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Nursing Simulation Laboratory Week 7: Peri-operative Care

Pre-operative care:

Mrs. Jones is second on the afternoon theatre list for surgery to repair her fractured left hip. She has been nil by mouth since a light breakfast at 0600hrs. Her consent has been signed and the anaesthetist has ordered a premedication to be given on call. As the RN caring for Mrs. Jones you need to ensure that she is adequately prepared for theatre.

After her surgery Mrs. Jones is escorted back to the ward by the Recovery room RN. In her handover the RN tells you that:

• Mrs. Jones condition has been stable throughout the procedure.
• She is drowsy but easily woken and is responding appropriately.
• All her observations have been within normal limits.
• She has IV therapy running via a cannula in her left arm. Her urine output via the IDC has been 50 - 75mls/hr.
• She has an NG tube in for stomach decompression which is on free drainage.
• Her BSL when checked in Recovery was 6.8mmol/L.
• The surgical wound on her left hip is clean and dry and covered with an opsite dressing.
• She was complaining of pain in Recovery and was given Morphine Sulphate with good effect.

As the RN caring for Mrs. Jones in the immediate post-operative period you will be monitoring her observations closely and observing for any post-op complications.

Simulation Laboratory Activities

This week in the nursing laboratories students will:

1. Complete relevant documentation prior to theatre, including the pre-operative checklist.
2. Measure Mrs. Jones for TED stockings and apply these effectively.
3. Educate Mrs. Jones about her post-operative care, deep breathing and coughing exercises and leg exercises.
4. Make up a post-operative bed and organize bedside requirements for Mrs. Jones on her return from theatre.

Following surgery:

1. Position Mrs. Jones in bed so that she is comfortable and to promote good respiratory function.

2. Document Mrs. Jones’ intake and output for the first four hours post-operatively.

3. Change her dressing, as her wound has oozed slightly.

4. Write a nursing note documenting care of Mrs. Jones.