Pre-Operative Preparations for Surgery

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Questions and Answers

Which factor is NOT mentioned as influencing preoperative preparations for a patient?

Urgency of the surgery

Patient's family medical history (correct)

Surgeon’s specific routines

Type of surgical procedure

What is typically true regarding the amount of supplies needed for minor versus major surgical procedures?

Minor procedures often require more supplies due to complexity

Major procedures usually need less supplies to ensure efficiency

The amount of supplies is generally greater for major procedures (correct)

Both types of procedures require the same amount of supplies

What is a common routine completed before a patient enters the operating room?

Preoperative consent process (correct)

Immediate discharge instructions

Post-surgical recovery plans

Orientation for surgical staff

Which of the following does NOT typically have an impact on preoperative patient preparation?

Geographical location of the hospital Signup and view all the answers

In emergency situations, how quickly can preoperative preparations be accomplished?

In hours or even minutes Signup and view all the answers

Which of the following factors does NOT typically determine the type of preoperative preparation required?

Social status of the patient Signup and view all the answers

What is the sequence of events from patient entry into the hospital to readiness for surgery primarily based on?

Factors like urgency, patient condition, and procedural requirements Signup and view all the answers

What type of surgical procedure typically requires less physical preparation?

Minor surgical procedures Signup and view all the answers

What is the primary reason why elderly patients need to be kept warm?

They have slower blood circulation, thinner skin, and less body hair Signup and view all the answers

What is the main difference between elective and emergency surgery?

The urgency of the surgery Signup and view all the answers

What is an example of an elective-urgent procedure?

Cardiac bypass Signup and view all the answers

What is the purpose of a surgeon's preference card?

To list the equipment and supplies required for a specific operation Signup and view all the answers

Why may extensive preoperative testing increase a patient's risk of infection?

It may weaken the immune system Signup and view all the answers

What is a 'stat' procedure?

A life or limb threatening condition requiring immediate surgery Signup and view all the answers

Why is it important to check the nurse's preoperative assessment and the nursing care plan?

To identify the individual needs of each patient Signup and view all the answers

What influences the number and complexity of laboratory and other diagnostic tests?

The nature of the problem and the patient's overall health Signup and view all the answers

Why is same day surgery considered elective?

Because it is scheduled at the patient's convenience Signup and view all the answers

What is an example of an emergency surgical procedure?

Open reduction of a fractured bone Signup and view all the answers

What is the primary reason a surgeon may order urinalysis before surgery?

To evaluate the patient's kidney function and detect urinary tract infections. Signup and view all the answers

Which of the following groups always requires a complete blood count (CBC) and an hCG pregnancy test preoperatively?

All females of childbearing age unless they are menopausal or have had a hysterectomy. Signup and view all the answers

What does a high specific gravity reading in urinalysis typically indicate?

Dehydration in the patient. Signup and view all the answers

If a urinalysis shows glucose in the urine, what condition could this potentially indicate?

Diabetes. Signup and view all the answers

In which condition might a low specific gravity in urine be observed?

Fluid overload or kidney disease. Signup and view all the answers

What is the normal pH range of urine?

4.6 to 8.0. Signup and view all the answers

Which of the following is NOT typically found in healthy urine?

White blood cells (WBCs). Signup and view all the answers

What is the most common routine hematology study ordered preoperatively?

Complete blood count (CBC). Signup and view all the answers

Which of the following can indicate the potential presence of kidney disease in a urinalysis?

Presence of protein. Signup and view all the answers

What effect might high carbon dioxide levels have on a patient's metabolism reflected in urinalysis pH?

It indicates alkalosis. Signup and view all the answers

What is the approximate blood volume of a seven-pound baby?

250 to 350 ml Signup and view all the answers

Why is it essential to closely monitor the wound suction container during pediatric surgery?

To track blood loss and prevent shock Signup and view all the answers

Why are special blood tests requested preoperatively in pediatric surgery?

To identify bleeding disorders Signup and view all the answers

Why are children more susceptible to respiratory infections than adults?

Because their immune systems are not fully developed Signup and view all the answers

Why is it important to avoid interrupting the feeding schedule for infants scheduled for surgery?

To prevent dehydration and weakness Signup and view all the answers

Why are elderly patients generally given special food and supplements preoperatively?

To promote wound healing Signup and view all the answers

Why is it essential to consider joint mobility when positioning geriatric patients?

To avoid joint injury and promote comfort Signup and view all the answers

Why are sedatives and narcotics used with caution in geriatric patients?

Because they have a lower tolerance to medications Signup and view all the answers

Why is it crucial to use special support devices and extra pillows when positioning geriatric patients?

To avoid joint stress and promote comfort Signup and view all the answers

Why do elderly patients generally heal more slowly than young people?

Because of age-related physiological changes Signup and view all the answers

Which of these preoperative procedures is NOT typically performed during a preadmission visit for an elective surgical patient?

Craniotomy Signup and view all the answers

What type of imaging technique is used to diagnose torn ligaments or cartilage, herniated nucleus pulposis, tumors, and abnormalities of organs?

