PeriAnesthesia Nursing Core Curriculum: Preprocedure, Phase I and Phase II PACU Nursing

Front Cover
IFC
PeriAnesthesia Nursing Core Curriculum: Preprocedure, Phase I and Phase II PACU Nursing
Copyright
Dedication
Contributors
Reviewers
Foreword
Preface
Acknowledgments
Contents
ONE -
Professional Competencies
1 - Evolution of Perianesthesia Care
I. Early Beginnings
II. Acceptance and Decline of Recovery Rooms
III. Ambulatory Surgery Focus
IV. Emergence of Organized Recovery Room Groups
V. First years (October 1980 to April 1982)
VI. ASPAN Developments
Bibliography
2 - Standards, Legal Issues, and Practice Settings
I. Definition of Standard
II. Evolution of Nursing Standards
III. Sources of Standards
IV. Standard Criteria
V. ANA Standards of Nursing Practice
VI. Agency for Healthcare Research and Quality (AHRQ)
VII. 2019–2020 Perianesthesia Nursing Standards, Practice Recommendations, and Interpretive Statements
VIII. Competency-Based Practice
IX. Ethical Issues
X. Legal Concepts
XI. Liability Issues
XII. Legal Process
XIII. Issues of Consent
XIV. Policies and Procedures
Bibliography
3 - Safety, Quality Improvement, and Regulatory and Accrediting Agencies
I. Workplace Definitions
II. ASPAN Safety Goal, Culture of Safety Characteristic, and Safety-Related Position Statements
III. Advocacy Organizational and Regulatory Patient Safety Resources
IV. Patient Safety Tools and Resources
V. Perianesthesia Nursing Implications and Approach to Data Management for Analysis
Bibliography
4 - Research and Evidence-Based Practice
I. Definition of Evidence-Based Practice (EBP)
II. Goal of EBP
III. Stimuli for EBP Initiatives
IV. Steps of EBP
V. Developing an Evidence-Based Culture
VI. Definition of Nursing Research
VII. Goals of Perianesthesia Nursing Research
VIII. Objectives of Perianesthesia Nursing Research
IX. Developing and Planning a Research Study
X. Components of a Research Proposal
XI. Ethical Issues in Nursing Research
XII. Providing and Analyzing Results of a Research Study
XIII. QI and the Research Process
XIV. Disseminating Research Findings
XV. Professional Responsibility for EBP and Research
Bibliography
TWO -
Preoperative Assessment Competencies
5 - Preoperative Evaluation
I. Timing of Preoperative Assessment
II. Purpose of Preoperative Assessment and Programs
III. Benefits of a Preoperative Assessment Program
IV. Types of Preoperative Assessments and Programs
V. Importance of Preoperative Assessment
VI. The Nursing History and Physical Examination
VII. Psychosocial Assessment
VIII. Diagnostic Assessment
IX. Scheduling Surgery
X. Patient Types
XI. Day of Surgery: General Preparation
XII. Regulatory (see Chapter 3)
Bibliography
6 - Preexisting Medical Conditions
I. Preexisting Medical Conditions
II. Cardiovascular Diseases (see Chapter 19)
III. Pulmonary Diseases (see Chapter 18)
IV. Renal Diseases (see Chapter 25)
V. Liver Diseases (see Chapter 22)
VI. Neuromuscular, Skeletal, Connective Tissue Diseases (see Chapters 8, 20, and 29)
VII. Endocrine Diseases (see Chapter 21)
VIII. Hematologic Diseases (see Chapter 24)
IX. Infectious Diseases
X. Substance use Disorder (see Chapter 17)
XI. Obesity (see Chapter 33)
Bibliography
7 - Transcultural Nursing and Alternative Therapies
I. Definitions of Culture, Transcultural, and Complementary
II. Major World Views of Health and Illness
III. Major Sectors of Health Care
IV. Traditional Healers
