Overview
Clinical Priorities Across the Perioperative Period
Surgery creates a predictable physiological stress response: catecholamines and inflammatory mediators increase heart rate, glucose release, vascular tone, and protein breakdown.
Surgery creates a predictable physiological stress response: catecholamines and inflammatory mediators increase heart rate, glucose release, vascular tone, and protein breakdown. Anaesthesia adds different risks by reducing airway reflexes, ventilation, blood pressure regulation, temperature control, and gastrointestinal motility. Pain, immobility, blood loss, fluid shifts, and altered oral intake then shape recovery. The nurse is therefore watching for a change that exceeds the expected response to the procedure or fails to improve along the expected trajectory. Preoperative care reduces avoidable risk before the first incision. Postoperative care asks whether airway, breathing, circulation, neurologic function, pain, temperature, elimination, and wound status are recovering safely. A single abnormal finding may be less informative than a trend: increasing oxygen needs, progressively falling blood pressure, worsening confusion, declining urine output, or expanding drainage signals deterioration even when an individual value has not yet crossed a dramatic threshold. The RPN works within provincial or territorial standards, employer policy, personal competence, and the assigned plan of care. Canadian practical-nursing competencies are supplemented by each regulator’s standards. In Ontario, the appropriateness of an RPN assignment is judged through...