MRI Signup and view all the answers

Which of these tests is NOT typically performed as part of a preadmission visit for an elective surgical patient?

Electroencephalogram Signup and view all the answers

Why are surgical patients 40 years old and over recommended to have a preoperative electrocardiogram?

To diagnose any heart problem that could influence the choice of anesthesia or change the surgeon’s choice of treatment Signup and view all the answers

Why does the surgeon request more lab tests and special diagnostic studies prior to performing a major procedure?

Because major procedures affect a greater number of body systems Signup and view all the answers

Which of these imaging techniques uses sonic energy echoes to visualize anatomical structures?

Ultrasound Signup and view all the answers

What may a preliminary minor surgical procedure, such as a tissue biopsy, help to achieve before performing a major corrective procedure?

Gain more information about the patient's condition Signup and view all the answers

Why do pediatric patients require special considerations before surgery?

Because of their different physical and psychological needs Signup and view all the answers

What is the purpose of using warm irrigating and skin prep solutions during surgery on pediatric patients?

To prevent rapid heat loss Signup and view all the answers

Why do infants lose body heat rapidly during surgery?

Because they have a larger body surface area in proportion to their body size Signup and view all the answers

What is the primary purpose of a preadmission clinic visit for an elective surgical patient?

To review the patient's medical history and order necessary tests Signup and view all the answers

What type of test is ordered for patients suspected of having syphilis?

Serology test Signup and view all the answers

What type of imaging technique is used to diagnose vascular abnormalities?

All of the above Signup and view all the answers

Why may the surgeon order additional tests before performing a major procedure?

To determine if surgery is necessary Signup and view all the answers

What is the difference between a CT scan and an MRI?

CT scans use X-rays, while MRIs use radiowaves and magnetic fields Signup and view all the answers

Why is a preoperative electrocardiogram recommended for all patients with a history of cardiovascular disease?

To identify any heart conditions that could impact surgery Signup and view all the answers

What type of medication may be given to patients undergoing general anesthesia?

All of the above Signup and view all the answers

Why is it important to monitor the temperature of pediatric patients during surgery?

To prevent rapid heat loss Signup and view all the answers

What aspect of the nursing care plan is reinforced upon patient arrival at the patient-care unit?

The preadmission interview details. Signup and view all the answers

Why do geriatric patients require special considerations before surgery?

Because of their different physical and psychological needs Signup and view all the answers

What is the primary role of the clinical nursing staff during the admission process?

To formulate a nursing care plan with the patient. Signup and view all the answers

What is the purpose of the anesthetist's interview with the patient?

To review anesthesia options and obtain informed consent. Signup and view all the answers

How does the process of patient admission typically begin?

With the completion of admission paperwork by A&D personnel. Signup and view all the answers

When are patients usually admitted for surgery?

One day before the scheduled surgery. Signup and view all the answers

What is one of the primary purposes of administering an enema before surgery?

To cleanse the bowel and ensure comfort. Signup and view all the answers

What may be used to keep pediatric patients warm during surgery?

Warm blankets Signup and view all the answers

Why is it important for patients to shower with antiseptic soap the evening before surgery?

To ensure the patient's skin is clean and free from microorganisms. Signup and view all the answers

What should happen when a patient is assigned to a surgical patient-care unit?

The patient learns about visitation policies and unit layout. Signup and view all the answers

What contingency may be required before a patient's shower or bath prior to surgery?

Removal of hair from the incision site. Signup and view all the answers

How do nurses typically prepare patients for postoperative exercises?

By teaching the exercises before surgery. Signup and view all the answers

Which of the following preoperative procedures would likely be conducted after the patient is already in the operating room?

Insertion of a nasogastric tube Signup and view all the answers

Which of the following statements accurately reflects the rationale behind administering a sedative to a surgical patient the night before surgery?

To help the patient relax and fall asleep, reducing the risk of complications during surgery Signup and view all the answers

Why is it important for the surgical team to be aware of all preoperative procedures that have been completed?

To ensure that the patient is properly prepared for surgery and that no steps have been missed Signup and view all the answers

Why is it particularly important for surgical patients to be NPO (nothing by mouth) after midnight?

To reduce the risk of vomiting and aspirating emesis into the lungs Signup and view all the answers

Which of the following is NOT a typical preoperative procedure for an adult patient?

Remaining in their own pajamas until after anesthesia induction Signup and view all the answers

In the context of preoperative preparations, what does the term 'transient' refer to?

Bacteria that are temporarily present on the skin and can be removed Signup and view all the answers

Why are vital signs taken multiple times during the preoperative period?

To provide a baseline for comparison with the patient's vital signs during and after surgery Signup and view all the answers

What is the primary purpose of the surgical checklist?

To confirm that all preoperative procedures have been completed Signup and view all the answers

What is the main reason for the increasing prevalence of ambulatory surgery?

Healthcare facilities and practitioners are seeking ways to control costs, making ambulatory surgery an attractive option Signup and view all the answers

Why is it important for OR technicians to have knowledge of preoperative procedures, even if they are not directly involved in performing them?

