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|Behavioral Objectives |Content Outline |Clinical Objectives |Learning Opportunities |

|Define the terms listed in the content column |Application of terms |Evaluate quality of care and learning |Review: |

|appropriate to the patient situations. |Abscess |needs of self, peers, or others. |Operating Room Orientation Packet in RNSG 2561 |

| |Anesthesia | |Readings: |

| |Anesthesiologist |Identify organizational procedures for |McKinney |

| |Anesthetist |reporting/ solving patient care |Adams |

| |Anticholinergics |problems. |Lewis |

| |Atelectasis | |Berman & Snyder |

| |Biopsy |Inform and support health rights of | |

| |Hyperventilation |patients. |TVCC Library – Nursing Education on Video |

| |Hypovolemic shock | | |

| |Hypoxia |Provide nursing care to patients and | |

| |Incentive spirometry |families within limits of nursing |Aseptic Nursing Techniques at the Bedside: |

| |Infection |knowledge and experience and the legal/|Demonstrations of Aseptic Techniques. |

| |Inflammation |ethical standards of care. | |

| |Informed consent | |Aseptic Nursing Techniques at the Bedside. |

| |Intraoperative |Select and carry out safe and | |

| |Lithotomy position |appropriate activities to assist |Aseptic Nursing Techniques at the Bedside: The |

| |Medical asepsis |patient to meet basic physio-logic |Sterile Field. |

| |Perioperative |needs, including: Circulation, | |

| |Postoperative |nutrition, oxygen-nation, activity, |Aseptic Nursing Techniques at the Bedside: |

| |Preoperative |elimination, comfort, rest and sleep. |Transmission of Infection. |

| |Pyogenic-pus producing | | |

| |Pyrogenic-fever |Carry out measure to prevent exposure |Aseptic Nursing Techniques in the OR: Creating and |

| |Surgical asepsis |to and transmission of pathogens. |Maintaining a Sterile Field. |

| |Surgical classifications | | |

| |Diagnostic |Evaluate quality of care and learning |Aseptic Nursing Techniques in the OR: Gowning, |

| |Curative |needs of self, peers, or others. |Gloving, and Surgical Skin Prep. |

| |Palliative | | |

| |Reconstruction/cosmetic |Assist health care providers in |Aseptic Nursing Techniques in the OR: Principles of |

| |Reparative |reporting patient care problems. |Sterile Technique. |

| |Surgical indications | | |

| |Emergency | |Aseptic Nursing Techniques in the OR: Surgical Hand |

| |Elective | |Scrub. |

| |Optional | | |

| |Required | | |

| |Urgent | | |

| |Endarterectomy |Collaborate with other health care | |

| | |providers and members of the | |

| | |organization to solve patient care | |

| | |problems. | |

|Compare and contrast the effects of surgery on the | | | |

|normal anatomy and physiology of major systems across |Anatomy and Physiology |Select and carry out appro-priate | |

