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Chapter 19.docx

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NURS 287
Rick Nilson

Chapter 19  The surgical suite is divided into three distinct areas: unrestricted, semirestricted, and restricted. o The unrestricted area is where personnel in street clothes can interact with those in scrub clothing. o In the semirestricted area, personnel must wear surgical attire and cover all head and facial hair. o In the restricted area—which includes the operating room (OR), the sink area, and clean core—masks are required to supplement surgical attire.  In the holding area, the perioperative nurse makes the final identification and assessment before the patient is transferred into the OR for surgery. Procedures such as inserting intravenous (IV) catheters and arterial lines, removing casts, and drug administration may occur here.  The OR is a unique acute care setting removed from other hospital clinical units. It is controlled geographically, environmentally, and bacteriologically, and it is restricted in terms of the inflow and outflow of personnel.  The perioperative nurse is a registered nurse who implements patient care during the perioperative period. This includes the following: o Preparing the OR for the patient o Serving as the patient’s advocate during surgery o Assessing the patient for additional needs or tasks before surgery o Educating the patient and family members  The function of circulating is implemented by the perioperative nurse who is not scrubbed, gowned, and gloved and remains in the unsterile field.  The function of scrubbing is implemented by the nurse who follows the designated scrub procedure, is gowned and gloved in sterile attire, and remains in the sterile field.  The registered nurse first assistant (RNFA) works in collaboration with the surgeon to produce an optimal surgical outcome for the patient.  Assessment data important to intraoperative nursing care include the patient’s vital signs, height, weight, and age; allergic reactions to food, drugs, and latex; condition and cleanliness of skin; skeletal and muscle impairments; perceptual difficulties; level of consciousness; nothing-by-mouth (NPO) status; and any sources of pain or discomfort.  Surgical hand antisepsis is required of all sterile members of the surgical team (scrub assistant, surgeon, and assistant
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