Practice in the Perioperative Nursing Environment Assignment

Added on - 22 Jul 2020

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Practice in the perioperativenursing environment
Table of ContentsINTRODUCTION...........................................................................................................................1Steps Taken By Enrolled Nurse For Patient Care............................................................................1Enrolled nurse scope of practice in Australia.................................................................................1PART 1............................................................................................................................................2Part-2................................................................................................................................................1PART-3............................................................................................................................................2PART 4............................................................................................................................................6CONCLUSION................................................................................................................................7REFERENCES................................................................................................................................8
INTRODUCTIONPerioperative nursing can be considered as a special nursing which involves working forpatients having invasive or operative practices (Cant and Cooper, 2010). Along with thesurgeons, these nurses works closely with them. The report includes different case studiesinvolving their surgical procedures along with the anaesthetic details.Steps Taken By Enrolled Nurse For Patient CareThere are some responsibilities that has been assigned to the Enrolled nurses by the Nursing andMidwifery Board of Australia (NMBA) and these are discussed as under :The Enrolled nurses (EN's) have to work under the supervision of a registered nurse andthe supervision can be direct as well as indirect.The enrolled nurses provides proper support and care to the patients, emotionally as wellas physically.These nurses facilitates the individual along with the family in order to maintain theirmental stability regarding the outcomes of the reports of the patient.These nurses utilizes their reflective skills in the whole decision making process ofservices and medications which are to be provided to the patient.They are well respected members of the nursing fraternity who are well educated and cango for further studies as well.They are meant to provide the delegated acre to the patients.If they have completed their study about the administrations of the medicines, they canadminister the medicines as well to the patients without the requirement of any furtherpreference (Enrolled Nurses and medicine administration, 2017).They take part with the registered nurses, in order to provide the patient an efficient andappropriate care. Attention of two nurses at a time can help the patients in a fast recovery.Enrolled nurse scope of practice in AustraliaThe practice of nursing and midwifery in Australia is regulated by the Nursing andMidwifery Board of Australia (NMBA). The main objective is to protect the public. If theenrolled nurses have studied the medication administration education at specific point of their1
career then they are able to administer medicines(Fisher, 2017). The medicines can beadministered by the enrolled nurses. Within the NMBA approved standards for practice anddecision-making standards the enrolled nurses are expected to practice. Under the direction andsupervisions of the registered nurse, the enrolled nurse provided the nursing care. The educated,qualified and regulated nurses must provide nursing care. By the extent of educationalpreparation, the scope of practice for enrolled nurses is determined. The acuity of a human thatneed nursing care can be determined with the help of scope of practice for nurses (Halcomb andAshley,2017).PART 11.As Laproscopic Nissen Fundoplication surgery is going to be done to Mr Snout. Thisoperation is being done for the treatment of gastroesophageal reflux disease (GERD) andalso of hiatal hernia. The procedure includes some steps such as operative techniques,anaesthetic considerations , temperature control and the venous gas embolism.The surgical procedures of this is done in a way that the fundus portion of the stomach is beingwrapped around the bottom part of the oesophagus and is being sewn there. Two to three hoursare a maximum for this surgery (Paul., 2016).While the operation of Mr Snout, anaesthesia induced with fentanyl, rocuronium and midazolamwill be used in the whole surgery. Also, it will be maintained with the sevoflurane andremifentanil.