|the lifespan. |Neurologic |nursing measures to promote | |

| |Respiratory |psychosocial well-being. | |

| |Cardiovascular | | |

| |Hepatic and Renal |Administer medications and treatments | |

| |Endocrine |safely. | |

| |Immunology | | |

| |Developmental considerations | | |

| |Infant | | |

| |Child | | |

| |Adolescent | | |

| |Adult | | |

|Analyze factors included in the assessment of the |Older adult | | |

|surgical patient, | | | |

|including the developmental and cultural |General Physical Assessment | | |

|considerations. |Interview | | |

| |Chief complaint | | |

| |Precipitating event | | |

| |Medical history | | |

| |Family/social/occupational history | | |

| |Medication history (prescription/non-prescription) | | |

| |Knowledge of surgical procedure | | |

| |Identify risk factors for surgery/anesthesia | | |

| |General Physical Assessment | | |

| |Neurological | | |

| |Level of consciousness (LOC) | | |

| |Psychosocial | | |

| |Anxieties | | |

| |Fear | | |

| |Mood | | |

| |Perception of event | | |

| |Emotional reaction/coping Mechanisms | | |

| |Availability of financial assistance | | |

| |Nutritional status/chemical substance use | | |

| |Obesity | | |

| |Drug or alcohol | | |

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| |Respirations | | |

| |Respiratory | | |

| |Rhythm | | |

| |Depth | | |

| |Effort | | |

| |Breath sounds | | |

| |Smoking | | |

| |Infection | | |

| |Cardiovascular | | |

| |Blood pressure | | |

| |Lying | | |

| |Sitting | | |

| |Standing | | |

| |Pulses | | |

| |Capillary refill time (CRT) | | |

| |Pre-existing conditions | | |

| |Gastrointestinal (GI | | |

| |Palpation | | |

| |Auscultation | | |

| |Hepatic and renal function | | |

| |Endocrine function | | |

| |Blood glucose (diabetes) | | |

| |Use of steroid medications | | |

| |Immunologic function | | |

| |Allergies | | |

| |Temperature | | |

| |Previous medication therapy | | |

| |Development considerations | | |

| |Age Specific | | |

| |Sensory limitations | | |

| |Mouth and teeth | | |

| |Skin | | |

| |Fears | | |

| |Special Needs Patient | | |

| |C. Preoperative assessment | | |

| |Nutrition | | |

| |Nothing by mouth (NPO) | | |

| |Dehydration | | |

| |Preoperative check list | | |

| |Baseline vital signs | | |

| | | | |

| |Post-operative assessment | | |

| |Airway patency | | |

| |Vital signs | | |

| |Neurological status | | |

| |Tubings and drains | | |

| |Surgical report | | |

| |Diagnosis (DX) – pre and post | | |

| |Medications given | | |

| |Problems occurred | | |

| |Pathology encountered | | |

| |Blood loss | | |

| |I & O | | |

| |Other data | | |

| |Post anesthesia care unit (PACU) scoring guide | | |

| |Diagnostic tests | | |

| |Laboratory studies | | |

| |Complete blood count (CBC) | | |

| |Prothrombin time (PT) | | |

| |Partial thromboplastin time (PTT) | | |

| |Electrolytes | | |

| |Urinalysis | | |

| |Type and cross match (TCX) | | |

| |Radiology | | |

| |Chest x-ray | | |

| |X-rays | | |

| |Electrocardiogram (EKG/ECG) | | |

| |Cultures | | |

| |Frozen sections | | |

| |Cultural influences | | |

| |Language | | |

| |Health beliefs/practices | | |

| |Spiritual beliefs | | |

| |Religious practices | | |

| |Developmental | | |

| |Age specific assessment data | | |

| |Vital signs | | |

| |Fluid/electrolytes | | |

| |Nutritional | | |

| |Physical changes | | |

| |Behavioral/emotional response to health care providers | | |

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|Discuss legal and ethical issues related to patients | Legal/ethical issues | | |

|undergoing a surgical procedure. |Informed consent | | |

| |Criteria | | |

| |Responsibilities | | |

| |Signatures | | |

| |Patient Rights | | |

| |Blood administration | | |

| |Confidentiality | | |

| |Privacy | | |

| |Patient advocate | | |

|Differentiate between the etiology, pathophysiology, |Selected surgical procedures | | |

|and clinical manifestations of selected surgical |Abdominal surgeries | | |

|procedures. |Laparoscopic | | |

| |Cholecystectomy | | |

| |Open | | |

| |Appendectomy | | |

| |Tonsillectomy & adenoidectomy (T&A) | | |

| |Myringotomy & tube insertion | | |

| |Total knee replacement (TKR) | | |

| |Laparoscopic knee surgeries | | |

| |Fractures – cast care | | |

| |Open reduction and internal fixation (ORIF) hip | | |

| |Total hip replacement (THR) | | |

|Discuss analysis, planning, implementation and |Selected nursing diagnoses/nursing implementation | | |

|evaluation for the nursing management of patients |Knowledge deficit: Preoperative teaching | | |

|undergoing a surgical procedure. |Independent interventions | | |

| |Assessment | | |

| |Knowledge level | | |

| |Developmental stage | | |

| |Expectations | | |

| |Pertinent information | | |

| |Exercises | | |

| |Turning | | |

| |Pain control | | |

| |Teaching aids | | |

| | | | |

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| |Collaborative interventions | | |

| |Informed consent | | |

| |Knowledge of surgical procedure | | |

| |Information about complications | | |

| |Legal | | |

| |Administer medications and monitor for desired effects and | | |

| |adverse/side effects | | |

| |Narcotics | | |

| |Analgesics | | |

| |Sedatives | | |

| |Tranquilizers | | |

| |Anticholinergic | | |

| |Nutrition and fluids | | |

| |Intestinal preparation | | |

| |Skin preparation | | |

| |Recognition of complications | | |

| |Evaluate outcome of nursing interventions: Patient demonstrates | | |

| |understanding | | |

| |Methods of evaluation | | |

| |Patient verbalizes understanding | | |

| |High risk for intraoperative complications | | |

| |Independent interventions | | |

| |Assessment | | |

| |Age related considerations | | |

| |Collaborate intervention | | |

| |Roles of surgical team | | |

| |Positioning | | |

| |Skin care/Center for Disease Control standards (CDC) | | |

| |Monitor for desired effects and adverse/side effects | | |

| |General anesthesia | | |

| |Gas inhalation | | |

| |Intravenous agents | | |

| |Conscious sedation | | |

| |Regional anesthesia | | |

| |Topical | | |

| |Spinal | | |

| |Epidural | | |

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| |Recognition of complications | | |

