Perioperative
rupture of an organ
Nursing
used to describe the
PERIOPERATIVE NURSING - 
nursing care provided in the total
surgical experience of the patient:           Type of surgery according to
a. Preoperative
b. Intraoperative
c. Postoperative.
Preoperative Phase
- Extends from the time the client is
admitted in the surgical unit, to the time
he/she is prepared for the surgical
procedure, until he is transported into
the operating room
Intraoperative Phase
-Extends from the time the client is
admitted to the OR, to the time of
administration of anesthesia, surgical
procedure is done, until he/she
is transported to the RR/PACU.
Postoperative Phase
Extends from the time the client is
-  a procedure to test for cervical cancer in
admitted to the recovery room, to the
time he is transported back into the
surgical unit, discharged from the
hospital, until the follow-up care.
4 Major Types of Pathologic
Process Requiring Surgical
Intervention (OPET)
Obstruction - impairment of the
flow of vital fluids ( blood, urine, CSF,
bile)
Perforation - 
Erosion - wearing off of a surface or
membrane
Tumors - abnormal new growths
purpose:
  Diagnostic – to establish
the presence of a  disease
condition. ( e.g biopsy)
 Exploratory – to determine
the extent of disease condition ( e.g
Ex-Lap )
 Curative – to treat the
disease condition
 Ablative – removal of an
organ “ectomy” 
 Constructive – repair of
congenitally defective  
organ  “plasty,  oorhaphy,pexy”    
Reconstructive – repair of damage
organ 
 Palliative – to relieve
distressing sign and  symptoms, not
necessarily to cure the disease.
Pap Smear  ------------>Diagnostic
A Pap smear, also called a Pap test, is
women.A Pap smear involves collecting
cells from your cervix — the lower,
narrow end of your uterus that's at the
top of your vagina.Detecting cervical
cancer early with a Pap smear gives
you a greater chance at a cure.
Tonsillectomy ----> Curative-Ablative
Tonsillectomy is a surgical procedure in
which both palatine tonsils are fully
removed from the back of the throat.
The procedure is mainly performed for
recurrent throat infections and
obstructive sleep apnea.
https://www.youtube.com/watch?v=oSRtTclbtsE&t=1s

Osteoplasty-> Curative - Constructive
replacement of lost bone tissue or
reconstruction of defective bony parts.
https://www.youtube.com/watch?v=ZSTAE-xlry8

Perineorrhaphy-->Curative - 
Reconstructive
suture of the perineum (Links to an
external site.) usually to repair a
laceration occurring during labor

Trachelorrhaphy--->Curative -
Constructive
Trachelectomy: Surgical removal of the
cervix, the lower portion of the uterus
that protrudes into the vagina.
Trachelectomy is done in younger
women with early cancer of the cervix
(with a tumor no larger than 2-3
centimeters). In this  surgery, the cervix
and the upper part of the vagina are
removed but the rest of the uterus is left
in place.
Skin Grafting-->Curative -
Reconstructive
the procedure by which such a piece of skin is
removed and transferred to a new area
Example of Ambulatory
Surgery
- Teeth extraction
https://www.youtube.com/watch?
v=waWUk7ZBGhg&feature=emb_logo

 Circumcision
 Vasectomy
 Cyst removal
 Tubal ligation
 How anesthesia works

Phase 1 :
Preoperative
Physiologic Assessment of
the Client undergoing
Surgery
 Presence of Pain
 Nutritional & Fluid and
Electrolyte Balance
 Cardiovascular /
Pulmonary Function
 Renal Function
 Gastrointestinal /
Liver Function
 Endocrine Function
 Neurologic Function
 Hematologic Function
 Use of Medication
 Presence of Trauma
& Infection
Manifestation of Fears
- anxiousness
- bewilderment
- anger
- tendency to exaggerate
- sad, evasive, tearful, clinging
- inability to concentrate
- short attention span
- failure to carry out simple
directions
- dazed
  Any surgical procedure
where scalpel, scissors,    
suture, hemostats of
eectrocoagulation may be 
used.
 Entrance into body cavity.
 Radiologic procedures,
particularly if a contrast
Informed Consent material is required.
 General anesthesia, local
Purposes of Informed infiltration and regional block.
Consent
 To ensure that the
client understand the nature
of the treatment including
the potential complications
and disfigurement
( explained by AMD )
 To indicate that the
client’s decision was made
without pressure.
 To protect the client
against unauthorized Requisites for
procedure. Validity of Informed
 To protect the Consent
surgeon and hospital
against legal action by a  Written permission is
client who claims that an best and legally accepted.
authorized procedure was  Signature is obtained
performed. with the client’s complete
  understanding of what to
occur.
Circumstances
Requiring Consent - adult sign their own operative
permit
-obtained before sedation Before Surgery:

 For minors, parents or  Correct any

someone standing in their dietary deficiencies
behalf, gives the consent.  Reduce an obese
person’s weight
Note: for a married emancipated minor
parental consent is not needed anymore,
 Correct fluid and
spouse is accepted electrolyte imbalances
 Restore
 For mentally ill and adequate blood volume
unconscious patient, with blood transfusion
consent must be taken from (BT)
the parents or legal  Treat chronic
guardian diseases
 If the patient is unable  Halt or treat any
to write, an “X” is accepted infectious process
if there is a witness to his  Treat an alcoholic
mark person with vitamins
 Secured without  supplementation,
pressure and threat IVF or fluids if dehydrated
 A witness is desirable
– nurse, physician or
authorized persons.
 When an emergency
situation exists, no consent
is necessary because
inaction at such time may
cause greater injury.
(permission via
telephone/cellphone is
accepted but must be
signed within 24hrs.)
 

Preoperative Care
Physical Preparation