Podcast
Questions and Answers
Which factor is NOT mentioned as influencing preoperative preparations for a patient?
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?
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?
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?
Which of the following does NOT typically have an impact on preoperative patient preparation?
In emergency situations, how quickly can preoperative preparations be accomplished?
In emergency situations, how quickly can preoperative preparations be accomplished?
Which of the following factors does NOT typically determine the type of preoperative preparation required?
Which of the following factors does NOT typically determine the type of preoperative preparation required?
What is the sequence of events from patient entry into the hospital to readiness for surgery primarily based on?
What is the sequence of events from patient entry into the hospital to readiness for surgery primarily based on?
What type of surgical procedure typically requires less physical preparation?
What type of surgical procedure typically requires less physical preparation?
What is the primary reason why elderly patients need to be kept warm?
What is the primary reason why elderly patients need to be kept warm?
What is the main difference between elective and emergency surgery?
What is the main difference between elective and emergency surgery?
What is an example of an elective-urgent procedure?
What is an example of an elective-urgent procedure?
What is the purpose of a surgeon's preference card?
What is the purpose of a surgeon's preference card?
Why may extensive preoperative testing increase a patient's risk of infection?
Why may extensive preoperative testing increase a patient's risk of infection?
What is a 'stat' procedure?
What is a 'stat' procedure?
Why is it important to check the nurse's preoperative assessment and the nursing care plan?
Why is it important to check the nurse's preoperative assessment and the nursing care plan?
What influences the number and complexity of laboratory and other diagnostic tests?
What influences the number and complexity of laboratory and other diagnostic tests?
Why is same day surgery considered elective?
Why is same day surgery considered elective?
What is an example of an emergency surgical procedure?
What is an example of an emergency surgical procedure?
What is the primary reason a surgeon may order urinalysis before surgery?
What is the primary reason a surgeon may order urinalysis before surgery?
Which of the following groups always requires a complete blood count (CBC) and an hCG pregnancy test preoperatively?
Which of the following groups always requires a complete blood count (CBC) and an hCG pregnancy test preoperatively?
What does a high specific gravity reading in urinalysis typically indicate?
What does a high specific gravity reading in urinalysis typically indicate?
If a urinalysis shows glucose in the urine, what condition could this potentially indicate?
If a urinalysis shows glucose in the urine, what condition could this potentially indicate?
In which condition might a low specific gravity in urine be observed?
In which condition might a low specific gravity in urine be observed?
What is the normal pH range of urine?
What is the normal pH range of urine?
Which of the following is NOT typically found in healthy urine?
Which of the following is NOT typically found in healthy urine?
What is the most common routine hematology study ordered preoperatively?
What is the most common routine hematology study ordered preoperatively?
Which of the following can indicate the potential presence of kidney disease in a urinalysis?
Which of the following can indicate the potential presence of kidney disease in a urinalysis?
What effect might high carbon dioxide levels have on a patient's metabolism reflected in urinalysis pH?
What effect might high carbon dioxide levels have on a patient's metabolism reflected in urinalysis pH?
What is the approximate blood volume of a seven-pound baby?
What is the approximate blood volume of a seven-pound baby?
Why is it essential to closely monitor the wound suction container during pediatric surgery?
Why is it essential to closely monitor the wound suction container during pediatric surgery?
Why are special blood tests requested preoperatively in pediatric surgery?
Why are special blood tests requested preoperatively in pediatric surgery?
Why are children more susceptible to respiratory infections than adults?
Why are children more susceptible to respiratory infections than adults?
Why is it important to avoid interrupting the feeding schedule for infants scheduled for surgery?
Why is it important to avoid interrupting the feeding schedule for infants scheduled for surgery?
Why are elderly patients generally given special food and supplements preoperatively?
Why are elderly patients generally given special food and supplements preoperatively?
Why is it essential to consider joint mobility when positioning geriatric patients?
Why is it essential to consider joint mobility when positioning geriatric patients?
Why are sedatives and narcotics used with caution in geriatric patients?
Why are sedatives and narcotics used with caution in geriatric patients?