V. Cultural Nursing Assessment
VI. Health Habits
VII. Cultural Beliefs
VIII. Key Cultural Communication Techniques
IX. Nutrition and Culture
X. Spiritual and Religious Needs
XI. Current Utilization of CTs
XII. Overview of Selected CTs
XIII. Gender Diversity
XIV. Preoperative Assessment of Perianesthesia Patients
XV. Perianesthesia Nursing Considerations
Bibliography
8 - The Developmentally and Physically Challenged Patient
I. Overview
II. The Developmentally Challenged Patient
III. Alzheimer Disease
IV. Hearing Impairment
V. Vision Impairment
VI. Speech Impairment
VII. Spinal Cord Injury (SCI; see Chapter 20)
VIII. Traumatic Brain Injury (TBI)
IX. Parkinson Disease (PD; see Chapter 6)
X. Multiple Sclerosis (MS; see Chapter 6)
XI. Myasthenia Gravis (MG; see Chapter 6)
XII. Autism Spectrum and Intellectual Disorders in the Pediatric Patient
XIII. Pediatric Motor/Neurological Disabilities
Bibliography
THREE -
Life Span Competencies
9 - The Pediatric Patient
I. Classification of Pediatric Patients by Age
II. Growth and Development Overview (Box 9.1)
III. Anatomy and Physiology Considerations
IV. Stressors
V. Family-Centered Care
VI. Phases of Perioperative Care for Pediatric Patient
VII. Preoperative Teaching
VIII. Preoperative Phase
IX. Intraoperative Treatment
X. PACU
XI. Discharge (Box 9.17)
Bibliography
10 - The Adolescent Patient
I. Classification By Age
II. Growth and Development (Table 10.1)
III. Adolescent Response to Surgery and Hospitalization
IV. Family-Centered Care
V. Phases of Perioperative and Procedural Care for the Adolescent Patient
VI. Postprocedural Considerations for Adolescents (see Chapters 36 to 38)
Bibliography
11 -
The Adult Patient
I. Definitions
II. Stages of Adulthood
III. Health, Wellness, and Illness
IV. Health and Illness Behavior
V. Stress Response Syndrome
VI. Stress Management
VII. Health Promotion and Prevention
VIII. Preoperative Health History Interview (see Chapter 5)
IX. Health Teaching-Learning(see Chapter 38)
Bibliography
12 - The Geriatric Patient
I. Overview
II. Definition of Geriatric or Older Adult
III. Theories of Aging
IV. Physiological Changes of Aging: Changes in Both Structure and Function
V. Psychosocial Consideration for the Elderly
VI. Elder Abuse (Usually Related to Family or Other Caregiver)
VII. Pharmacologic Alterations in Aging
VIII. Considerations Before Surgery (Box 12.1)
IX. Intraoperative Considerations for the Older Adult
X. Anesthetic Options for Older Adult Patient (see Chapter 14)
XI. Postanesthesia Priorities for the Older Adult Patient in Phase I (Box 12.2)
XII. Postanesthesia Phase II and Extended Observation Phase (see Chapter 37)
Bibliography
FOUR -
Perianesthesia Competencies
13 - Fluid, Electrolyte, and Acid-Base Balance
I. Fluid and Electrolyte Balance Overview
II. Body Fluid Distribution
II. Physiological Particle (Solute) Distribution
IV. Hormonal Regulators of Blood Volume
V. Fluid and Electrolyte-Related Perianesthesia Issues
VI. Fluid Imbalances (Box 13.2)
VII. Acid-Base Concepts: Physiology of Chemical Balance
VIII. Primary Acid-Base Imbalance
IX. Mixed Acid-Base Imbalances
X. Physiological Compensation of Acid-Base Imbalances
XI. Interpreting ABGs
Bibliography
14 - Anesthesia, Moderate Sedation/Analgesia
I. Sedation: A Continuum (Table 14.1)
II. Presedation Assessment
III. Procedural Care
IV. Airway Management and Management of Respiratory Complications