(https://emedicine.medscape.com/article/1892517-overview?pa=zDoUG%2BUEvC1UmEoSIWGgM3H4Fj8T3Okci5BJtgnx%2FEYkLbHYm3GSPxhAV%2FFyvaSYLqFsyV%2Fdhg20ybnRLaHm4urXVu%2Ff6yEbtozmzn9k4Ws%3D)REFERENCE:Paul., F. 2016. Laproscopic Nissen Fundoplication. [Online]. Available through:<https://emedicine.medscape.com/article/1892517-overview?pa=zDoUG%2BUEvC1UmEoSIWGgM3H4Fj8T3Okci5BJtgnx%2FEYkLbHYm3GSPxhAV%2FFyvaSYLqFsyV%2Fdhg20ybnRLaHm4urXVu%2Ff6yEbtozmzn9k4Ws%3D>. [Accessedon 21stOctober 2017].2.Mrs Blogs at the time of undergoing theExcision of SCC Left Forearm with SCG fromLeft upper arm surgery. Although she has no health issues but is undergoing this surgeryfor basal and squamous cell skin cancers. First a thin layer of the skin is getting removed2
by the surgeon (Wells and et.al., 2013). Then, proper checking of the sample is beingdone under the microscope. Another layer of the skin is being reduced if cancer cells areseen.Local anaesthesia is being used in this procedure and the cancer cells are being excluded off theskin.(https://www.cancer.org/cancer/basal-and-squamous-cell-skin-cancer/treating/surgery.html)REFERENCE:Suregry for Squamous cell skin cancers. 2017. [Online]. Available through:<https://www.cancer.org/cancer/basal-and-squamous-cell-skin-cancer/treating/surgery.html>.[Accessed on 21stOctober 2017].3.Mrs Weeding is undergoing a surgery of Hemiathroplasty right knee. Sometimes,arthroscopic debridement is being observed in mild joint issues which includesmechanical symptoms. The surgical procedures include the hemiarthroplasty whichreplaces the whole ball of the joint (Pupkiewicz, Kitson and Perry, 2015). Also, it permitsthe patients to start walking after the surgery itself, in order to get it back as soon aspossible, so that the patient may not have to face any issue.4.Ms Bell, a stenographer would be under going a surgery, Dupuytrens Contracture Lefthand. Because of this situation, her fingers have bent. A recurrence rate in this problem isabout 39%. The surgical procedure for this should be done on an metacarpophalangealjoint if the contracture has been observed as 30% or more (Higgs and Fernandez, 2016).Local anaesthesia will be provided to Ms Bell here but it should be induced withepinephrine. It is also considered as the wide awake approach and this involvesfascietomy with no tourniquet (William, 2017). This approach provides better outcomeswith the lower risk rate to the patient as well.https://www.medicinenet.com/dupuytren_contracture/article.htmREFERENCE:William., C. 2017. [Online]. Available through :<https://www.medicinenet.com/dupuytren_contracture/article.htm>. [Accessed on 21stOctober2017].3
5.Ms Holly Meredith will be undergoing bilateral breast augmentation. As she is notsatisfied with her body, she plans to have a surgery. This surgery is meant for enhancingthe breasts with the help of surgical placement or implantation. There are two types ofbreast implantation which involves silicone or saline filled (Cant and Cooper, 2010). Sheis opting the silicon based, although both the methods have their own set of advantages.General anaesthesia is given in this condition as it provides sufficient relief from themedications given.https://www.nhs.uk/conditions/cosmetic-treatments-guide/pages/breast-enlargement.aspxREFERENCE:Breast enlargement. 2017. [Online]. Available through:<https://www.nhs.uk/conditions/cosmetic-treatments-guide/pages/breast-enlargement.aspx>.[Accessed on 21stOctober 2017].6.Mr Smith has been going under an abdominoplasty and liposuction surgery as he wasfacing some issues. As he has some issue with his obesity, he is getting treated under thissurgery. It is a cosmetic surgery in which the focus is on making the abdominal flatter. Inthis, the excess fat is being removed by the surgeons (Reath, 2013). General anaesthesiawill be given to Mr Smith so as to stay from the pain for a period of time.https://www.dbreath.com/blog/coolsculpting-vs-liposuction-vs-tummy-tuck-heres-the-skinny/REFERENCEReath. 2013. [Online]. Available through: <https://www.dbreath.com/blog/coolsculpting-vs-liposuction-vs-tummy-tuck-heres-the-skinny/>. [Accessed on 21stOctober 2017].4
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