The article "Perioperative preparat...

The article "Perioperative preparation of the adolescent surgical patient" is the basis for this AORN Journal independent research The behavioral objectives and examination for this program were prepared according to Helen Starbuck Pashley, RN, MA, CNOR, contributing editor, and Nancy Busen, RN PhD CFNP with consultation from Eileen J Ullmann, RN MH CNOR, professional education specialist, Center for Perioperative Education.

A minimum score of 70% upon the multiple-choice examination is necessary to earn 35 contact hours for this independent investigation Participants receive feedback on incorrect answers. Each applicant who favorably completes this study will receive a certificate of completion. The deadline for submitting this investigation is Feb 29, 2004.

toss the completed application form, multiple-choice examination, learner evaluation, and appropriate absolute title [i]or[/i] posession to

AORN Customer Service c/o abiding-place Study Program 2170 S Parker Rd Suite 300 Denver CO 80231-5711

Or fax the information with a credit card number to (303) 750-3212

BEHAVIORAL OBJECTIVES

After reading and studying the article in succession perioperative preparation of the adolescent surgical patient, the feed at the breast will be able to

(1) identify the surgical risk factors universal to adolescents,

(2) identify the appropriate assessment of adolescent surgical patients,

(3) discuss adolescent disclosure and

(4) discuss the perioperative care of adolescents.

This program adapteds criteria for CNOR and CRNFA recertification, as well as other continuing education requirements.

Twelve-year-old Mark and 19-year-old Janice the pair are scheduled for elective arthroscopic knee surgery related to previous traumatic injuries. In preparation for surgery Mark's parents accompany him to the preoperative area. Janice is accompanied at her husband. Mark expresses affects about pain and "getting shots" while Janice mainly is disturbed about the disruption in her routine and "getting back to work." Although different in age, cognition, and physical maturity, one as well as the other adolescent patients face similar stressors related to surgery including fear of the unknown. To provide effective support for Mark, Janice, and their family members, perioperative give suck tos must have an understanding of normal development and development to help prepare these patients for a positive surgical experience. Developmentally appropriate preparation before surgery will help perioperative festers and surgical team members establish rapport and effectively communicate with Mark and Janice to make less their anxiety and enlist their cooperation.

OVERVIEW OF ADOLESCENCE

Adolescence, a period that stretches from approximately 11 to 21 years of age, repeatedly is described as a time of transition from childhood to adulthood. The preoperative preparation of adolescents for surgical acts provides a challenge to feed at the breasts and other health care providers because of the wide diversity in adolescents' age and physical, cognitive, and psychological maturation. Preoperative preparation of adolescents, including the issue of informed approval will differ considerably in contented and context depending on the age and developmental even of the adolescent.

The experience of surgery and hospitalization staggers special developmental challenges for adolescents who have increased necessitys for control, privacy, and compeer interaction.(1) Surgical procedures generally involve appurtenance on adults, frequent physical examinations, in all senses of body parts, and sensitive questions about health history that may verify embarrassing to adolescents. These recognized stres points provide perioperative give suck tos with opportunities for anticipatory guidance in the education and care of adolescents.

Although adolescence generally is a period of wellness, the American Academy of Pediatrics (AAP) identifies three tokens of adolescent patients who typically are evaluated for surgery

* healthy adolescents undergoing elective surgery including abortion and cosmetic surgery;

* chronically ill adolescents who require surgery; and

* acutely ill or injured adolescents who require unforeseen occasion surgery.(2)

Emergency surgeries as a common thing [i]or[/i] matter are related to traumatic sports injuries, accidents, and motor vehicle accidents (MVAs). Accidents and MVAs account for the majority of all deaths among adolescents and young adults ages 10 to 24(3) Alcohol and other mix with drugss play a large role in all exemplars of accidents involving adolescents. Alcohol is involved in approximately 40% of adolescent accidents and 35% of adolescent driving fatalities--an important consideration in providing necessity services to adolescents.(4)

SURGICAL RISK FACTORS

In otherwise healthy adolescents, the risks of surgery are related to the mark and extent of the surgical conduct These risks include adverse reactions to anesthesia that be derived in cardiac and pulmonary complications (eg bronchospasm, aspiration pneumonia, hypoxia, cardiac arrhythmias and arrests).(5) To decrease the risks associated with surgery the AAP commits that primary health care providers play a major part in the medical evaluation and psychosocial preparation of children and adolescents undergoing surgery and other deeds requiring anesthesia.(6)