V. Moderate Sedation, Pharmacological Agents
VI. Recovery After Moderate Sedation
VII. Moderate Sedation Risk Management
VIII. Pharmacokinetics and Pharmacodynamics of Sedation and Anesthetic Agents
IX. Stages of Anesthesia
X. Local Anesthesia Options
XI. Regional Techniques
XII. Anesthetic Induction Agents
XIII. Opioid Anesthetics
XIV. Anesthetic Adjuncts
XV. Volatile Inhalational Anesthetics
XVI. Gaseous Inhalational Anesthetic: Nitrous Oxide (N2O)
XVII. Nondepolarizing Muscle Relaxants (NDMRs)
XVIII. Depolarizing Muscle Relaxants (DMRs) (Succinylcholine)
XIX. NDMRs Reversal Agents: Anticholinesterases
XX. NDMRs Reversal Agents: Sugammadex
Bibliography
15 - Thermoregulation
I. Basic Terms and Definitions
II. Thermoregulation Physiology
III. Perioperative Thermoregulation
IV. Planned Perioperative Hypothermia
V. Unplanned Perioperative Hypothermia
VI. Malignant Hyperthermia
Bibliography
16 - Postoperative/Postdischarge Nausea and Vomiting
I. Definitions
II. Consequences of PONV or PDNV
III. Etiology of PONV and PDNV
IV. Incidence of PONV and PDNV
V. Risk Factors for PONV
VI. Assessment of PONV
VII. PONV Plan
VIII. Prophylactic Interventions
IX. Rescue Interventions
X. Complementary Therapies
XI. Pediatric PONV Therapy Considerations
XII. PONV/PDNV Nursing Interventions
XIII. Documentation
Bibliography
17 - Pain and Comfort
I. Pain
II. Comfort
III. Pain and Comfort Management
Bibliography
FIVE -
System Competencies
18 - Respiratory
I. Respiratory Anatomy and Physiology
II. Respiratory Assessment
III. Respiratory Pathophysiology
IV. Pulmonary Diagnostic and Surgical Procedures
V. Postanesthesia Respiratory Care
Bibliography
19 - Cardiovascular
I. Cardiac Anatomy and Physiology
II. Vascular Structure and Function (Fig. 19.3)
III. Foundations of Tissue Oxygenation
IV. Pathologies: Congenital Heart Disease (CHD; Box 19.1)
V. Coronary Artery Disease
VI. Myocardial Infarction (MI)
VII. Valvular Heart Disease
VIII. Other Acquired Diseases
IX. Assessment and Management
X. Rhythm Monitoring
XI. Goals of Hemodynamic Monitoring
XII. Physiological Variables Affecting Cardiac Function
XIII. Hemodynamic Evaluation of Cardiac Function
XIV. Limitations of Hemodynamic Monitoring
XV. Concepts of Pressure Monitoring
XVI. Arterial Pressure Monitoring (Arterial Line)
XVII. CVP Monitoring
XVIII. PA Pressure Monitoring Via PA Catheter
XIX. Cardiac Output Measurement
XX. SvO2
XXI. Cardiovascular Operative and Invasive Procedures
XXII. Cardiac Complications (see Chapters 31 and 36)
XXIII. PACU Admission (Phase I)
XXIV. Immediate Patient Management
Bibliography
20 - Neurological
I. Anatomy and Physiology of the Central Nervous System (CNS)
II. Anatomy and Physiology of the Spine and Spinal Cord
III. Anatomy and Physiology of the Peripheral Nervous System
IV. Assessment
V. Dynamics of ICP
VI. Neurological Complications
VII. Diagnostic Tools
VIII. Disorders Potentially Requiring Surgical Intervention
IX. Selected Operative Procedures
X. Disorders Potentially Requiring Spinal Surgery
XI. Common Spinal Operative Procedures
XII. Other Outpatient Procedures
XIII. Postanesthesia Care for Spinal Surgery
Bibliography
21 - Endocrine
I. Hypothalamus (Fig. 21.1)
II. Pineal Gland (see Fig. 21.1)
III. Thymus (see Fig. 21.1)
IV. Thyroid Gland
V. Parathyroid Glands (see Figs. 21.1 and 21.2)
VI. Pituitary Gland (see Fig. 21.1)
VII. Adrenal Glands (see Fig. 21.1)
