If a perioperative nurse notices that their patient is worried, they should take the appropriate nursing action to relieve her concerns: listen carefully, reassure, encourage her to express her anxiety or fear, then address it, and offer emotional support. Her level of anxiety would only rise if every surgical detail was explained.
Anxiety is natural before any stressful event, such as surgery, and it causes hypertension, an elevated pulse, and an increased respiration rate. On the patient's Preassessment Information Sheet, the Medical History section should include information about hypertension, COPD, and heart disease.
In addition to other areas of expertise, the perioperative nurse must be knowledgeable with anatomy, surgical techniques, instruments, OR equipment, and perioperative safety. Endotracheal tubes are inserted by the anesthesiologist or nurse anesthetist. While helping with intubation, the perioperative nurse is not responsible for locating internal anatomic markers to guarantee proper tube placement.
Age over 50, a history of varicose veins, myocardial infarction, atrial fibrillation, malignancy, ischemic stroke, prior DVT, diabetes, obesity, paralysis, and inhibitor deficient condition are risk factors for deep vein thrombosis (DVT). Ovarian cysts in the past do not enhance the risk of DVT.
A never event is a negative occurrence that is easily quantified and clearly recognizable, causes substantial disability or death, and is typically preventable. The following situations should never occur: wrong-patient or wrong-body-part surgery; improper technique; retention of a foreign object after surgery; medication error or contaminated medication; inappropriate equipment use; IV air embolism; incompatible blood transfusion; stage 3 or 4 decubitus ulcers from improper positioning; wrong inhalation agent; burns; falls; or the death of an ASA Class 1 patient.
Deep vein thrombosis is avoided with graduated compression stockings (sometimes called sequential stockings). Proper posture prevents pressure sores from developing. Infections can be avoided with proper sanitary technique. Electrical damage can be prevented by using the right grounding methods and receiving proper instruction on how to use OR equipment. Due to the possibility of causing a pulmonary embolism, sequential stockings should not be used on the leg that is not affected by a DVT.
In addition to more typical worries related to surgery and anesthesia, the preoperative patient facing a breast biopsy also faces the anxiety of a change in body image (disfigurement). Anesthesia and surgical procedures can cause anxiety due to a variety of factors, including but not limited to potential surgical outcomes, lifestyle implications, loss of control, pain, and even death.