| |Arrest/Dysrhythmias | | |

| |Hypotension/hypertension | | |

| |Hemorrhage | | |

| |Evaluation outcome | | |

| |Patient will return to preanesthetic level of consciousness (LOC) | | |

| |Ineffective airway clearance Post Anesthesia | | |

| |Care Unit (PACU) | | |

| |Independent interventions | | |

| |Assessment respiratory function | | |

| |Age related considerations | | |

| |Maintain open airway | | |

| |Promoting lung expansion | | |

| |Turn, cough, and deep breathe | | |

| |Incentive spirometry | | |

| |Splint incision | | |

| |Collaborative interventions | | |

| |Administer oxygen | | |

| |Administer medications and monitor for desired effects and | | |

| |adverse/side effects | | |

| |Narcan | | |

| |Diagnostic tests | | |

| |Arterial blood gases (ABG) | | |

| |Pulse oximeter | | |

| |Recognizing complications | | |

| |Arrest/Dysrhythmias | | |

| |Hypertension/hypotension | | |

| |Respiratory depression | | |

| |Bronchospasms | | |

| |Laryngospasm | | |

| |Malignant/hyperthermia | | |

| |Hypothermia | | |

| |Aspiration | | |

| |Atelectasis | | |

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| |Evaluation outcome | | |

| |Maintain patent airway with adequate exchange | | |

| |SaO2 94% or greater (>) | | |

| |Fluid and electrolyte imbalance (post-operative) | | |

| |Independent interventions | | |

| |Assessment | | |

| |Age related hydration status | | |

| |Intake and output | | |

| |Monitor pertinent diagnostic tests | | |

| |Maintain skin integrity | | |

| |Collaborative interventions | | |

| |Administer replacement fluid | | |

| |Oral replacement solutions | | |

| |Intravenous therapy | | |

| |Administration medications and monitor for desired effects/adverse | | |

| |effects | | |

| |Potassium chloride (KCL) | | |

| |Recognition of complications | | |

| |Hypovolemic shock | | |

| |Hyper/hypokalemia | | |

| |Hyper/Hyponatremia | | |

| |Fluid volume excess | | |

| |Evaluation outcome: Patient will demonstrate adequate perfusion as | | |

| |exhibited by: | | |

| |Intake & Output | | |

| |Electrolyte balance | | |

| |Vital signs | | |

| |Pain and other postoperative discomforts | | |

| |Independent interventions | | |

| |Assess coping strategies and related factors | | |

| |Pain assessment | | |

| |Perception of pain | | |

| |Pain assessment scales | | |

| |Physiologic responses | | |

| |Behavioral responses | | |

| |Influencing factors | | |

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| |Past experience with pain | | |

| |Anxiety | | |

| |Culture | | |

| |Age | | |

| |Placebo effect | | |

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| |Provide physical care | | |

| |Manage anxiety | | |

| |Pain management strategies | | |

| |Theories of acute pain management | | |

| |Pharmacologic interventions | | |

| |Nonpharmacologic measures | | |

| |Massage | | |

| |Ice and heat | | |

| |Transcutaneous electrical nerve stimulation (TENS) | | |

| |Distraction | | |

| |Relaxation techniques | | |

| |Guided imagery | | |

| |Hypnosis | | |

| |Skin Traction | | |

| |Skeletal Traction | | |

| |Teach appropriate and safe ways to use analgesics | | |

| |Collaborative interventions | | |

| |Administer medications and monitor for desired effects and | | |

| |adverse/side effects | | |

| |Analgesics | | |

| |Preventive approach (around the clock schedule) | | |

| |Individual doses | | |

| |Patient-controlled analgesia (PCA) | | |

| |Opioids | | |

| |NSAIDs | | |

| |Routes | | |

| |Parenteral | | |

| |Oral | | |

| |Rectal | | |

| |Intraspinal | | |

| |Anticoagulants | | |

| |Recognizing complications | | |

| |Respiratory depression and sedation | | |

| |Nausea and vomiting | | |

| |Constipation | | |

| |Inadequate pain relief | | |

| |Addiction and tolerance | | |

| |Impaired circulation | | |

| |Evaluation of outcome | | |

| |Achieves pain relief | | |

| |Administers prescribed analgesic medications correctly | | |

| |Uses nonpharmacologic pain strategies as recommended | | |

| |Reports minimal side effects of interventions | | |

| |Potential other post operative complication | | |

| |Independent interventions | | |

| |Assessment | | |

| |Respiratory | | |

| |Circulatory | | |

| |Neurologic | | |

| |Drainage | | |

| |Comfort | | |

| |Psychologic | | |

| |Safety | | |

| |Equipment | | |

| |Age related considerations | | |

| |Monitor pertinent diagnostic tests | | |

| |Collaborative interventions | | |

| |Fluid and electrolyte replacement | | |

| |Medications | | |

| |Recognition of complications | | |

| |Hypovolemia shock | | |

| |Hemorrhage | | |

| |Deep vein thrombosis (DVT) | | |

| |Wound infection | | |

| |Peritonitis | | |

| |Evisceration | | |

| |Dehiscence | | |

| |Urinary retention | | |

| |Gastrointestinal dysfunction | | |

| |Compartment Syndrome | | |

| |Fat Emboli | | |

| |Evaluation outcome | | |

| |Patient will return to preanesthetic LOC, sensory – motor activity, | | |

| |vital signs 20% plus or minus. | | |

| |Patient will be able to perform activities of daily living. | | |

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N:ADN/Spring 09/RNSG 2504 Unit III Care of the Patient Experiencing the Perioperative Cycle Revised 11/12

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