hypoglycemic which can come on very rapidly during anesthesia or the postoperative periods  Assessment of renal function :- anesthetic drugs and their metabolites are excreted through kidney function is essential.  Assessment of immunological function:- Patient must assess any kind of allergies any history of reaction especially to drugs.
 Assessment of prior drugs therapy:-  What drugs has the patient been taking on his own or given by some other doctors  Any drug addiction  Alcohol addiction  Risk factors :-  If there are too many negative factors the patient is considered a poor surgical risk  some risk factors for any surgical procedure are,  Hypovolemia  Toxic condition  Electrolight imbalance
 Dehydration  Pulmonary disease  Renal disease  Hepatic disease  Cardiac failure  Hypertension  Thromboembolism  Diabetic mellitus  Thyroid mal function
 Operative permit :-  To protect against the claims of unauthorized surgery.  Before singing the permits, the patient should be given complete explanation of  What surgery need to be done  Possible complication  Possible disability from removal of body part  Explain the whole procedure  If patient is minor (<18 years) than take sign from guardian
If patient above age 18 and mentally healthy than patient can done signature. If patient is unconscious than family members will do sign. Responsible family member can sign those are-  Father or mother  Husband and wife  Brother and sister
 No patient should be force to sign an operative permit.  Refusing to have an operation or surgical procedure is a person right and privilege.