VIII. Diabetes Mellitus in the Surgical Patient
IX. Pancreas Transplantation and Pancreatectomy (see Chapter 22)
X. Reproductive Glands (see Fig. 21.1)
Bibliography
22 - Gastrointestinal
I. Anatomy and Physiology
II. Pathophysiology
III. Diagnostic Tests or Procedures
IV. Intraoperative Concerns
V. GI Operative Procedures
VI. General Postanesthesia Care Concerns
Bibliography
23 -
General Surgery
I. Overview
II. Breast
III. Gallbladder
IV. Spleen
V. Esophagus-Stomach
VI. Appendix
VII. Intestine
VIII. Anal-RectalDisorders
IX. Hernias
X. Thyroid Gland and Parathyroid Gland (see Chapter 21)
XI. Lymph nodes
XII. Skin
XIII. Minimally Invasive Surgery/Robotic Surgery
Bibliography
24 - Hematology
I. Overview
II. Perianesthesia Issues Related To Hematology
III. Hematology Components: Blood Cells and Clotting Factors
IV. Coagulation: A Chain of Events To Ensure Hemostasis
V. Transfusion Physiology: Blood Cell Compatibility
VI. Administering Blood and Blood Products
Bibliography
25 - Renal/Genitourinary
I. Genitourinary System Anatomy
II. Adult Male Anatomy
III. Adult Female Anatomy
IV. Renal Physiology
V. Pathophysiology
VI. Assessment
VII. Nursing Diagnosis
VIII. Renal Surgery
IX. Genitourinary Surgery
X. Laparoscopy
Acknowledgment
Bibliography
26 - Obstetrics and Gynecology
I. Anatomy and Physiology
II. Congenital and Anatomical Abnormalities
III. Physiological Changes of Pregnancy
IV. Pregnancy Complications
V. Assessment of Fetal Well-Being
VI. Obstetric Anesthesia/Analgesia
VII. Postpartum Care
VIII. Diagnostic or Preoperative Evaluation
IX. Gynecological Operative Procedures
X. Nursing Priorities
XI. Postanesthesia Priorities
Bibliography
27 - Ophthalmology
I. Anatomy and Physiology of the Eye (Fig. 27.1)
II. Preoperative Considerations
III. Common Ophthalmic Surgical Procedures
IV. Anesthetic Considerations
V. Drugs Frequently Used for Ophthalmological Surgery (Table 27.1)
VI. Postoperative Considerations
VII. Possible Complications of Ophthalmic Surgery
Bibliography
28 - Oral/Maxillofacial/Dental
I. Overview
II. Anatomy and Physiology
III. Preanesthesia Assessment and Parameters Specific to Procedures
IV. Intraoperative Priorities
V. Postanesthesia Priorities
VI. Common Operative Procedures (see also Chapters 30 and 32)
Bibliography
29 - Orthopedics and Podiatry
I. Anatomy and Physiology
II. Pathophysiology of the Musculoskeletal System
III. Common Therapeutic Devices
IV. Assessment Parameters
V. Complications Common To Orthopedics
VI. The Perianesthesia Experience
VII. Common Operative Procedures
VIII. Types of Orthopedic/Podiatric Surgery (Table 29.1)
IX. Regional Anesthesia for Surgery
X. Enhanced Recovery After Surgery (ERAS)
Bibliography
30 - Otorhinolaryngology
I. Anatomy and Physiology
II. Pathophysiology
III. Assessment
IV. Procedures
Bibliography
31 - Peripheral Vascular Disease
I. Anatomy and Physiology
II. Pathophysiology
III. Diagnostic Assessments
IV. Perioperative Assessments
V. Procedures
VI. PACU Nursing Interventions for Specific Vascular Procedures
VII. Patient and Family Discharge Education (see Chapters 37 and 38)
Bibliography
32 - Plastic and Reconstruction
I. Overview
II. Anatomy and Physiology
III. Assessment
IV. Perioperative Concerns
V. Cosmetic Body Procedures (Box 32.1)
VI. Cosmetic Breast and Chest Procedures
VII. Cosmetic Head and Neck Procedures
VIII. General Reconstructive Procedures (Box 32.2)
