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Age and Culturally Appropriate Health Assessment Techniques for Certified Perioperative Nurse (CNOR)

Age and Culturally Appropriate Health Assessment Techniques for Certified Perioperative Nurse (CNOR)

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Outline

Age and Culturally Appropriate Health Assessment Techniques

Guidelines:

Proper preoperative workup to be completed
Maximize patient autonomy
Advanced directive!
- Suspension of DNR/DNI common before surgery, define the details!
- Decision makers common
Identify risk populations
- Dementia worsens with anesthesia
- Pressure ulcers
- Comorbidities

Considerations:

Mental competency
Old and young first, to avoid prolonged NPO times
- facility specific
Consider pre-admission and overnight stay
Separation from family can be painful
- some facilities allow parents for induction
- Pre-op is a terrible family memory
Do not give false hope
- “It will be fine”
- “Nobody has xyz happen”
Religious items

Nurse’s Role:

Ensure complete and present advanced directive
Compassionate ethical bedside care
Advocate for patient’s desires in the room
- OK to request swap if uncomfortable, but this is a request. Patient care will happen empathetically regardless

Pitfalls:

Patient’s sense of humor masks concerns
- Often based from anxiety
Vague suspension of DNR/DNI
Privacy in pre-op and PACU uncertain

Examples:

Patient desires family pastor to pre-op before surgery (allowed, patient can refuse to roll back whenever they desire, but rescheduling to a different day may occur)
No blood products requests from a patient (clarify case-specific relevance, such as bovine implant or donor materials)
- Include provider!

Linchpins (Key Points):

Nurse serves as the patient’s link between their wants and the healthcare system

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Transcript

References

Association of periOperative Registered Nurses. (2022). Guidelines for Perioperative Practice (2022 ed.).

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