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Obstetric Care
GUEST EDITORIAL
Obstetric Care Judith H. Poole, PhD, RNC THE JUNE 2005 issue of JoPAN focuses on the specialty of gynecologic and obstetrical perianesthesia nursing. Although care for this population incorporates the basic principles of postanesthesia nursing care, there are unique considerations for certain patient groups, especially the obstetrical surgical patient. This special focus issue provides the reader with a variety of topics covering the perianesthesia continuum of care, including ambulatory surgical settings, to the critically ill obstetric patient. The body of knowledge related to general surgical and perianesthesia nursing care of the obstetric and gynecologic patient is emerging. I hope this issue will increase awareness of the needs for this patient population and provide a new appreciation for the basic differences of the obstetrical and gynecologic patient population. This specialty issue features two articles addressing communication and standard-of-care issues for the surgical obstetric patient. “Communication to Facilitate Care of the Obstetrical Surgical Patient in a Postanesthesia Care Setting” by Keiko Torgersen addresses the importance of communication between care providers to improve patient care and improve outcomes. Susan Shaver and David Shaver’s article, “Perioperative Assessment of the Obstetrical Patient Undergoing Abdominal Surgery” focuses on normal maternal physiologic adaptations to pregnancy and the implications for perioperative care. Both articles focus on the need for direct, clear, and concise communication between the obstetrical caregivers and the staff providing perioperative and postanesthesia care. Three articles focus on the care provided to the critically ill obstetric patient. Although pregnancy and childbirth are generally considered to be normal physiologic processes, complications can arise quickly. Once complications occur, a hemodynamically stable patient can become unstable very quickly, and rapid assessment and intervention is required for optimal outcomes. “When Your Patient Is From the Obstetric Department: Postpartum Hemorrhage and Massive Transfusion” by Melanie Chichester provides a review of the significance of postpartum hemorrhage and an excellent discussion of the nursing care for the patient requiring massive transfusion therapy.
Journal of PeriAnesthesia Nursing, Vol 20, No 3 (June), 2005: p 159
Kim Noble’s article, “Pathophysiology Corner: The Critically Ill Obstetric Patient” provides a case study that nicely illustrates how the normal state can become a crisis state. As this article illustrates, once a problem is identified, patient status can change quickly, altering the perceived birth experience and creating challenges for the nursing staff. I am pleased to include a continuing education article in this focus issue of JoPAN. Carol Curran’s article, “Perianesthesia Care Following Obstetrical Emergencies At-Risk for Multisystem Organ Dysfunction” examines current trends in the obstetrical patient population and illustrates how the obstetrical patient may be at increased risk of developing multisystem organ dysfunction when complications occur during pregnancy and childbirth. This article clearly demonstrates how a routine condition can develop into a crisis in this patient population. Control of nausea and vomiting is also an area of care common to all postoperative patients. Ali Asghar Ghods, Mohsen Soleimani, and Mahnaz Narimani’s article, “Effect of Postoperative Supplemental Oxygen on Nausea and Vomiting After Cesarean Birth” reports outcomes from an experimental study examining the effect of supplemental oxygen on patient nausea and vomiting in the immediate postoperative period. “Transcervical Tubal Sterilization in the Ambulatory Surgery Setting” by Nancy Burden provides an overview of issues related to the care of the woman undergoing sterilization. This article also addresses a description of the procedure and aftercare for the patient.