IX. Breast Reconstructive Procedures
X. Overview of Burns
XI. Common Surgical Burn Procedures
XII. Intraoperative Considerations for the Burn Patient
XIII. Postoperative Concerns for the Burn Patient
Bibliography
33 - Bariatrics
I. Overview
II. Anatomy and Physiology of Digestion and Absorption
III. Obesity
IV. Bariatric Surgery
V. Nursing Process
Bibliography
34 - Trauma
I. Overview
II. Prehospital
III. Mechanism of Injury
IV. Stabilization Phase
V. Diagnostic Studies and Protocols
VI. Collaborative Approach
VII. Postanesthesia Care
VIII. Shock in the Multi-
Bibliography
35 - Interventional Radiology and Special Procedures
I. Overview
II. Assessment
III. Endoscopic Procedures
IV. IR Procedures
V. Vascular Procedures (see Chapter 31)
VI. Electroconvulsive Therapy
VII. Pulmonary Procedures
Bibliography
36 - Perianesthesia Complications
I. Perianesthesia Setting
II. Critical Postanesthesia Assessments (see Chapter 37)
III. Airway Integrity (Box 36.2)
IV. Cardiovascular Stability (Box 36.3 and see Chapter 19)
V. GI Issues (see Chapter 22)
VI. Neurological Concerns (see Chapters 20 and 37)
VII. Thermoregulation (see Chapter 15)
Bibliography
SIX -
Education and Discharge Competencies
37 - Postoperative/Postprocedure Assessment
I. Definitions
II. Postanesthesia and Postprocedural Care Settings
III. Pacu Phase I Care
IV. Pacu Phase II Care
Bibliography
38 - Discharge Criteria, Education, and Postprocedure Care
I. Discharge Criteria
II. Length of Stay
III. Discharge Scoring System
IV. Phase I Discharge—Data Collected, Documented, and Evaluated; Consider Relevant Preoperative Status, Including But Not Limite...
V. Phase II Discharge—Data Collected, Documented, and Evaluated
VI. Documentation of Nursing Assessment Will Reflect Patient Met Discharge Criteria
VII. Postanesthesia Scoring System (see Box 38.1)
VIII. Provide Follow-
IX. Patient Education
X. Benefits of Patient and Family Education
XI. Challenges of Discharge Instructions
XII. Patient Education and Training
XIII. Applying the Principles of Learning Allows the Professional Registered Nurse To Prepare an Effective Method of Teaching
XIV. Assessment
XV. Nursing Diagnosis
XVI. Planning
XVII. Implementation
XVIII. Discharge Teaching: Side Effects of Specialized Anesthesia Medication (Selected)
XIX. Postprocedure Follow-Up
XX. Postprocedure Care/Extended Care/Ongoing Care
Bibliography
A - Certification of Perianesthesia Nurses: The CPAN and CAPA Certification Programs
I. Benefits of CPAN and CAPA Certification
II. Sponsorship of CPAN/CAPA Certification Programs
III. Certification of Perianesthesia Nurses
IV. Definition of Certification
V. National Accreditation of the CPAN and CAPA Certification Programs
VI. CPAN and CAPA Certification Credentials
VII. Eligibility Requirements
VIII. Basis for Examinations: A Role-Delineation Study (Study of Practice)
IX. Development of Examinations
X. Description of CPAN and CAPA Examinations
XI. Studying for the CPAN and/or CAPA Certification Examinations
XII. The Application and Testing Process
XIII. Certification Period: Recertification
XIV. ABPANC Contact Information
Bibliography
B - Testing Concepts and Strategies
I. Testing Concepts
II. Purposes of Testing
III. Types of Questions/Items
IV. Preparing to Take a Test
V. Time Management Guidelines
VI. Taking the Test
VII. Take Home Points
Bibliography
INDEX
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z