الفهرس 
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Abstract
Summary The immediate post-anesthesia phase one period is a critical time for the patient. Close and constant observation is essential. Immediately following an operation, patients remain at high risk of critical events but with good monitoring the most events can be treated early. Post anesthetic phase one patients must be monitored and assessed closely for any deterioration in condition and the relevant post anesthesia care plan or pathway must be implemented. The nursing care guidelines to improve post anaesthesia phase one care outcomes for patients who have anaesthesia or sedation Nursing plays critical role in returning the patient to an optimal level of physiological functioning The aim of this study was to investigate the impact of nursing care< guidelines for post anesthetic (phase one) on patient outcome at Assiut university . Quasi experimental research design was used to conduct
this study. The sample of this study Sample was (102) collected over
sixth months (from December 2013 to May 2014) that divided to two groups
(control and study).The study conducted with microsurgical reconstructive
post anesthesia care unit of Assiut University Hospital.
Tools of the study:
Three tools were used by researcher to collect the data for this study.
Tool I: Patients assessment sheet consists of three parts, part one: preoperative
assessment includes of socio-demographic data of the patient as
code, age and sex, and laboratory investigation. Part two: intra operative
assessment including of clinical data as type of anesthesia and duration of
anesthesia, hemodynamic parameters and respiratory assessment. Part
three: immediately post anesthesia assessment sheet including of hemodynamic
parameters, respiratory assessment and immediately post anesSummary
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thesia complication. Tool II: Richmond Agitation Sedation Scale. Tool
III: faces pain scales.
The main result:
The result of the present study revealed that percentage related age in
the control group was more than half of patient in age group 18-30 years old
while in the study group was half of patients in age group 18-30years old
and there were no statistically significant difference between both groups of
the study.
As regard the gender, the current study revealed that two third of
control group and more than two third of the study group were males
patients with no statistically significant difference between control and study
groups
Regarding to post anesthesia complication, the most complication of
cardiovascular were hypotension and tachycardia in both groups with no statistically
significant difference between control and study groups.
Respiratory complication in the present study was airway obstruction
in both groups with statistically significant difference between study and
control groups.
The result of current study showed the most common of complications
of nerves system was pain related operation and hypothermia with statistically
significant difference between control and study groups.
The result of the present study revealed that most patients low body
temperature immediately post anesthesia in both groups but improved by interventions
in study group with shows highly statistically significant difference
between control and study groups through the entire time interval.
As regarding monitoring blood pressure immediately post anesthesia
in both groups, the current study revealed that mean arterial blood pressure
through the entire time interval for control group within normal range but
Summary
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improved and stabilization with intervention in study group with highly statistically
significant difference between both groups during phase one time.
The present study showed stabilization of heart rate by nursing care
guideline intervention with statistically significant difference between control
group and study group for heart rate in the post anesthesia phase one
time interval.
As regard to immediately post anesthesia pain related operation the
result of the current study revealed decrease post-operative pain level with
continuous evaluated pain level and intervention in study group compare
with control group and there was statistically significant difference between
control group and study group to all study time interval.
Based on the findings of oxygen modes immediately post anesthesia
revealed control group of oxygen supplementation by air room mode and in
study group with intervention the oxygen supplementation by simple mask
mode with flow 3L/hr. So, showed highly statistically significance
difference between control and study groups for oxygen supplementation
and also inspired oxygen fraction (Fio2) concentration oxygen
supplementation for control and study groups (21% vs 40%) respectively.
The finding of the current study related to respiratory rate
immediately post anesthesia revealed improved and stabilized with
intervention in study group and there were highly statistically significance differences between control and study groups to all study time intervalAs regard to oxygen saturation immediately post anesthesia revealed
improved with sample mask mode oxygen supplementation and an others
nursing intervention (patient head position and section) in study group and there were highly statistically significance differences between control andstudy groups to all study time interval Summary29Regarding to depth, pattern breathing, breath sound and accessory.