- Describe the ASA (American Society of Anesthesiologists) classification system.
| Classification | Physical condition description | Example of a client that would be in this category (this does not have to be a client that you observed) |
| ASA I (P 1) | ||
| ASA II (P 2) | ||
| ASA III (P 3) | ||
| ASA IV (P 4) | ||
| ASA V (P 5) | ||
| ASA VI (P 6) |
- List the surgeries that were observed and complete the following information related to each.
| Surgical procedure observed | ASA Class | Identify pre-op surgical risks related to client history and lifestyle choices including client’s routine medications | Nursing care and post-op assessments needed related to pre-op risk factors and medications |
- Pre-operative Care: Select a client to focus on for questions 3-7. Complete/observe an admission and all the paperwork required in the operating room.
- Primary diagnosis:
- Secondary diagnoses:
- Surgical procedure:
- Identify any surgical prep that had to be completed. Include the purpose for the prep (medications, bowel prep, NPO status, etc…) as well.
- What preoperative lab work was done what is the rationale? If you were unable to find any lab results, what lab tests would you anticipate being done prior to surgery?
- List the follow-up questions that were initiated during the admission process. Note the purpose for your question. If you were unable to complete this with your client, list what questions you would ask.
| Questions | Purpose for the question |
- Identify the key items that needed to be taught to the client prior to surgery and the purpose of the teaching. If you were unable to teach the client, then list what you would teach.
| Client education topic | Purpose for the education |
- Intra-operative Care: what medications may be used throughout the operative process and list the rationale for them? This should be a comprehensive list of types of medications that are typically used during surgery. Highlight & Provide client response to ones they received.
| Pre/Intra/Post | Medication | Dose | Purpose of drug | Client response to med |
- Define 4 post-general anesthesia complication that can occur and how you would monitor for them. Please use your textbook.
- List and define the roles of the surgical nurses and other collaborative team members. As you discuss these roles, remember to discuss how the role interplays with surgical asepsis and how the team members are responsible to complete surgical asepsis.
- Post-operative care: Describe your client’s status in the PACU (Post Anesthesia Care Unit).
- Airway:
- Breathing:
- Circulation:
- Safety:
- Discuss the RN role in pain management.
- Describe the 3 top priorities of care specific to your client and the rationale for these.
- What did you feel you learned the most about today during your rotation in the OR?
- Find an institutional policy by using Essentia/Sanford online resources or ask about one from a staff member. Please do not ask to have one printed out or take home. Discuss how this policy relates to current practice.
- Find a research article about unsafe practice and “workarounds” in health care and briefly discuss the meaning of the article.
- Describe one situation that you observed in any of your clinical experiences that is not congruent with best practice guidelines.
- What do evidence and regulating agencies recommend for best practice in this situation? Please be detailed in your responses and include rationale.
- What interventions would you initiate to try to change the practice observed in the previous questions? Again, please be detailed in your responses and include rationale.
- What are some barriers to initiating and maintaining best practice?
Include Bibliography
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