Why is it crucial to use special support devices and extra pillows when positioning geriatric patients?
Why is it crucial to use special support devices and extra pillows when positioning geriatric patients?
Why do elderly patients generally heal more slowly than young people?
Why do elderly patients generally heal more slowly than young people?
Which of these preoperative procedures is NOT typically performed during a preadmission visit for an elective surgical patient?
Which of these preoperative procedures is NOT typically performed during a preadmission visit for an elective surgical patient?
What type of imaging technique is used to diagnose torn ligaments or cartilage, herniated nucleus pulposis, tumors, and abnormalities of organs?
What type of imaging technique is used to diagnose torn ligaments or cartilage, herniated nucleus pulposis, tumors, and abnormalities of organs?
Which of these tests is NOT typically performed as part of a preadmission visit for an elective surgical patient?
Which of these tests is NOT typically performed as part of a preadmission visit for an elective surgical patient?
Why are surgical patients 40 years old and over recommended to have a preoperative electrocardiogram?
Why are surgical patients 40 years old and over recommended to have a preoperative electrocardiogram?
Why does the surgeon request more lab tests and special diagnostic studies prior to performing a major procedure?
Why does the surgeon request more lab tests and special diagnostic studies prior to performing a major procedure?
Which of these imaging techniques uses sonic energy echoes to visualize anatomical structures?
Which of these imaging techniques uses sonic energy echoes to visualize anatomical structures?
What may a preliminary minor surgical procedure, such as a tissue biopsy, help to achieve before performing a major corrective procedure?
What may a preliminary minor surgical procedure, such as a tissue biopsy, help to achieve before performing a major corrective procedure?
Why do pediatric patients require special considerations before surgery?
Why do pediatric patients require special considerations before surgery?
What is the purpose of using warm irrigating and skin prep solutions during surgery on pediatric patients?
What is the purpose of using warm irrigating and skin prep solutions during surgery on pediatric patients?
Why do infants lose body heat rapidly during surgery?
Why do infants lose body heat rapidly during surgery?
What is the primary purpose of a preadmission clinic visit for an elective surgical patient?
What is the primary purpose of a preadmission clinic visit for an elective surgical patient?
What type of test is ordered for patients suspected of having syphilis?
What type of test is ordered for patients suspected of having syphilis?
What type of imaging technique is used to diagnose vascular abnormalities?
What type of imaging technique is used to diagnose vascular abnormalities?
Why may the surgeon order additional tests before performing a major procedure?
Why may the surgeon order additional tests before performing a major procedure?
What is the difference between a CT scan and an MRI?
What is the difference between a CT scan and an MRI?
Why is a preoperative electrocardiogram recommended for all patients with a history of cardiovascular disease?
Why is a preoperative electrocardiogram recommended for all patients with a history of cardiovascular disease?
What type of medication may be given to patients undergoing general anesthesia?
What type of medication may be given to patients undergoing general anesthesia?
Why is it important to monitor the temperature of pediatric patients during surgery?
Why is it important to monitor the temperature of pediatric patients during surgery?
What aspect of the nursing care plan is reinforced upon patient arrival at the patient-care unit?
What aspect of the nursing care plan is reinforced upon patient arrival at the patient-care unit?
Why do geriatric patients require special considerations before surgery?
Why do geriatric patients require special considerations before surgery?
What is the primary role of the clinical nursing staff during the admission process?
What is the primary role of the clinical nursing staff during the admission process?
What is the purpose of the anesthetist's interview with the patient?
What is the purpose of the anesthetist's interview with the patient?
How does the process of patient admission typically begin?
How does the process of patient admission typically begin?
When are patients usually admitted for surgery?
When are patients usually admitted for surgery?
What is one of the primary purposes of administering an enema before surgery?
What is one of the primary purposes of administering an enema before surgery?
What may be used to keep pediatric patients warm during surgery?
What may be used to keep pediatric patients warm during surgery?
Why is it important for patients to shower with antiseptic soap the evening before surgery?
Why is it important for patients to shower with antiseptic soap the evening before surgery?