Judith H. Poole, PhD, RNC, is a Perinatal Clinical Nurse Specialist in Women’s Services at Presbyterian Healthcare System, Charlotte, NC. The ideas or opinions expressed in this editorial are those solely of the author and do not necessarily reflect the opinions of ASPAN, the Journal, or the Publisher. Address correspondence to Judith H. Poole, PhD, RNC, Perinatal CNS, Women’s Services, 200 Hawthorne Lane, Charlotte, NC 28233; e-mail address: [email protected]. © 2005 by American Society of PeriAnesthesia Nurses. 1089-9472/05/2003-0001$30.00/0 doi:10.1016/j.jopan.2005.04.001
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Obstetric Care Judith H. Poole, PhD, RNC THE JUNE 2005 issue of JoPAN focuses on the specialty of gynecologic and obstetrical perianesthesia nursing. Although care for this population incorporates the basic principles of postanesthesia nursing care, there are unique considerations for certain patient groups, especially the obstetrical surgical patient. This special focus issue provides the reader with a variety of topics covering the perianesthesia continuum of care, including ambulatory surgical settings, to the critically ill obstetric patient. The body of knowledge related to general surgical and perianesthesia nursing care of the obstetric and gynecologic patient is emerging. I hope this issue will increase awareness of the needs for this patient population and provide a new appreciation for the basic differences of the obstetrical and gynecologic patient population. This specialty issue features two articles addressing communication and standard-of-care issues for the surgical obstetric patient. “Communication to Facilitate Care of the Obstetrical Surgical Patient in a Postanesthesia Care Setting” by Keiko Torgersen addresses the importance of communication between care providers to improve patient care and improve outcomes. Susan Shaver and David Shaver’s article, “Perioperative Assessment of the Obstetrical Patient Undergoing Abdominal Surgery” focuses on normal maternal physiologic adaptations to pregnancy and the implications for perioperative care. Both articles focus on the need for direct, clear, and concise communication between the obstetrical caregivers and the staff providing perioperative and postanesthesia care. Three articles focus on the care provided to the critically ill obstetric patient. Although pregnancy and childbirth are generally considered to be normal physiologic processes, complications can arise quickly. Once complications occur, a hemodynamically stable patient can become unstable very quickly, and rapid assessment and intervention is required for optimal outcomes. “When Your Patient Is From the Obstetric Department: Postpartum Hemorrhage and Massive Transfusion” by Melanie Chichester provides a review of the significance of postpartum hemorrhage and an excellent discussion of the nursing care for the patient requiring massive transfusion therapy.
Journal of PeriAnesthesia Nursing, Vol 20, No 3 (June), 2005: p 159
Kim Noble’s article, “Pathophysiology Corner: The Critically Ill Obstetric Patient” provides a case study that nicely illustrates how the normal state can become a crisis state. As this article illustrates, once a problem is identified, patient status can change quickly, altering the perceived birth experience and creating challenges for the nursing staff. I am pleased to include a continuing education article in this focus issue of JoPAN. Carol Curran’s article, “Perianesthesia Care Following Obstetrical Emergencies At-Risk for Multisystem Organ Dysfunction” examines current trends in the obstetrical patient population and illustrates how the obstetrical patient may be at increased risk of developing multisystem organ dysfunction when complications occur during pregnancy and childbirth. This article clearly demonstrates how a routine condition can develop into a crisis in this patient population. Control of nausea and vomiting is also an area of care common to all postoperative patients. Ali Asghar Ghods, Mohsen Soleimani, and Mahnaz Narimani’s article, “Effect of Postoperative Supplemental Oxygen on Nausea and Vomiting After Cesarean Birth” reports outcomes from an experimental study examining the effect of supplemental oxygen on patient nausea and vomiting in the immediate postoperative period. “Transcervical Tubal Sterilization in the Ambulatory Surgery Setting” by Nancy Burden provides an overview of issues related to the care of the woman undergoing sterilization. This article also addresses a description of the procedure and aftercare for the patient.
Judith H. Poole, PhD, RNC, is a Perinatal Clinical Nurse Specialist in Women’s Services at Presbyterian Healthcare System, Charlotte, NC. The ideas or opinions expressed in this editorial are those solely of the author and do not necessarily reflect the opinions of ASPAN, the Journal, or the Publisher. Address correspondence to Judith H. Poole, PhD, RNC, Perinatal CNS, Women’s Services, 200 Hawthorne Lane, Charlotte, NC 28233; e-mail address: [email protected]. © 2005 by American Society of PeriAnesthesia Nurses. 1089-9472/05/2003-0001$30.00/0 doi:10.1016/j.jopan.2005.04.001
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