Preoperative Care

Prepared by Dr.Thuraya osman

Preoperative Period

Begins when the patient is scheduled for surgery and ends at the time of transfer to the surgical suite. Nurse functions as educator, advocate, and promoter of health and safety.

Reason for Surgery

Diagnostic Curative Palliative Preventive Explorative Cosmetic

Urgency of Surgery

Urgency:

Elective Emergent

May be performed in a variety of settings.

Patient Interview and Nursing Assessment

Psychosocial Assessment Patient Interview

Nursing Assessment

Past Health History Medications Allergies

Review of Systems

Cardiovascular system Respiratory system Neurologic system Genitourinary system Hepatic system Integumentary system Musculoskeletal system Endocrine system Immune system Fluid and Electrolyte status Nutritional status
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Objective Data
Physical Examination Laboratory and Diagnostic Testing

Urinalysis Blood type and crossmatch Complete blood count or hemoglobin level and hematocrit Clotting studies Electrolyte levels Serum creatinine level, BUN Pregnancy test (HCG) Chest x-ray examination Electrocardiogram
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Nursing Management

Preoperative teaching. Informed consent:

Physician is responsible for obtaining signed consent before sedation and/or surgery. The nurses role may be witnessing the patients signature on the consent form and being a patient advocate, verifying that the patient or family understands the information presented in the consent form and that consent for surgery is truly voluntary. Consent can be withdrawn at any time.
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Day of Surgery Preparation

Nursing responsibilities immediately before surgery

Final preoperative teaching Assessment and communication of pertinent findings Ensuring that all preoperative preparation orders have been completed Ensuring that records and reports are present and complete to accompany the patient to the OR.

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Preoperative Chart Review

Ensure all documentation, preoperative procedures, and orders are complete. Check the surgical consent form and others for completeness. Document allergies. Document height and weight. History and Physical. Baseline vital signs.

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Preoperative Chart Review (Contd)

Ensure results of all laboratory and diagnostic tests are on the chart. Document and report any abnormal results. Report special needs and concerns.

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Preoperative Patient Preparation

Patient should remove most clothing and wear a hospital gown. Valuables should remain with family member or be locked up. Tape rings in place if they cannot be removed. Remove all pierced jewelry.

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Preoperative Patient Preparation (Contd)

Patient wears an identification band. Dentures, prosthetic devices, hearing aids, contact lenses, fingernail polish, and artificial nails must be removed.

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Preoperative Drugs

Reduce anxiety Promote relaxation Reduce nasal and oral secretions Inhibit gastric secretion Decrease the amount of anesthetic needed for the induction and maintenance of anesthesia Prevent Post-Op infection Increase gastric emptying; prevent nausea and vomiting Relieve pain during preoperative procedures
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Patient Transfer to Surgical Suite

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