What should happen when a patient is assigned to a surgical patient-care unit?
What should happen when a patient is assigned to a surgical patient-care unit?
What contingency may be required before a patient's shower or bath prior to surgery?
What contingency may be required before a patient's shower or bath prior to surgery?
How do nurses typically prepare patients for postoperative exercises?
How do nurses typically prepare patients for postoperative exercises?
Which of the following preoperative procedures would likely be conducted after the patient is already in the operating room?
Which of the following preoperative procedures would likely be conducted after the patient is already in the operating room?
Which of the following statements accurately reflects the rationale behind administering a sedative to a surgical patient the night before surgery?
Which of the following statements accurately reflects the rationale behind administering a sedative to a surgical patient the night before surgery?
Why is it important for the surgical team to be aware of all preoperative procedures that have been completed?
Why is it important for the surgical team to be aware of all preoperative procedures that have been completed?
Why is it particularly important for surgical patients to be NPO (nothing by mouth) after midnight?
Why is it particularly important for surgical patients to be NPO (nothing by mouth) after midnight?
Which of the following is NOT a typical preoperative procedure for an adult patient?
Which of the following is NOT a typical preoperative procedure for an adult patient?
In the context of preoperative preparations, what does the term 'transient' refer to?
In the context of preoperative preparations, what does the term 'transient' refer to?
Why are vital signs taken multiple times during the preoperative period?
Why are vital signs taken multiple times during the preoperative period?
What is the primary purpose of the surgical checklist?
What is the primary purpose of the surgical checklist?
What is the main reason for the increasing prevalence of ambulatory surgery?
What is the main reason for the increasing prevalence of ambulatory surgery?
Why is it important for OR technicians to have knowledge of preoperative procedures, even if they are not directly involved in performing them?
Why is it important for OR technicians to have knowledge of preoperative procedures, even if they are not directly involved in performing them?
What is the normal range of Hemoglobin (Hgb) in grams per 100 milliliter (ml) for males?
What is the normal range of Hemoglobin (Hgb) in grams per 100 milliliter (ml) for males?
What does a White Blood Cell (WBC) count over 11,000 usually indicate?
What does a White Blood Cell (WBC) count over 11,000 usually indicate?
What is the purpose of prothrombin time (PT) and partial thromboplastin time (PTT) tests?
What is the purpose of prothrombin time (PT) and partial thromboplastin time (PTT) tests?
What is the purpose of a bleeding time test?
What is the purpose of a bleeding time test?
What is the purpose of crossmatching?
What is the purpose of crossmatching?
What is usually required for patients younger than 40 years of age without evidence of chest disease?
What is usually required for patients younger than 40 years of age without evidence of chest disease?
What does a platelet count indicate?
What does a platelet count indicate?
What does a low Hematocrit (Hct) indicate?
What does a low Hematocrit (Hct) indicate?
What is the purpose of typing and crossmatching?
What is the purpose of typing and crossmatching?
What is the purpose of a biopsy?
What is the purpose of a biopsy?
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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.
Preoperative Preparation
- Preoperative preparations vary by individual needs and surgical procedures.
- Inpatient preparation includes medical history review and initial assessments before hospital admission.
Preadmission Phase
- Initial patient information is gathered to ease admission stress.
- Nursing staff formulates care plans and provides preoperative education.
- Anesthesia assessment includes discussing options and obtaining consent.
Day Before Surgery
- Inpatients typically admitted the day prior for procedural completion and education on postoperative exercises.
- Antiseptic showers are required to minimize infection risk, and NPO status is initiated after midnight.
Day of Surgery
- Morning procedures include vital sign checks, preoperative medication administration, and surgical checklist verification before patient transport to the operating room.
- Elastic antiembolism stockings may be applied, and special procedures dictated by the surgeon may be initiated.
Ambulatory Surgery
- Ambulatory surgery allows same-day procedures without overnight admission.
- Preoperative preparations are completed before the surgery, which is increasingly used for more complex operations.
- Future estimates suggest up to 60% of surgeries may be performed on an outpatient basis.
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