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quick guides to procedure

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                                      quick guides to operations and procedures

 

 

 

 

 

post operative nursing care

  • airway               -attention to maintanence of airway
  • breathing           -ensure adequate ventalation
  • circulation         -assess the patient for evidence of blood loss :colour, pulse, blood pressure, respitory rate,oxygen saturations, level of consciousness
  1. always check anaesthetic chart for specific post op instructions
  2. monitor obs quarter hourly for 1 hour, then half hourly fortwo hours then hourly for 4 hours
  3. observe wound at above times for signs of heamorrhage, swelling, or dehissing. repad wound if seepage is slight, contact medical staff if more severe
  4. if abdominal drain in situ close observation for heamorrhage and/or suddenfluid loss, seperate drain charts should be used for each drainand losses also need to be added to FBC
  5. maintain accurate FBC
  6. record when patient passes urine post operativle, observe for urinary retention and/or dribbling (may need a catheter)
  7. ensure patient receives adequate analgesia and anti-emetics
  8. assist with post op wash when patient feels able and provide oral hygiene
  9. liase with medical staff to determine when patient can eat and drink
  10. consult with senoir member of nursing staff or medical staff if unsure about anything above

 

 

computerised tomography arterioportography (CTAP)
 
pre procedure
  • fluids only for 6 hours prior to procedure
  • baseline obs plus colour, sensation, movement and pedal pulse
  • consent
  • notes and x-rays to go with ptient
  • working venflon in situ

 

post procedure

  • lie flat for 4 hours, then 24 hour bed rest
  • quarter hourly obs pluse colour, sensation, movement and pedal pulse, then half hourly obs for 6 hours
  • diet and fluids as able
  • record when passed urine

endoscopic retrograde cholangiopancreatography (ERCP)

pre procedure

  • fast for 6 hours prior to procedure
  • baseline obs
  • informed consent
  • working venflon in right arm
  • jewelry and dentures removed theater gown on
  • IV fluids if required, IV anti biotics(2.25 / 4.5g tazocin or cefuroxime)
  • FBC, notes and x-rays to go with patient 

post procedure

  • bed rest until fully awake
  • quarter hourly obs for 1 hour the half hourly for 6 hours
  • fast for 4 hours then review by medical staff
  • record when passed urine
  • continue IV fluids until adequate oral

chemoembolisation

pre procedure

  • fast for 6 hours prior to procedure
  • baseline obs plus colour, sensation, movement and pedal pulse
  • informed consent
  • working venflon in right arm
  • jewelry and dentures removed theater gown on
  • IV fluids if required, IV anti biotics
  • FBC, notes and x-rays to go with patient 

post procedure

  • lie flat for 4 hours, then 24 hour bed rest
  • quarter hourly obs pluse colour, sensation, movement and pedal pulse, then half hourly obs for 6 hours
  • diet and fluids as able
  • record when passed urine
  • accurate FBC

percutaneous transhepatic cholangiography (PTC)

pre procedure

  • fluids only for 6 hours prior to procedure
  • IV fluids if required
  • baseline obs
  • VIT K especially if patient is jaundiced
  • Iv antibiotics (tazocin 4.5)
  • consent
  • notes and x-rays to go with ptient
  • working venflon in situ

post procedure

  • half hourly obs for 6 hours then 4 hourly
  • bed rest for 12 hours
  • observe entry site
  • if drain in situ compensation for loss
  • diet and fluids as able
  • record when passed urine
  • accurate FBC
  • blood cultures if temperature developes

abdominal ultrasound scan (AUSS)

pre procedure

  • informed consent
  • NBM
  • IV fluids from midnight before
  • jewelery removed and gown worn
  • notes and x-rays to go with patient

post procedure

  • nill post procedure care required

barium enema

pre procedure

  • low residual diet for 2 days prior to procedure
  • breakfast then clear fluids the day before
  • FBC from midnight
  • one fleet at 10:00 then another at 1600 the day before
  • medical staff to decide if IV fluids required
  • if patient not running clear inform medical staff

post procedure

  • D+F
  • ensure barium is expelled (may need an aperient)
  • observe for signs of dehydration

CT scan

pre procedure

  • diet and fluids unless department requested otherwise
  • working venflon
  • jewelry removed and gown worn
  • notes x-rays and kardex to go with patient

post procedure

  • no formal care required
  • observe for sign of reaction to contrast

 

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