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What does the peri-operative nurse role involve?

- Patient advocacy
- Scientific nursing interventions
– Critical thinking
– Clinical reasoning
– Caring
– Comfort


What is the environment of the operating room?

Restricted area-accessed through semi restricted area masks and other
PPE required to supplement perioperative attire during surgery or procedure

Lighting – low to high intensity range for a precise view of the surgical
site. Ultraviolet UV lighting/UV radiation reduces the number of microrganisms in the air

Temperature -20-22 degrees celsius can inhibit bacterial growth

Humidity- 50%-60% inhibits bacterial growth decreases potential risks
with static electricity

Positive Air Pressure-prevents airflow from entering from halls and corridors. Filters and controlled airflow in the ventilating systems provide dust control and a role in reducing postoperative infection in complex surgical procedures

AS/NZ Standards indicate air conditioners ultraclean air systems minimum 20
air changes per hour

Electrical equipment – checked frequently by biomedical engineers/functioning/ electrical safety

Communication System- delivery routine emergency messages throughout the
perioperative environment

The Australian College of Perioperative Nurses (ACORN) outlines standards for
the planning and design of operating


Describe the Anaesthetic nurses role?

- Functions accordance with the ANZCA Guidelines
– Prepares and checks the anaesthetic machine
– Prepares and checks anaesthetic equipment and intravenous
– and arterial lines as required
– Acts as a patient advocate at all times
– Participates in time- out
– Assists the anaesthetist in the induction and maintenance of the anaesthetic
– Understands and prepares for any anaesthetic emergency and assists in any anaesthetic emergency
– Assists the anaesthetist in safe extubation on completion of surgery


What is the scrub nurses role?

- Reviews anatomy and physiology and surgical procedure
– Completes surgical hand and arm scrub gowns /gloves self
– Prepares instrument table and organises sterile equipment
– Assists with skin preparation and draping of the surgical site
– Participates in time-out
- Passes instruments to surgeon and assistant by anticipating their needs
- Maintains an accurate account of sponges needles instruments and other medical devices that may be retained in the patient
- Maintains practice of aseptic techniques in self and others
- Reports medications used by the surgeon and monitors irrigation fluids used for calculation of blood loss


What is the circulating nurses role?

- Plans and coordinates intraoperative nursing care
- Assists in preparing the operating room ensuring supplies and equipment are available and in working order and sterile
- Maintain aseptic technique in all required activities
- Monitors self /others in practices of aseptic technique
- Identifies and admits the patient to the operating room
– Participates in time-out
– Maintains an accurate count of sponges needles instruments and other medical devices that may be retained in the patient
– Documents intraoperative care/ Surginet


What is the Postanaesthesia Care Unit PACU Nurse Role?

Stage 1 recovery patient unconscious
– Require one to one nursing care
– Close monitoring of vital signs
– Temperature
– Assessment of possible postoperative complications
– Medications for pain and postoperative nausea and vomiting (PONV) intravenously faster onset than intramuscular and oral
- Patients transferred to Stage 2 recovery or a postsurgical ward area when appropriate discharge criteria has been met
- Requires minimum of a 1:4 nurse to patient ratio for lowacuity uncomplicated patients
- Higher staffing ratio to be considered when higher- acuity
patients are admitted to the area


What does the initial PACU assessment involve?

initial PACU assessment:

Airway- patency/ oral or nasal airway/supraglottic airway LMA

Breathing –respiratory rate and quality/ auscultated breath sounds/ pulse oximetry/ supplemental oxygen

Circulation-ECG monitoring/ rate and rhythm / blood pressure/ temperature / capillary refill (peripheral return) / colour and temperature of the skin/ peripheral pulses

Neurological- level of consciousness/ orientation/ sensory and motor status/ pupil size and reaction

Gastrointestinal –nausea/ vomiting/intake/ fluids/ irrigations
– Genitourinary –output/ urine/ drains
– Surgical site -dressings and drainage/ per vagina loss/ fundal height/ pain/ incision

– Other- other surgery-specific assessments or observations/
pedal pulses/ vascular observations / Glasgow Coma Scale