b.
Giving the patient and significant others complete learning and teaching
guidelines regarding the surgery.
c.
Instructing and demonstrating exercises that will benefit the patient
postoperatively.
d.
Planning for discharge and any projected changes in lifestyle due to the
surgery.
1-4.
SURGICAL EXPERIENCE
Surgery is an important event in any individual's life. It represents a serious
decision involving the patient's body and his health. It also produces physical and
psychological stress on the body relative to the extent of the surgery and injury to the
tissue involved. The patient must understand what is proposed, understand all the
risks, and give his consent.
a.
Physical Stress. Surgery produces actual physical damage to tissues of
the body.
(1)
An incision is a cutting of the skin and other tissues. The internal
organs and tissues of the body are handled by the surgeon and assistants. This could
lead to bruising of tissues, injury to tissues, or inflammation of tissues that could result
in pain after the anesthesia wears off.
(2)
Incisions through the skin and mucous membranes penetrate the
protective barriers of the internal organs. This puts a patient at risk of microorganisms
entering the body and causing infection. Surgery requires strict attention to aseptic
technique, use of sterile materials, and thorough disinfecting of the skin around the
operative site.
(3)
The effects of anesthesia and other medications tend to last well into
the postoperative recovery period. These drugs could have a depressant effect on the
body; they decrease pain and reduce awareness of one's surroundings. The effect on
the body systems is to slow the systems down and make them hypoactive.
b.
Psychological Stress. The physical stress of surgery is greatly enhanced
by the psychological stress of anxiety and worry, which uses up energy that is needed
for healing of tissues in the postoperative period. When surgery is needed, one's
deepest and worst fears are often felt. A preoperative patient may experience a number
of fears. However, the following fears are common among surgical patients:
(1)
Loss of part of the body.
(2)
Unconsciousness and the inability to know or control what is
happening.
MD0915
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