Intraoperative Nursing Functions
The circulating nurse manages the operating room and protects the safety and health needs of the patient by monitoring activities of members of the surgical team and checking the conditions in the operating room. Responsibilities of a circulation nurse are the following:
- Assures cleanliness in the OR.
- Guarantees the proper room temperature, humidity and lighting in OR.
- Make certain that equipments are safely functioning.
- Ensure that supplies and materials are available for use during surgical procedures.
- Monitors aseptic technique while coordinating the movement of related personnel.
- Monitors the patient throughout the operative procedure to ensure the person’s safety and well being.
- Scrubbing for surgery.
- Setting up sterile tables.
- Preparing sutures and special equipments.
- Assists the surgeon and assistant during the surgical procedure by anticipating the required instruments, sponges, drains and other equipment.
- Keeps track of the time the patient is under anesthesia and the time the wound is open.
- Checks equipments and materials such as needles, sponges and instruments as the surgical incision is closed.
Classification of Physical status for Anesthesia before Surgery
The anesthesiologist should visit the patient before the surgery to provide information, answer questions and allay fears that may exist in the patient’s mind. The choice of anesthetic agent will be discussed and the patient has an opportunity to disclose and the patient has opportunity to disclose previous reactions and information about any medication currently being taken that may affect the choice of an agent. Aside from that, the patient’s general condition must also be assessed because it may affect the management of anesthesia. Thus, the anesthesiologist assesses the patient’s cardiovascular system and lungs. Inquiry about preexisting pulmonary infection sand the extent to which the patient smokes must also be determined. The classification of a client’s physical status for anesthesia before surgery is summarized below.
Classification of Physical Status for Anesthesia Before Surgery
|Good||No organic disease; no systemic disturbance||Uncomplicated hernias, fracture|
|Fair||Mild to moderate systemic disturbance||Mild cardiac (I and II) disease, mild diabetes|
|Poor||Severe systemic disturbance||Poorly controlled diabetes, pulmonary complications, moderate cardiac (III) disease|
|Serious||Systemic disease threatening life||Severe renal disease, severe cardiac disease (IV), decompensation|
|Moribund||Little chance of survival but submitting to operation in desperation||Massive pulmonary embolus, ruptured abdominal aneurysm with profound shock|
|Emergency||Any of the abive when surgery is performed in an emergency situation||An uncomplicated hernia that is now strangulated and associated with nausea and vomiting.|
Source: Brunner and Suddarth’s Medical-Surgical Nursing by Smeltzer and Bare