Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
-
J. Perianesth. Nurs. · Oct 1998
ReviewPreoperative assessment criteria and patient teaching for ambulatory surgery patients.
Today's trend is to have the surgical patient return to the comfort of his or her home rather than be admitted to the hospital for expensive nursing and medical care. The perioperative team must initially assess the patient's American Society of Anesthesiology status, anxiety level, food and drugs to which he or she may be allergic, and skin integrity; obtain a medical and surgical history and consent; review laboratory, electrocardiogram, and radiological results; and perform preoperative teaching (e.g., which medications to take or withhold preoperatively, when to withhold food and fluids) and postoperative teaching (e.g., catheter care, dressing changes). In addition, the nurse needs to anticipate and be prepared for medical emergencies such as airway management problems and malignant hyperthermia. ⋯ Proper evaluation is the key to success for positive surgical outcomes. Given the time constraints in the ambulatory surgical setting, assessing and teaching the patient on the day of surgery is not feasible or appropriate. Reaching out to the patient a few days before surgery either in the patient's home, in the ambulatory surgery center, or by telephone is the ultimate goal.
-
J. Perianesth. Nurs. · Oct 1998
ReviewMalignant hyperthermia: considerations for ambulatory surgery.
Patient care offered on an ambulatory basis continues to grow as evidenced by the high percentage of surgical procedures now being performed in such a setting. Many ambulatory surgical facilities are free standing and remote from the primary hospital location. ⋯ A comprehensive plan of patient care under these circumstances includes (1) the ability to identify the high-risk patient and to plan their care accordingly, (2) early recognition of the signs and symptoms of malignant hyperthermia, and (3) being prepared to promptly and efficiently treat a malignant hyperthermic event. This review article will offer guidelines for managing the malignant hyperthermia-susceptible patient in the remote ambulatory surgical setting.
-
J. Perianesth. Nurs. · Oct 1998
Constant temperature monitoring: a study of temperature patterns in the postanesthesia care unit.
Patients admitted to the PACU from the operating room exhibit fluctuations in core body temperature during the course of their stay in the PACU. Some patients present with normothermia and experience temperature decreases later in their stay. PACU policy does not dictate that temperatures be measured at a predetermined frequency in the absence of hypothermia; thus, it is possible that hypothermia may not be detected at its onset. ⋯ Monitoring temperatures more frequently will result in detecting hypothermia at its onset. Nurses may use the axillary device as a trend for continuous monitoring. Length of stay may be shortened if temperature management is embraced by the PACU nurse.