8.15. Monitoring the patient during surgery: Monitoring the patient's circulation

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8.15. Monitoring the patient during surgery: Monitoring the patient's circulation

The role of nursing in the operating room is multifaceted and one of the most crucial functions is patient monitoring during surgery. Monitoring the patient's circulation is an integral part of this responsibility. This involves ongoing assessment of the patient's cardiovascular system to ensure cardiac function is maintained throughout the surgery.

Monitoring the patient's circulation is essential for the early detection of any hemodynamic changes that may occur during surgery. This includes changes in blood pressure, heart rate, cardiac output, and oxygen saturation. The nurse must be aware of these parameters and ready to intervene if any of them deviate from normal limits.

Blood Pressure

Blood pressure is a vital indicator of tissue perfusion and cardiac function. The nurse must monitor the patient's blood pressure continuously during surgery. This can be done via a non-invasive blood pressure monitor or an invasive arterial catheter, depending on the nature of the surgery and the patient's condition.

Heart Rate

Heart rate is another vital parameter that must be continuously monitored. Changes in heart rate may indicate a response to stress, pain, hypoxia, or the effects of anesthetic medications. The nurse must be ready to intervene if the heart rate becomes too high (tachycardia) or too slow (bradycardia).

Cardiac Output

Cardiac output is the amount of blood the heart pumps per minute. It is an important indicator of heart efficiency and tissue perfusion. The nurse can monitor cardiac output through a Swan-Ganz catheter or a minimally invasive cardiac output monitor. Changes in cardiac output may indicate cardiac dysfunction, hypovolemia, or response to anesthetic medications.

Oxygen Saturation

Oxygen saturation is an indicator of the amount of oxygen in the blood. The nurse should continuously monitor the patient's oxygen saturation using a pulse oximeter. A drop in oxygen saturation can indicate hypoxia, which is a dangerous condition that requires immediate intervention.

In addition to these parameters, the nurse should also monitor the patient's temperature, skin color, diuresis and pupillary response. The nurse should be alert for any sign of deterioration, such as pallor, cyanosis, sweating, agitation, or confusion. These signs could indicate shock, which is a medical emergency that requires immediate intervention.

In summary, monitoring a patient's circulation during surgery is a crucial nursing function in the OR. The nurse must be well trained and equipped to carry out this monitoring effectively and intervene promptly when necessary. This is vital to patient safety and the success of the surgery.

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249. Maintenance of asepsis in the Surgical Center