This is my OR/PACU. I didn't get it back yet, but i will add all the comments i got for it as soon as i'll get it back.
1. Identify 5 of the 6 types of stressors that patients experience during the perioperative period. Give at least one example of each type.
1. Physical: positioning and incision
2. Microbiological: risk for infection due to a break in the first line of defense and antibiotic therapy
3. Developmental: neonates/infants (small blood volume and limited fluid reserves), older adults (decreased kidney function and lower percentage of body water)
4. Psychosocial: Vegan (limited protein sources)
5. Physiological: Obesity (takes longer to heal), diabetes
2. Based on what you have observed in the OR/PACU, identify two priority nursing diagnoses for perioperative care at the following times.
a. Twelve hours pre-op
1. Deficient Knowledge related to lack of education about perioperative process.
2. Fear related to loss of control during anesthesia.
b. Intra-operative period
1. Risk for infection related to break in the first line of defense secondary to surgery
2. Ineffective protection related to effects of anesthesia secondary to surgery
c. One hour post-op.
1. Ineffective breathing patterns related to effects of anesthesia secondary to surgery
2. Risk for injury (bleeding) related to incision secondary to surgery.
3. Identify three ways the nurse maintains asepses in the operating room.
1. Assesses the surgical site for moles, warts, rashes, and other skin conditions, and prepares surgical site with antimicrobial agents.
2. Draping the patient with sterile drapes.
3. Assesses sterile field for breaks in sterility (holes)
4. Identify three ways the nurse maintains electrical safety in the room
1. Removing faulty equipments
2. Assure equipment is plugged in correctly (right circuits)
3. Assure proper placement of electrical equipment.
5. Identify three additional safety measures used in the OR/PACU
1. “Time Out” before the surgery begins
2. Counting all of the equipment
3. Proper positioning
6. Describe the commonalities of nursing interventions in the OR/PACU
Patient is position properly, patient’s safety is maintained by monitoring everything that is attached to the patient. Urine output is measured carefully and vital signs re monitored in both OR and PACU
7 Describe the differences in nursing care in the OR/PACU
Patient is able to protect him/her self during postoperative care, therefore less protection is
needed. Psychological support in needed during postoperative care, little communication done
during intraoperative period.
8. Identify two different positions a patient may be placed in during an operative procedure. Give
an example of an operation that require that position and identify an intraoperative and/or
postoperative nursing assessment for each position.
a. Position b. Example c. Nursing Assessment
1. Dorsal recumbent Hysterectomy Prevent hyperextension of neck
Assess sacrum for edema
Assess sacrum and heels for pressure ulcers
2. Prone Position Spinal surgery Assess for pressure ulcer on the
face
place pillow under the head to prevent flexion or hyperextension of the neck
support lower legs on a pillow or allow feet to fall naturally over end of the operation table to prevent foot drop
9. Identify two ways the OR/PACU nurse acts as a patient advocate
1. Preventing physical, electrical and microbiological hazards
2. Time Out (Identification of the patient and surgery site and type)
10. identify the criteria used to determine a patient’s length of stay in the PACU
Awake and oriented , able to maintain clear airway, deep breathing and coughing freely, VS are
stable or consistent with preoperative vital signs for at least 30 minutes. Protective reflexes
(gag, swallowing) are active. Able to move all extremities, adequate I&O, afebrile or febrile
condition has been attended to. Dressings are dry and intact; there is no overt drainage.
11. Discuss how this experience will affect the post operative care you give to your patients.
This experience gives a better understanding of complications the patient is experiencing. I was
able to visualize some of the stressors the patient is experiencing during intraoperative care. I
was able to see the changes in vital signs and their changes during the surgery. While seeing the
breathing patterns immediately after the surgery it became clear how important it was to
closely monitor breathing (respiration rate was changing rapidly for 3 to 50 breath/min in just a
few minutes. I was able to better understand the healing process after seeing the size and depth
of the incision.