Pre Operative, Intra Operative and Post Operative Neurology System Impairment

Dr. Masliani

Pre Operative
Pre operation Nursing is begin when surgery action decision at take, and end when does client at carry over operation room

Assessment
Health History Physical Examination Documentation vital sign and Basic data at will uphold for that time comparison

Assessment
Organ function likes Asses towards respiration status Function hepar and kidney Endocrine function and Immunology function.

Informed Consent
Nurse responsibility in relation to informed consent ascertain that informed consent at give doctor at can voluntarily from client

Patient Education Pre Operation

Action supportive and education that done nurse to help operation patient in increase the well-being self before and after surgery

Intra Operative
Nursing intra operative be part from stage Nursing preoperative

GENERAL PRINCIPLES
Room Aseptic Principle Patient Aseptic Principle Instrumen Aseptic Principle

Function of Intra operative Nursing

Circulation nurse impersonates to regulate operation space and protect welfare and patient need with observe operation team member activity and investigate condition in operation space. Responsibility predominantly cover to ascertain cleanliness, appropriate temperature, humidity, illumination, watch over permanent device functioned and availability various materials that wanted before, during and postoperative
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Nursing Activity as General

Nursing activity that done during stage intra operative cover 4 matters, that is: a. Safety Management b. Monitoring Physiologist c. Monitoring Psychologies d. Rules and coordination Nursing Care

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Action that done for security guarantee among others: 1. Patient position arrangement 2. Turn on tool grounding to patient 3. Give physical support and psychologies in client to tranquilize patient during operation so that co-operative patient. 4. Ascertain that any device that wanted ready like: liquid infuse, oxygen, total sponges, needle and correct instrument
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Operation Team
Sterile : a. Surgeon b. Operation assistant c. nurse instrumentation (scub nurse)

Non Sterile : a. Expert anastesi b. Nurse anastesi c. Circulating nurse d. Technician (tool operator, pathologist etc. ) surgical team

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a. b. c.
a. b. c. d. e.

Sterile nurse haves: Prepare tool supplying and ingredient that need for operation Fossilize surgeon and assistant moment operation procedure goes on Help tool execution preparation that wanted to like needle, , scalpel, cashier and instrument that wanted for operation. Circular of Nurse have a duty: Assess, plan, implementation and evaluate nursing activity that can fulfill patient need. Defend environment safe and pleasant Prepare aid to every team member follows need. Take care communication delivers team member at operation space. Help to overcome problem that.

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NURSING DIAGNOSIS
Nursing diagnosis in stage intra operative usually appear: risk infection b. d procedure invasive (wound incisi)? Risk injury b, d example external environment condition structure environment, maintained tools, instrumentation and medicines use anastesi.
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NURSING IMPLEMENTATION
1. Give emotional support 2. Regulate appropriate position for patient 3. Defend condition asepsis dive surgery 4. Watch over patient temperature stability 5. Monitor the happening of hyperthermia malignant 6. Help operation wound closing 7. Help drainage 8. Move patient from operation space to space restoration/ICU
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POST OPERATIVE NURSING

Post operative Nursing later time periods from preoperative Nursing

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Stage of post operative Nursing

Treatment post operative cover several stages, among others: 1. patient transfer from operation room to treatment unit pasca anastesi (recovery room) 2. treatment post anastesi at restoration space (recovery room) 3. patient transportation to space takes 4. treatment at space takes
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Patient treatment aim at spur: 1. Defend breath road 2. Defend ventilation/oxygenation 3. Defend blood circulation 4. Generality observation, observation vomits and drainage 5. Balance liquid 6. Defend freshmen and prevent risk injury
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Treatment at space takes

a. Vital marking monitor and patient generality, drainage, tube/interval, and complication b. Wound management c. Mobilization early d. Rehabilitation e. Discharge Planning

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Nursing Diagnosis
Nursing Diagnosis may be appear? at the (time) of pasca operation a. b. c. d. e. f. g. Impaired gas exchange r. t residual effect of anesthesia Ineffective airway clearance r. t increased secretion Pain r. t surgical incision and positioning during surgery Impaired skin integrity r. t surgical wound, drains and wound infection Potential injury r. t effect of anesthesia, sedation and immobility Fluid volume deficit r. t fluid loss during surgery Altered patterns of urinary elimation (decreased) r. t anesthesia agent and immobility h. Activity intolerance r. t surgery and prolonged bed rest i. Self-care deficit r. t surgical wound, pain and treatment regimen j. Knowledge deficit r. t lack of information about treatment regimen

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Collaborative problem: a. change perfusion secondary network towards hypovolemia and vasoconstriction b. hypovolemia c. pk: infection d. etc

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Nursing Intervention
In general nursing intervention that given to patient post operation covers the followings: 1. ascertain optimal respiration function 2. increase expansion lung 3. cause the loss of uncomforted pasca operative: pain 4. cause the loss of discontent 5. cause the loss of sick and vomit 6. cause the loss of distension abdomen 7. cause the loss of hiccup
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cnt
8. Defend normal body temperature 9. Avoid dispute 10. Defend normal nutrition status 11. Increase function urinations normal 12. Increase to eliminate intestines 13. Position arrangement 14. Ambulasi 15. Practice in place sleep
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Thank you Any Question Guys..?

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