case study

‘Perioperative’ nursing refers to the patient throughout their entire ‘surgical experience’. That is, the pre-, intra-, and postoperative stages of the surgical procedure (Gilmour, 2005, p. 18; Steelman, 2011, p. 1). An important aspect of perioperative nursing is the provision of evidence-based care. As such, there should be clear and accurate rationales underpinning the nursing interventions which are to be performed in a safe, efficient and cost effective way. Furthermore, it is vital for the perioperative nurse to have well developed skills and knowledge of a range of different nursing domains including human anatomy, surgical procedures and equipment, and techniques to deliver caring and comforting high quality care (Steelman, 2011, pp. 1-2). This essay will explore the different nursing aspects related to the care of a patient in the perioperative setting. The exploration will be framed within the case study of Jane, a 45 year-old woman who sustained head injuries following fall. A CT scan revealed Jane had a large subdural haematoma and required emergency surgery. In this response, Jane’s presenting pathophysiology, the treatment goals and priorities identified following comprehensive assessment will be discussed. Throughout the discussion, particular focus will be given to the nursing implications relevant to the varied roles and responsibilities of the different perioperative nurses involved in this specialty area.
Acute subdural haematoma usually occurs after severe, high-impact head injuries such as motor vehicle accidents or falls. The pathophysiology of the subdural haematoma is the accumulation of blood between the dura and the brain, a space normally occupied by a thin cushion of fluid. The blood puts the brain under pressure, which can trigger a wide range of clinical signs and symptoms including changes in level of consciousness, pupillary signs, and hemiparesis (Farrell & Dempsey, 2011, p. 2004). Coma, increasing blood pressure, decreasing