Essay on Preoperative Nursing Case Study

Preoperative 1) The preoperative nurses reinforced education that was given to the patients by their doctor about the risks and benefits of the procedure they were undergoing. They also ensured that all consent forms were signed and explained the process of the procedure. They started peripheral IVs that were needed and hung fluids and any antibiotics that the doctor ordered before the surgery. The nurses also made sure that the patients followed any instructions that were given to them such as NPO and asked if the patient was still sure they wanted to go through with the procedure.

In terms of patient education, the nurse explained to the patient where they would be going for the surgery and the postop recovery procedures. They assured that the patient would be monitored closely after the surgery and that there would be nurses present when they awoke. My patient was going in for a laparoscopic gallbladder removal but there was a chance that the doctor might have to do a traditional removal and open the patient up if there were complications. She explained if that were to happen the patient would have to stay overnight for further observation.

The atient responded with questions regarding how much of a chance that would be and explained that he really wanted to go home the same day. The nurse also included the family in the education and told them what they would have to do while the patient was in surgery and when the doctor would come out and talk with them. 3) The patient was very nervous about having to stay overnight and specifically told me to let him know what happened during the surgery after he woke up.

He was excited however to get rid of the pain that he had been experiencing due to the gallbladder infections he had been aving. The nurse reassured the patient that if he had to stay overnight that there were good reasons for it and they just wanted him to go home healthy and not have further complications. 4) The nurse focused her assessment on the health history of the patient and made sure that he was suitable for anesthesia. She also checked his blood sugar because he was diabetic to make sure he would not experience any difficulties with hypoglycemia.

Lungs were assessed to ensure that there would be no complications with respiratory status postop. Like stated before, all consent forms were double hecked and the type of surgery was verified with the patient 5) Time out was done with both the surgeon and the anesthesiologist to ensure that they had the right patient, the right procedure, and all the risks and benefits were clear during the handoff of the patient. Intraoperative 1) My patient underwent a laparoscopic removal of his gallbladder due to gallstones and reoccurring infection.

It went very smooth and there were no complications. They made four incisions where they inserted a camera, the cauterizing machine, suctioning, and irrigation equipment. It all took about 50 minutes to complete. The surgeon first went in and removed fat that was covering the gallbladder. She then clamed the bile ducts so there would be no bile spilling into the abdominal cavity after they were severed. Then she began to cut the bile ducts and removed the gallbladder. )

Medications used were: Versed to initially put the patient asleep; Lidocaine was then used to help intubate the patient; then a anesthetic gas was pumped into the patients lungs to maintain the anesthesia; vasopressors were used during the surgery to keep the blood ressure high enough to perfuse the rest of the organs; a thrombin spray was used after the removal of the gallbladder to stop any bleeding. 3) There were three nurses present during the procedure that were all assigned to different roles.

There were two scrub nurses that were in charge of assisting the surgeon with the equipment and one of them was also in charge of constantly monitoring the patient’s vital signs with the anthologist. A circulating nurse was used to chart the whole procedure and fetch additional equipment outside of the room if needed. 4) They all went through a second time out to verify he patients identity, type of procedure, and any complications that may arise during the procedure.

They worked very well together in monitoring the patient and assisting the physicians. Postoperative 1) This nurse focused on the vital signs every 15 minutes and respiratory status of the patient when he awoke. She also provided additional pain medication when the patient asked for it and any antiemetic’s if the patient began to feel sick. This is also when the patient began to be gradually be introduced into oral fluids starting with ice chips and moving to water. She made ure that the patient was stable enough to move to phase 2 of the recovery.

During phase 2 the patient was given food and further monitored to ensure that he was well enough to go home. The patient was told that he would have to ambulate and void in order to be released. 2) She ensured that all incisions were closed properly and that there were no signs of hemorrhage. Her pain assessment was focused on the abdomen and right shoulder as this is common with this type of procedure due to abdominal expansion with gas. She also ensured that the patients airway was stable due to intubation. During handoff, the intraoperative team identified the patient, explained what procedure he underwent, explained his comorbidities (diabetes, COPD, and sleep apnea), gave their assessment of the patient, and recommendations of further medications that could be given to combat pain and nausea. Reflections 1)

The nurses were very good with explaining the plan with the patient and following through with that plan throughout the whole procedure. Any questions that the patient had were answered truthfully. All assessments were passed on effectively from one area to the next. SCIP measures that I observed were preop antibiotics given before the surgery, the absence of a urinary catheter, and the timely removal of the IV when it was no longer needed. Also hair removal was done in the preoperative area on the surgical site. All items were accounted for in the OR before the patient was able to move on to the next area. 3)1 thought overall this is a great experience to have for all nurses. It is important to see what really goes on throughout this process in order to understand potential risks of having a surgical procedure and what should be done if complications occur.

That being said, I don’t feel like I would really enjoy this type of nursing because a lot of skills were not used. The main skill was a thorough nursing assessment. I enjoyed being in the OR and acutally seeing the surgery but I did not like being in a standing position for a long period of time. I would rather be running around a unit checking multiple patinets then standing over an operating table. The one thing that surprised me the most was smelling the burning flesh from the cauterizer as it really made everything seem more real. That is something that I wasn’t really expecting going into it.