Transcript PATIENT CARE CONCEPTS

PATIENT CARE CONCEPTS
WEEK 7
Physical Health
• Relate the following health and wellness
concepts to the surgical patient and the
surgical technologist role:
• Physical activity
• Nutrition
• Tobacco use
• Alcohol use
• Stress
Post-Operative Complications
• Complications are difficulties post-operatively
that warrant immediate treatment and may result
in returning to surgery.
• Complications are accepted as risks of having
surgery, so are shared with the patient preoperatively before the surgical consent is signed
• Can result in prolonged hospitalization as well
as prolonging a patient’s recovery or return to
normal function
Types of Post-Operative
Complications
• Shock is inadequate blood flow, therefore poor
oxygenation to vital organs that can result in
irreversible damage to the organs involved
• Hemorrhage is heavy bleeding during, shortly
after, or some time after surgery
• Pulmonary Embolus or PE occurs when a
blood clot forms, is dislodged, and is carried to
the heart’s pulmonary artery
Types of Post-Operative
Complications Continued
• Respiratory secretion impairment can be from
inadequate clearing of secretions by the patient
(coughing, turning, deep breathing) or the
accidental aspiration of secretions. This can
result in aspiration pneumonia.
• Gastro-intestinal/bowel obstruction is most
often seen after surgery involving the abdomen.
It can occur in 3 to 5 days post-op or years down
the road.
Types of Post-operative
Complications Continued
• Post-op Psychoses is caused by
temporary lack of oxygen to the brain. It
can result in depression, anxiety, mental
confusion, and hallucinations. This can
also be a result of the anesthetic or pain
medications.
• Retained foreign body
Equipment/Immediate Access
Preparing for Complications
• Keep set-up sterile as well as yourself if
able until the patient is assuredly stable
and ready for transport
• Need to be prepared should you have to
go back in to a patient
• Oxygen
• Defibrillator
Post-Anesthesia Care Unit
(PACU)
• Given there are no complications,
established criteria must be met by the
patient before they can be discharged to
the surgical floor of the hospital or home in
the case of out-patient surgery
Post-Operative/Discharge
Instructions
• May vary with type of operation
• Activity will be encouraged/Limits will be on
lifting, pulling, and straining
• Rest will be encouraged
• Driving and operation of heavy machinery may
be discouraged for awhile
• Resumption of sexual intercourse may have a
time frame
• Resumption of showering and tub bathing may
have a time frame
Discharge or Post-Operative
Instructions Continued
• Alcoholic beverage consumption may have a
time frame
• Smoking will be discouraged
• Diet may be progressive
• Instructions on dressing changes will be given
• Prescriptions will be given
• Follow-up doctor appointment will be made
Discharge or Post-Operative
Instructions Continued
• The following will be reported to the patient’s
doctor by the patient immediately:
• Fever
• Prolonged nausea and vomiting
• Swelling or excessive bleeding
• Excessive pain
• Inability to urinate or void
• Inability to pass stool or defecate
Death and Dying
(The Grieving Process)
• Kübler-Ross Stages of Grief as experienced
by the patient and the family:
• Denial-does not accept death as a reality.
Pretends it isn’t happening. This prolongs
communication of concerns.
• Anger-Important not to take personally if the
health care provider. The person is expressing
their sense of helplessness and outrage over
their situation.
Kübler-Ross Stages of Grief
Continued
• Bargaining-involves a deal made with
God, the doctor, or nurse. For example “If
I can live until my grandson is born next
month, I’ll be ready to die.” When
possible, requests will be granted.
• Depression-the previous methods are no
longer working. The person feels sad and
full of anguish. Death is a reality. Support
is important at this time.
Kübler-Ross Stages of Grief
Continued
• Acceptance-The person has accepted the fact
they are going to die and is at relative peace
with it. They will want loved ones near. They
may or may not want to reflect on the past and
consider the future without them.
• These stages do not always occur in order.
Patients and families may go back and forth
between stages and will likely each be at
different stages.
Organ Transplantation and
Procurement Facts
• Organ transplantation is one of the twentieth
century’s greatest breakthroughs
• Fifteen people die every day waiting to receive
an organ transplant
• Supply and demand gaps are growing
• Organ procurement is based on patients and
families volunteering to donate their organs
• Cost is a factor (many insurances do not cover
expense/cost can range from $35,000 to
$200,000 the first year of a transplant