Rotinas na clínica cirúrgica para enfermeiros e técnicos de enfermagem

Summary

This video provides an in-depth guide for nurses and nursing technicians working in a surgical clinic. It covers essential tasks such as patient admission, pre-operative care, post-operative monitoring, and communication with the surgical team. Key points include understanding patient conditions, managing surgical drains, ensuring proper fluid balance, and addressing complications like shock or infection. Emphasis is placed on vigilance in the first few hours after surgery, maintaining communication with both patients and the surgical team, and ensuring a safe and smooth recovery process for patients.

Takeaways

• 😀 Ensure the surgical clinic team is complete before starting the day.
• 😀 Always verify the type and location of surgery before receiving a patient.
• 😀 Pre-operative protocols like fasting and preparation should be followed strictly.
• 😀 Always check with the surgical team about any post-operative complications or delays.
• 😀 Ensure the patient’s recovery from anesthesia is stable before moving them to the clinic.
• 😀 Monitor patients closely in the first 6 hours post-surgery for signs of complications.
• 😀 Be aware of different types of drains and the proper care for them, including suction drains and bags.
• 😀 Assess the patient's hydration balance and diuresis, especially after surgery with large fluid infusions.
• 😀 Keep a close eye on the patient's vital signs to detect early signs of shock or infection.
• 😀 Communication with family and patient about post-operative care and restrictions is essential.
• 😀 Instability in the patient, such as reduced Glasgow Coma Scale, requires immediate medical intervention and may not be suitable for a regular surgical clinic.

Q & A

What is the first step when admitting a patient for surgery in a surgical clinic?

The first step is to verify if the team is complete and ensure the patient is admitted correctly, with all necessary documents such as the admission forms and medical records. The patient may also be instructed on fasting protocols depending on the surgery schedule.

How do you prepare a patient for surgery in a surgical clinic?

Preparation involves ensuring the patient is admitted the day before surgery, verifying fasting instructions, confirming surgical details, and possibly performing pre-surgery procedures like hair removal (tricotomy) depending on the area of surgery.

Why is it important to ask about the patient's surgery details when receiving them from the surgical center?

It is crucial to understand the specifics of the surgery, including any complications or stability issues, as this helps in anticipating post-operative care needs. This information ensures you can provide the right support to the patient upon their return to the clinic.

What are the key factors to monitor when a patient returns from surgery?

You should monitor the patient's vital signs, consciousness level, presence of any drains, and their mobility. You also need to assess the surgical site and be vigilant for any signs of complications, such as fever, bleeding, or infection.

What types of drains may a patient have post-surgery, and what is important to monitor about them?

Patients may return with different types of drains, such as suction drains or water-seal drains. It's important to know the type of drain, ensure it is functioning properly, and provide instructions to the patient and family about care and when to seek help.

What signs should nurses be aware of when a patient is in the early post-operative period?

Nurses should monitor for signs of instability, such as abnormal vital signs, fever, or signs of tissue dehiscence (wound opening). Immediate attention is needed if any of these occur to prevent further complications.

Why is it crucial to monitor a patient's urine output after surgery?

Monitoring urine output is essential to assess kidney function and hydration status. If a patient has not urinated several hours after surgery, it could indicate a need for interventions such as a catheter or further evaluation for possible complications like dehydration or urinary retention.

What should a nurse do if a patient exhibits signs of shock after surgery?

If a patient shows signs of shock, such as low blood pressure or altered consciousness, it is essential to act quickly. The nurse should notify a doctor immediately and ensure the patient is closely monitored for signs of internal bleeding or other complications.

What is the nurse's responsibility when receiving a patient with a reduced Glasgow Coma Scale (GCS)?

If a patient has a reduced GCS score, it is critical that they are not admitted to the general surgical clinic, as they require close monitoring by a doctor. In such cases, the nurse should arrange for immediate intervention and transport to an ICU or recovery area where a medical professional can manage their care.

How does the surgical clinic differentiate between stable and unstable post-operative patients?

The clinic ensures patients are stable before transfer by evaluating their vital signs, consciousness, and any complications from the surgery. Patients who are unstable, such as those with a decreased Glasgow score or signs of shock, must be treated in an environment with constant medical supervision.