To identify potential complications that may arise during surgery due to incomplete or incorrect preparation Signup and view all the answers

What is the normal range of Hemoglobin (Hgb) in grams per 100 milliliter (ml) for males?

13.0 - 18.0 Signup and view all the answers

What does a White Blood Cell (WBC) count over 11,000 usually indicate?

Infection Signup and view all the answers

What is the purpose of prothrombin time (PT) and partial thromboplastin time (PTT) tests?

To determine the necessity for blood transfusion Signup and view all the answers

What is the purpose of a bleeding time test?

To measure the blood's ability to clot Signup and view all the answers

What is the purpose of crossmatching?

To determine compatibility of the patient's blood and donor blood Signup and view all the answers

What is usually required for patients younger than 40 years of age without evidence of chest disease?

No preoperative radiographic studies Signup and view all the answers

What does a platelet count indicate?

The patient's risk of hemorrhage during surgery Signup and view all the answers

What does a low Hematocrit (Hct) indicate?

Anemia or internal bleeding Signup and view all the answers

What is the purpose of typing and crossmatching?

To determine the patient's blood group and reserve compatible donor blood units Signup and view all the answers

What is the purpose of a biopsy?

To diagnose a disease or condition Signup and view all the answers

Study Notes

Preoperative Patient Preparation

Multiple hospital departments collaborate to prepare patients for surgery, which may take days or can be expedited in emergencies.
Essential routines are needed to ensure patient safety before surgery, including tests, special procedures, and obtaining legal consent.

Factors Affecting Preoperative Preparation

Type of Surgical Procedure: Major procedures generally require more lab tests and diagnostics to assess the status of various body systems compared to minor procedures.
Type of Anesthesia: Preparation is tailored to the anesthesia method chosen. General anesthesia typically involves tranquilizers and agents to manage secretions, while regional or local anesthetics may require different medications.
Patient's Age and Condition: Pediatric and geriatric patients have unique needs. Pediatric patients require temperature monitoring and may be fed shortly before surgery, while elderly patients may need modified drug dosages and special care due to slower healing.
Surgical Urgency: Surgeries are classified as elective (scheduled at convenience), elective-urgent (not immediately life-threatening but necessary), and emergency (required to address life or limb-threatening issues).
Surgeon's Preferences: Each surgeon has specific preferences impacting preparation, cataloged on preference cards detailing instruments, supplies, and techniques required for different operations.
Complexity of Tests: The need for extensive laboratory tests can elongate the preoperative timeline and increase anxiety and infection risk for patients.

Evaluation of the Surgical Patient

Surgeons often order various lab tests to assess patients, including urinalysis, hematology studies, X-rays, and electrocardiograms (ECG).
Laboratory tests guide the evaluation of a patient's overall health and readiness for surgery.

Laboratory Tests

Urinalysis: Measures kidney function and presence of infection; generally not needed except for specific surgeries.
Hematology Studies: Commonly include a complete blood count (CBC), crucial for evaluating blood components and potential health risks during surgery.
CBC Normal Values:
- WBC: 4,000 - 11,000 (both male and female)
- RBC (Male): 4.6 - 6.2, (Female): 4.2 - 5.4
- Hgb (Male): 13.0 - 18.0, (Female): 12.0 - 16.0
- Hct (Male): 40 - 54, (Female): 38 - 47
- Platelet Count: 150,000 - 400,000

Blood Coagulation Studies

Tests measure blood clotting ability, including bleeding time and clotting times which inform preoperative risk assessments.

Blood Typing and Crossmatching

If a transfusion may be necessary, blood typing and crossmatching are performed preoperatively to ensure compatibility.### Blood Typing and Crossmatching
Blood is tested to determine A, B, O blood group and Rh factor (positive/negative).
Crossmatching finds compatibility between patient’s and donor blood.
Compatible donor blood units are reserved post-typing and crossmatching.

Pathology Studies

Preoperative pathology studies often involve biopsies on tissue, bone marrow, or fluid.
Common collection methods include excision, aspiration, and needle biopsy.
Samples are sent to the clinical pathology lab for diagnosis.

Radiographic Studies

Chest X-rays are not typically required for patients under 40 without chest disease, while elderly and high-risk patients routinely undergo them.
Other radiographic procedures are dictated by surgical requirements, like X-rays for fractures or mammograms for breast surgeries.
CT scans may be ordered by neurosurgeons for brain evaluations.
Ultrasound uses sonic energy for various diagnoses, including prenatal checks and detecting stones.
MRI allows visualization of soft tissues for conditions like torn ligaments or tumors.

Electrocardiogram

Patients 40 and over typically undergo a preoperative ECG to assess heart health, particularly those with cardiovascular history.
ECG abnormalities may delay surgery for further studies.

Additional Tests and Procedures

Specific tests, such as liver function studies or serology tests, may be requested based on medical history.
Preoperative EEGs may be indicated for craniotomy patients to evaluate brain activity.
Familiarity with tests helps healthcare providers empathize with patients.