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Chapter 17PreoperativeCare

1) The document discusses preoperative care which includes assessing the patient's health history, medications, allergies and systems through interviews and examinations. 2) It also covers providing preoperative teaching to patients about the surgery, expectations, restrictions and how to participate in their recovery. 3) The nursing management involves legal consents, preoperative preparation checks, identification of the patient and transporting them safely to the operating room.

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Alem Ayahu
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14 views26 pages

Chapter 17PreoperativeCare

1) The document discusses preoperative care which includes assessing the patient's health history, medications, allergies and systems through interviews and examinations. 2) It also covers providing preoperative teaching to patients about the surgery, expectations, restrictions and how to participate in their recovery. 3) The nursing management involves legal consents, preoperative preparation checks, identification of the patient and transporting them safely to the operating room.

Uploaded by

Alem Ayahu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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Preoperative Care

(relates to Chapter 17, “Nursing Management:


Preoperative Care,” in the textbook)

1
Surgery
• Performed for:
– Diagnosis
– Cure
– Palliation
– Prevention
– Exploration
– Cosmetic improvement

2
Patient Interview

• Purpose
– Obtain health information
– Determine expectations
– Provide and clarify
information on procedure
– Assess emotional state and
readiness

3
Nursing Assessment of the
Preoperative Patient
• Subjective Data
- Psychosocial Assessment
Anxiety
Common fears
Hope

4
Nursing Assessment
(Subj. data cont’d)

• Health history

• Medications

• Allergies

5
Nursing Assessment

Review of systems
• Cardiovascular function

• Respiratory system

• Nervous system

• Urinary system
6
Nursing Assessment

– Review of systems (cont’d)


• Integumentary system
• Musculoskeletal system
• Endocrine system
• Immune system
• Fluid & Electrolyte status
• Nutritional status

7
Nursing Assessment-
Objective Data

• Physical examination

• Laboratory and diagnostic


testing

– Indicator of perioperative
risk and overall outcome

8
Nursing Management

Preoperative teaching
• Patient has right to know what
to expect and how to participate
– Increases patient satisfaction
– Reduces fear, anxiety, stress,
pain, and vomiting

9
Nursing Management

– Teaching documented in
medical record (pt. chart)
– Sensory information
– Instruction on deep breathing,
coughing, and moving
postoperatively
• Teach rationale to reinforce
• Practice

10
Pre-Operative Teaching

• Deep breathing, coughing,


incentive spirometry
• Mobility and active body
movement
– Ambulation/leg exercises

11
Patient Teaching

– Inform patients and families


if there will be tubes, drains,
monitoring devices, or
special equipment
postoperatively
– Discuss pain management

12
Patient Teaching

– Provide patient with


information
• Fluid/food restrictions
(prevents aspiration, N/V)
• Need for enema
• Need for shower
preoperatively/ skin prep

13
Nursing Management

Legal preparation
• Check that all forms have been
correctly signed and are present
in chart
– Informed consent
– Blood transfusion

14
Nursing Management

• Must include adequate


disclosure of diagnosis,
treatment, risks, and
probability of success

15
Nursing Management

• Patient must demonstrate clear


understanding and
comprehension
– Signed before any
preoperative drugs given
• Voluntary consent

16
Nursing Management

• Surgeon responsible for


obtaining consent
– Nurse may obtain and
witness signature (varies)
– Verify patient has
understanding
• Permission may be withdrawn
at any time

17
Nursing Management

• Advance directives, living wills,


and power of attorney included
in chart

18
Nursing Management

Day-of-surgery preparation
• Final preoperative teaching
• Assessment & communication
of pertinent findings
• Ensure completion of pre-op
prep orders

19
Nursing Management

Day-of-surgery preparation (pre-


op checklist)
– Labs
– Verify signed consent
– History and physical exam
– Baseline vitals
– Consultation records
– Nurse’s notes
20
Nursing Management

• Patient should not wear any


cosmetics
– Observation of skin color is
important
– Remove nail polish for pulse
oximeter
• Identification and allergy bands

21
Nursing Management

• Valuables returned to family


member or locked up
– Wedding ring taped to finger
• Dentures, contacts, prostheses
are removed

22
Nursing Management

• Void before surgery


– Prevents involuntary
elimination under anesthesia
or early postoperative
recovery
– Done before administration
of medication

23
Nursing Management
• Pre-operative Medications
– Give as ordered (scheduled
time, on call, sent to OR)
• Safety considerations
– Regularly scheduled
medications
• Verify with MD
• Cardiac meds, asthma
• Insulin

24
Nursing Management

Transportation to OR
• In-patients transported by cart
to surgery from room
– Side rails raised and secured
– Chart and preoperative
equipment with patient
– Family may accompany to
holding
25
Nursing Management

• Outpatients transported by
cart, wheelchair, or may walk
– Method of transport
documented by nurse
responsible for transfer
• Family instructed on waiting
area where they can be
informed of progress

26

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