peroperative phase
when the person decides to have surgery until the OR table
could last months
roles of a preoperative nurse
complete physical exam
history
allergies
pre-op checklist
labs
informed consent
preoperative assessment
baseline vitals
psychologic status
physiologic factors
surgical site
home meds
review results of diagnostic studies
culture and ethical factors
consent form signed
intraopertive phase
While they are in the OR with an emphasis on safety
,postoperative phase
PACU until follow-up visit
Factors that increase surgery risk
Age
Obesity
Malnutrition
Dehydration
Cardiovascular & respiratory disease
Diabetes (trouble with delayed healing)
Renal &liver disease (trouble with metabolize medications)
Alcoholism
Nicotine use
how long should nicotine us be suspended before surgery
6 weeks
Medications that need to be stopped before surgery
Anticoagulants
Diuretics
Phenothiazines
MAOI's
body system reiview
Confirms the presence or absence of disease
alerts to areas to closely examine
provide essential data to determine specific preoperative tests
,alerts to areas to closely examine
provide essential data to determine specific preoperative tests
informed consent
an active and shared decision making process between the HCP
and patient
three conditions for consent to be vaild
adequate disclosure of diagnosis, nature and purpose of
treatment, risks, % of successful outcomes, ability/risks/benefits
of alternative treatment
clear understanding before pre-op medications are administered
consent is voluntary
Preop teaching
what to expect
how to take part effectively during surgery
only for non-emergent surgeries
promotes patient safety
decreases fear, anxiety, stress, complications, LOS, and recovery
time
increases patient understanding
what should all patients be taught unless contraindicated
deep breathing, coughing, and early ambulation
Day of surgery patient should be informed of
, specifics on the procedure
arrival time, registration, parking, what to wear, what to bring,
and the need for an accompanying care giver
specific regarding food intake (NPO the night before elective
surgery)
Day of surgery nurse responsibilites
verification of allergies and medication
consent form
preoperative teaching
assessment and pt findings
verified completion of labs and diagnostic studies
all preoperative orders completed
baseline vitals
prep skin
encourage patient to void
preop check list
common preoperative meds
antibiotics
anticholinergics
antidiabetics
benzos
beta blockers
histamine 2 receptor antagonist
opioids
sensory information