Step 6: Identify a
contrary case
rANXIETY L.
Physical - tachycardia/Asystolic B/P/tachypnoe
Stress Response
—- Anaesthetic
Psychological - Fear ~- Scarring/AB
~ Unknown
" Death
s‘ Pain
Social - Altered B l ______
Work---------—
Activities/Pleasure
- Loss of Earnings
Time Off
— Pre med
Pre Op Anxiety -........ Relaxation / distraction
Information
Anaesthetic -
Anxiety
Induction
Maintenance
Emergence
Tacb/p
Intra Op- Surgery— ----- Aseptic tech
" Safety
Post Op - Pain
Delaying healing
Infection
DVT/PE
Complication - eg haemorrhage
During the preoperative visit, Mrs H,
a 40-year-old woman admitted for
investigations of melena requiring
sigmoidoscopy, greeted the anaesthetic
nurse specialist with a firm hand shake
and a smile. Mrs H had insulin dependent
diabetes mellitus (IDDM) and her condition
was stable at present as documented in
her admission nursing and medical notes.
She managed her condition by checking
blood glucose levels four hourly and selfadministering
subcutaneous insulin as
required. She settled into the ward, was
reading a book, watching TV and looking
forward to receiving her visitors. Mrs
H indicated that this was not her first
experience of sigmoidoscopy and felt
relatively assured of what was to occur
during her perioperative journey.