4 Preoperative Care

 can be performed in the surgeon’s office then referred to the preoperative
testing center of the hospital or ambulatory care facility

 in emergency situation, it can performed in the ER department or in the unit
the patient is admitted
 it include the following:
1. Medical history & physical examination
2. Laboratory tests: Hemoglobin, hematocrit, blood urea nitrogen & blood
glucose, hematocrit, complete blood count,urinalysis
3. Blood type and crossmatch
4. Chest x-ray study
5. Electrocardiogram
6. Diagnostic Procedures
7. Written Instructions
• NPO after midnight
• Take any essential oral medication with minimal fluid intake
• The skin should cleansed to prepare the surgical site
• Nail polish & acrylic nails should be removed
• Jewelry & valuables should be left at home to ensure safekeeping
• Patients should be given other special instructions about what is
expected
8. Informed consent
9. Nurse interview
9. Anesthesia assessment
10. Evening before an elective surgical procedure: Bowel preparation &
bedtime sedation for sleep
PROS OF PREOPERATIVE VISITS
1. An experienced perioperative / perianesthesia nurse is well qualified to
discuss a patient’s OR experience
2. The perioperative /perianesthesia nurse can review critical data before the
procedure and assess the patient before planning care
3. Visits improve & individualize intraoperative care & efficiency & prevent
needless delays in the OR
4. Visits foster a meaningful nurse-patient relationship
5. Visits make intraoperative observations more meaningful by establishing a
baseline for the measurement of patient outcome
6. Visits contribute to patient cooperation & involvement by facilitating
communication
7. Visits enhance the positive self image of the perioperative nurse &
contribute to job satisfaction which in turn reduces job turnover
CONS OF PREOPERATIVE VISITS
1. Cost containment measures may not provide adequate staffing or allow time
to visit patients
2. The admission of patients on the day of the surgical procedure or late the
Day before the procedures makes the timing of visits difficult
3. Visits may produce friction among different team factions if the program is
Not well planned & executed
4. Repetitious interviewing may lead to a stereotyped manner & a lack of
Enthusiasm & spontaneity on the part of nurse interviewers
5. If the nurse interviewing skills are not practice, patients may feel their
Privacy is being invaded
6. Barriers to visits may rise from the nurse’s inability to do the following
1. Inform the client about what to expect postoperatively
2. Inform the client to notify the nurse if any pain is experienced
postoperatively & that pain medication will be prescribed to be given as the
client requests
3. Inform the client that requesting a narcotic after surgery will not make the
client a drug addict
4. Demonstrate the use of a client-controlled analgesia pump if its use is
prescribed
5. Instruct the client to use the noninvasive pain relief techniques such as
relaxation, distraction techniques, and guided imagery before the pain occurs
and as soon as the pain is noticed
6. The client should be instructed not to smoke for at least 24 hours before
surgery
7. Instruct the client in deep breathing and coughing techniques, the use of
incentive spirometry and the importance of performing the techniques
postoperatively to prevent the development of pneumonia
8. Instruct the client in leg & foot exercises to prevent venous stasis of blood
and facilitate venous blood return
9. Instruct the client in how to splint an incision and to turn and reposition
10. Inform the client of any invasive devices that may be needed after surgery
such as nasogastric tube, drain, foley catheter, epidural catheter, intravenous
or subclavian lines
11. Instruct the client not to pull on any of the invasive devices as they will be
removed as soon as possible
1. The patient puts on a clean hospital gown
2. Jewelry is removed for safekeeping
3. Unless otherwise ordered, dentures and removable bridges are removed
before the administration of the general anesthetic to safeguard them and to
prevent them from obstructing respiration
4. All removable prostheses are removed for safekeeping
5. Long hair may be braided and covered with caps
6. Antiembolic stockings or elastic bandages may be ordered for the lower
extremities to prevent embolic phenomena
7. The patients voids to prevent overdistention of the bladder or incontinence
during unconsciousness
8. If ordered, an antibiotic is given preoperatively to establish and reach a
therapeutic blood level of antibiotic prophylaxis intraoperatively
9. Preanesthesia medications are given as ordered to eliminate apprehension
by making the patient calm, drowsy and confortable
10. The patient, bed and chart are accurately identified and identifications are
fastened securely in place
1. Greet the patient and validate the identity of the patient, stretcher or bed
and chart
2. Check the side rails, restraining straps, IV infusions and indwelling catheters
3. Observe the patient for any reaction to the medication
4. Observe the patient’s anxiety level
5. Check the history and physical examination data, laboratory test, x-ray
Reports and consent forms or documentation in the patient’s chart
6. Review the plan of care or care map

BEFORE INDUCTION OF ANESTHESIA
1. Checking and assembling equipment before the patient enters the room
2. Reviewing the preoperative physical examination, history and laboratory
Reports
3. Making certain that the patient is comfortable and secure on the operating
bed
BEFORE INDUCTION OF ANESTHESIA
4. Checking the preoperative checklist
5. Checking the patient’s vital signs to obtain a baseline for the subsequent
assessment of vital signs while the patient is anesthetized
6. Listening to the heart and lungs and then connecting ECG monitor leads
and attaching the pulse oximeter and other monitorinf devices
7. Preparing for and explaining the induction procedure to the patient
SACH CONTROLLED FORMS
THANK YOU!

4 Preoperative Care

Uploaded by

Copyright:

Available Formats

4 Preoperative Care

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

4 Preoperative Care

Uploaded by

Copyright:

Available Formats

 can be performed in the surgeon’s office then referred to the preoperative

testing center of the hospital or ambulatory care facility

6. Review the plan of care or care map

You might also like