Question

1. What is the Pre-Operative Phase

A. What essential Data should the Nurse Obtain From the Patient and Family.

B. What Patient Education should be provided during the Pre Operative evaluation, this education is directed at prevention of Post operative Complications.

1. Coughing an Deep Breathng, use of Spirometer

2. Leg Exercises

3. Pain Control

2. What is the roll of the Circulating Nurse.

3. Why do we do Time Outs, is instrument and sponge count important and why.

4. What is The PACU, what nursing Interventions are conducted in the PACU and Why?

What is Malignant Hyperthermia?

Answer 1

1) Pre-operative phase is the initial phase which starts when the decision to have surgery is taken and ends when the surgical procedure begins. This phase can range from minutes( in case of emergency) to months(planned surgery). During this phase patient is prepared both physically as well as psychologically for the surgery to have better surgical outcomes.

A) Nurse should obtain the following data from the patient and Family

• Name, Age,Sex,
• Medical problem for which surgery is scheduled
• Medical history of the patient, e.g other co-morbid diseases or medical problems.
• Surgical history of the patient, like plastic surgery, rhinoplasty etc.
• Medical history of family.
• Any other medication taking
• Alcohol or tobacco use
• physical assessment of patient vitals, weight, height, emotional status.

B) Patient education is necessary during preoperative phase to prepare patient for the surgery and reduce the postoperative complications. Pre-operative education includes,

• Coughing and deep breathing exercise, which involves inhaling of several deep breaths followed by short breath and cough, to promote blood oxygenation and reduce the risk of postoperative respiratory complications.
• Leg exercise to stimulate blood circulation and increase venous return. It reduces the risk of thrombus formation due to blood clotting . Hence prevents patient from deep vein thrombosis (DVT).
• Promote early mobility to improve overall circulation, lung expansion, muscle tone and muscle strength.
• Prevention from pressure injuries by changing position regularly and facilitating movements.
• Adequate Intake of fluids and diet high in fiber to avoid constipation
• Pain management.

2) Circulating nurse is an important part pat of the surgical team to prepare the patient for the surgery ,maintain the operation room and manage the patient postoperatively. Circulating nurse does the necessary assessment of patient before surgery, protects the patient during surgery and provides postoperative care as well. In addition, it is the responsibility of circulating nurse to manage and prepare the operation room for surgery , keep track of all the necessary supplies and equipments used in the surgery and ensure that nothing is left at the surgical site of patient.

3) Time out is the universal Protocol,for preventing surgery, at wrong site, by wrong procedure, and to wrong person for all accredited hospitals, ambulatory care centers. We do time out to ensure that the procedure we follow is right and are doing it on right person at the proper site.

yes instrument and sponge count is important foe patient safety. Equipments and instruments are at risk of being retained inside the patient and therefore require proper counting and documentation to eliminate the risk. It is the responsibility of circulating and instrument nurse to perform the surgical count.

4) PACU is post anesthesia care unit. Patient is sent to PACU unit to recover and wake up after anesthesia and surgery. Patients are closely monitored , vitals are noted, fluid are given and pain management are some of the important function performed by PACU unit.

Malignant hyperthermia is a severe elevation in body temperature resulting from hypermetabolic crisis in skeletal muscle. It occurs in susceptible persons in reaction to a particular medication used for general anesthesia during surgery. Symptoms include high fever, Tachycardia, muscle rigidity and hyperkalemia.