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Chapter 14: Preoperative Nursing Management
Key Concepts
Definition: Preoperative phase begins when the decision for surgery is
made & ends when the patient enters the OR.
Types of Surgery:
o Elective: Planned (e.g., hernia repair)
o Urgent: Needs prompt attention (e.g., gallstones with cholecystitis)
o Emergent: Immediate (e.g., trauma, ruptured aneurysm)
Nursing Roles
Assessment:
o Health history (comorbidities, allergies, medications, substance
use)
o Physical exam (baseline vitals, airway, cardiac, renal)
o Psychosocial (anxiety, fears, cultural beliefs)
Preoperative Testing:
o CBC, electrolytes, coagulation, pregnancy test, ECG, CXR
Informed Consent:
o Provider obtains consent; nurse witnesses & ensures patient
understanding.
Preoperative Teaching:
o Deep breathing, coughing, incentive spirometry
o Early ambulation, pain control, procedure expectations
Special Considerations:
o Geriatric, obese, diabetic, immunocompromised patients
Chapter 15: Intraoperative Nursing Management
Key Concepts
Phases of OR:
o Preoperative holding: final ID, assessments
o Intraoperative phase: time in OR until PACU transfer
Surgical Team Members
, 2
Surgeon Circulating nurse (non-sterile,
Scrub nurse/tech (sterile documentation, safety)
field)
Anesthesia provider
Nursing Priorities
Aseptic Technique o General, regional, local,
Positioning to prevent nerve conscious sedation
injury, pressure ulcers Complications:
Time-Out/Universal Protocol o Malignant hyperthermia
o Correct patient, procedure, (rigid muscles, ↑ temp) —
site treat with Dantrolene
Anesthesia Monitoring: o Blood loss, anaphylaxis,
hypothermia
Chapter 16: Postoperative Nursing Management
Key Concepts
Phases:
o Phase I (PACU): o Phase II: Pre-discharge
Immediate recovery; teaching
monitor ABCs o Phase III: Extended
observation or home care
Priority Assessments
Airway/Breathing: Stridor, Wound/Dressing: Monitor for
hypoxia bleeding, drainage
Circulation: HR, BP, bleeding Urine Output: Should be ≥30
LOC: Neuro status, orientation mL/hr.
Pain Management: IV opioids,
PCA
Common Complications
Respiratory: Atelectasis, Cardiovascular: DVT, PE,
pneumonia, hypoventilation hypotension, dysrhythmias
Chapter 14: Preoperative Nursing Management
Key Concepts
Definition: Preoperative phase begins when the decision for surgery is
made & ends when the patient enters the OR.
Types of Surgery:
o Elective: Planned (e.g., hernia repair)
o Urgent: Needs prompt attention (e.g., gallstones with cholecystitis)
o Emergent: Immediate (e.g., trauma, ruptured aneurysm)
Nursing Roles
Assessment:
o Health history (comorbidities, allergies, medications, substance
use)
o Physical exam (baseline vitals, airway, cardiac, renal)
o Psychosocial (anxiety, fears, cultural beliefs)
Preoperative Testing:
o CBC, electrolytes, coagulation, pregnancy test, ECG, CXR
Informed Consent:
o Provider obtains consent; nurse witnesses & ensures patient
understanding.
Preoperative Teaching:
o Deep breathing, coughing, incentive spirometry
o Early ambulation, pain control, procedure expectations
Special Considerations:
o Geriatric, obese, diabetic, immunocompromised patients
Chapter 15: Intraoperative Nursing Management
Key Concepts
Phases of OR:
o Preoperative holding: final ID, assessments
o Intraoperative phase: time in OR until PACU transfer
Surgical Team Members
, 2
Surgeon Circulating nurse (non-sterile,
Scrub nurse/tech (sterile documentation, safety)
field)
Anesthesia provider
Nursing Priorities
Aseptic Technique o General, regional, local,
Positioning to prevent nerve conscious sedation
injury, pressure ulcers Complications:
Time-Out/Universal Protocol o Malignant hyperthermia
o Correct patient, procedure, (rigid muscles, ↑ temp) —
site treat with Dantrolene
Anesthesia Monitoring: o Blood loss, anaphylaxis,
hypothermia
Chapter 16: Postoperative Nursing Management
Key Concepts
Phases:
o Phase I (PACU): o Phase II: Pre-discharge
Immediate recovery; teaching
monitor ABCs o Phase III: Extended
observation or home care
Priority Assessments
Airway/Breathing: Stridor, Wound/Dressing: Monitor for
hypoxia bleeding, drainage
Circulation: HR, BP, bleeding Urine Output: Should be ≥30
LOC: Neuro status, orientation mL/hr.
Pain Management: IV opioids,
PCA
Common Complications
Respiratory: Atelectasis, Cardiovascular: DVT, PE,
pneumonia, hypoventilation hypotension, dysrhythmias
