92262 Adult Nursing: Surgical

Subject level: Undergraduate

Handbook description

This subject focuses on adults experiencing alterations to health which require surgical interventions. Using the functional health patterns, students are introduced to the exercise of clinical judgment in nursing practice to provide acute care, recovery, rehabilitation and prevention. Clinical judgment and associated psychomotor skills are developed through the use of case studies which are based on current epidemiological trends.

Subject objectives/outcomes

On successful completion of this subject students should be able to:

1. demonstrate the knowledge, skills and application of nursing assessment, nursing diagnosis and nursing management for patients undergoing surgical interventions (ANMC competencies: 2.5; 3.3; 5.2)
2. apply Gordon's Functional Health Patterns to surgical patients in a range of settings (ANMC competencies: 1.2; 3.2; 5.1)
3. provide nursing care for patients based on the ANMC National Competency Standards for the Registered Nurse (ANMC competencies: passim)
4. provide nursing care that is culturally sensitive and is consistent with the Code of Professional Conduct for Nurses in Australia and Code of Ethics for Nurses in Australia (ANMC competencies: 1.1; 1.3; 2.1)
5. explore and use best evidence to inform your nursing practice (ANMC competencies:.6; 3.2; 4.1)
6. reflect on the meanings of health and illness experiences of patients in a range of health care settings (ANMC competencies: 2.3; 6.1; 9.5)
7. explore the concept of resource availability in the provision of nursing care within a range of acute care settings (ANMC competencies: 2.7; 7.5; 7.8)
8. develop skills in patient education and health promotion (ANMC competencies: 7.1; 7.7; 9.4)
9. explain and demonstrate the essential steps in basic life support (ANMC competencies: 1.2; 2.2; 7.4).

Content

Introduction/revision of the nursing process and Gordon's Functional Health Patterns

• Discussion of subject and subject assessments
• Revision of Basic Life Support
• Case Study: Developing a Nursing Diagnosis (ND)

The surgical patient:

• What surgery means to the patient
• Range of intervention strategies
• Nursing calculations quiz*
• Management of the pre-operative patient
• Administering oral and subcutaneous medications
• Case Study: Developing rationales for ND and nursing goals

Pre-operative care:

• Informed consent
• Types of anaesthesia
• Patient preparation
• Skill demonstration and practice: IM injections, BSL
• Case study: Developing pre-op nursing interventions

Intra-operative care:

• Operating room
• Recovery room
• Surgical asepsis
• Skill demonstration and practice: Surgical hand wash, donning sterile gloves, insertion of airway, pulse oximetry reading
• Airway maintenance
• Oxygen therapy

Post operative care:

• Patient observations
• Skill demonstration and practice: Simple wound dressing, removal of sutures/clips, taking a wound swab
• Case study: Developing post-op nursing interventions
• Surgical pain management:
• Pain assessment
• Pharmacological approach of pain relief
• Non-pharmacological approach of pain relief
• Skill demonstration and practice: Using a PCA pump
• Pain assessment
• Managing elimination needs in the post-op period

Fluid and electrolyte issues for the surgical patient

• Skill demonstration and practice: Initiating IV therapy and administering IV medications
• Assessment of hydration status

Common post-operative complications:

• Pneumonia
• Atelectasis
• Pulmonary embolism
• Deep vein thrombosis

• Skill demonstration and practice: Incentive spirometry, assisting with breathing and coughing exercises, teaching ROM exercises and application of antiembolic stockings
• Assessing respiratory and circulatory complications
• Using Doppler's
• Making sense of a simple chest X-ray
• Preparation for clinical practice
• Wound healing: Physiology of wound healing, Inflammation, Wound infection

• Skill demonstration and practice: Shortening and removal of drains (vacuum and non-vacuum)
• Wound management
• Case study: Evaluation

Nutritional requirements of the surgical patient

• Skill demonstration and practice: Collection of urine specimen for microbiology
• Preparing patients and families for discharge
• Discussion on exam
• Subject evaluation