Case Study, Chapter 17, Preoperative Nursing Management
1. Joan Arnold, 67 years of age, is a female patient who underwent a
coronary angiogram that diagnosed severe coronary artery disease in three
of her coronary arteries, the left anterior descending, the left circumflex, and
the right coronary artery. She is scheduled for a coronary artery bypass graft
operation tomorrow. The nurse provides patient education for Mrs. Arnold
and her husband, which includes watching a hospital video on the operation;
the intensive care environment; what to expect after the surgery; the
recovery period; and cardiac rehabilitation. The video also covered the
importance of coughing and deep breathing, using an incentive spirometer,
splinting, early ambulation, pain medication, and how to position oneself
safely. The video stressed the importance of not rolling onto the side that the
chest tube may be in place postoperatively. The video also discussed the
preoperative preparation. The nurse also provided a booklet on the subject
material. The nurse had a session with the patient and her husband to assess
their understanding and to answer any questions they may have had.
(Learning Objectives 5 to 7)
a. What specific preoperative nursing measures should the nurse review
with the patient to help decrease the risk for postoperative
complications?
The nurse should encourage mobility/active body movement to
improve circulation and promote optimal respiratory function.
The nurse should teach the patient deep breathing and
splinting when coughing. Coughing helps to mobilize secretions
so atelectasis or other lung complications from occurring.
(page. 429)
b. Explain the role of the nurse when implementing the immediate
preoperative preparation the day before surgery and the morning of
the surgery?
The nurse should individualize patient education. The nurse
should make the resoursces available such as written
instructions and telephone numbers. The nurse should also
allow the patient/family to ask questions to relieve any anxiety
that they might have.(page.429)
2. The nurse in a gynecology clinic is completing preoperative teaching for a
patient scheduled for an abdominal hysterectomy next week. The patient
states that she is currently taking 325 mg of aspirin daily for chronic joint
pain, along with a multivitamin. The patient has type 2 diabetes; she closely
monitors her blood glucose levels. Currently, she is taking an oral
hypoglycemic agent. The nurse advises her to ask the anesthesiologist
1. Joan Arnold, 67 years of age, is a female patient who underwent a
coronary angiogram that diagnosed severe coronary artery disease in three
of her coronary arteries, the left anterior descending, the left circumflex, and
the right coronary artery. She is scheduled for a coronary artery bypass graft
operation tomorrow. The nurse provides patient education for Mrs. Arnold
and her husband, which includes watching a hospital video on the operation;
the intensive care environment; what to expect after the surgery; the
recovery period; and cardiac rehabilitation. The video also covered the
importance of coughing and deep breathing, using an incentive spirometer,
splinting, early ambulation, pain medication, and how to position oneself
safely. The video stressed the importance of not rolling onto the side that the
chest tube may be in place postoperatively. The video also discussed the
preoperative preparation. The nurse also provided a booklet on the subject
material. The nurse had a session with the patient and her husband to assess
their understanding and to answer any questions they may have had.
(Learning Objectives 5 to 7)
a. What specific preoperative nursing measures should the nurse review
with the patient to help decrease the risk for postoperative
complications?
The nurse should encourage mobility/active body movement to
improve circulation and promote optimal respiratory function.
The nurse should teach the patient deep breathing and
splinting when coughing. Coughing helps to mobilize secretions
so atelectasis or other lung complications from occurring.
(page. 429)
b. Explain the role of the nurse when implementing the immediate
preoperative preparation the day before surgery and the morning of
the surgery?
The nurse should individualize patient education. The nurse
should make the resoursces available such as written
instructions and telephone numbers. The nurse should also
allow the patient/family to ask questions to relieve any anxiety
that they might have.(page.429)
2. The nurse in a gynecology clinic is completing preoperative teaching for a
patient scheduled for an abdominal hysterectomy next week. The patient
states that she is currently taking 325 mg of aspirin daily for chronic joint
pain, along with a multivitamin. The patient has type 2 diabetes; she closely
monitors her blood glucose levels. Currently, she is taking an oral
hypoglycemic agent. The nurse advises her to ask the anesthesiologist
