Podcast
Questions and Answers
Antibiotics may be ______ with anesthetic agents.
Antibiotics may be ______ with anesthetic agents.
incompatible
Fear of ______ is a common psychological concern among surgical clients.
Fear of ______ is a common psychological concern among surgical clients.
pain
A ______ must be placed in the client’s arm if an allergy exists.
A ______ must be placed in the client’s arm if an allergy exists.
band
Diabetes mellitus requires strict control of ______ levels.
Diabetes mellitus requires strict control of ______ levels.
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Leg and Foot exercises are important to prevent venous ______ and thrombus formation.
Leg and Foot exercises are important to prevent venous ______ and thrombus formation.
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The purpose of informed consent is to protect the surgeon and the hospital against claims of unauthorized ______.
The purpose of informed consent is to protect the surgeon and the hospital against claims of unauthorized ______.
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For a minor patient, it is necessary for the parents or nearest relative to sign the ______ for the procedure.
For a minor patient, it is necessary for the parents or nearest relative to sign the ______ for the procedure.
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Site marking is essential for ensuring the correct ______ during a surgical procedure.
Site marking is essential for ensuring the correct ______ during a surgical procedure.
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It is part of the nurse’s role as a client advocate to confirm that the client understands the ______ given to them.
It is part of the nurse’s role as a client advocate to confirm that the client understands the ______ given to them.
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Regularly taken drugs like ______ should not be discontinued abruptly before surgery.
Regularly taken drugs like ______ should not be discontinued abruptly before surgery.
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Study Notes
Preoperative Phase Goals
- Assess and correct physiologic and psychological issues to mitigate surgical risks.
- Provide comprehensive learning materials for patients and their relatives about the surgery.
- Instruct postoperative exercises to facilitate recovery.
- Plan for discharge and potential lifestyle changes due to surgery.
Legal Aspects
- Informed consent is crucial to protect both the surgeon and the patient.
- Consent ensures clients are aware of surgery risks and prevents unauthorized procedures.
- The surgeon must obtain the operative permit, explaining the procedure, alternatives, and complications.
Consent for Minor Patients
- Consent for surgery must be signed by parents or nearest relatives for minor patients.
- Emancipated minors may sign their own consent.
Emergency Situations
- Consents are not required for emergency care if:
- There is an immediate threat to life.
- Experts confirm it’s an emergency.
- The client cannot consent.
- No legally authorized person can be contacted.
Site Marking
- An identifiable mark is made by the surgeon with patient involvement.
- The mark must be visible post-preparation and applicable to procedures with laterality or multiple structures.
Physiologic Assessment Factors
- Evaluate age, nutritional status, fluid and electrolyte balance, general and mental health, and economic/occupational status.
Regular Medication Review
- Steroids should not be stopped abruptly before surgery.
- Watch for anticoagulants and salicylates, which could increase bleeding.
- Awareness of antibiotics' effects on anesthesia.
- Tranquilizers may enhance narcotic effects and cause hypotension.
- Antihypertensives risk shock from blood pressure drop.
- Diuretics may lead to potassium loss.
- Chronic alcohol use poses surgical risks.
Psychological Assessment
- Address fears related to the unknown, anesthesia, pain, death, body image disturbance, and concerns about finances or roles.
Nursing Interventions for Anxiety
- Understand clients' fears and coping patterns.
- Build a trusting relationship with clients.
- Explain routine procedures and allow questions.
- Show confidence in medical staff.
- Provide spiritual care as needed.
Physiologic Preparation
- Respiratory: chest x-ray.
- Cardiovascular: ECG, CBC, blood typing, PT/PTT, electrolytes.
- Renal: urinalysis.
Past Medical History Considerations
- Identify allergies and provide an allergy band.
- Assess for bleeding tendencies and medications that affect clotting.
- Regular use of steroids may increase infection risk.
- Monitor diabetes management for proper glucose control.
- Evaluate history of embolic events due to immobility risks.
Preoperative Teaching
- Instruct leg/foot exercises to prevent venous stasis and thrombus.
- Teach diaphragmatic breathing and coughing for lung health.
- Encourage the use of an incentive spirometer to prevent atelectasis.
- Positioning and ambulation to promote circulation.
Evening Before Surgery Preparations
- Ensure a full bath to decrease skin microorganisms.
- Remove hair with electric clippers if needed.
- Prepare GI tract, ensuring the client is NPO and may require a cleansing enema.
- Advise against alcohol/smoking for 24 hours pre-surgery.
- Administer sedatives for rest if ordered.
Day Of Surgery Preparations
- Morning tasks include hygiene, gowning, and removing accessories.
- Verify vital signs and consent documentation.
- Confirm pre-op checklist and special orders.
- Support clients emotionally.
Preoperative Medications Purpose
- Administer medications 60-90 minutes prior to anesthesia to alleviate anxiety, decrease secretions, reduce anesthesia dosage, and create amnesia.
Types of Preoperative Medications
- Sedatives: Decrease anxiety and reduce BP/pulse (e.g., midazolam, lorazepam).
- Tranquilizers: Lower anxiety levels but may cause hypotension (e.g., Thorazine, Phenergan).
- Narcotic Analgesics: Reduce anxiety and narcotics use during surgery (e.g., Morphine, Fentanyl).
- Vagolytics: Manage tracheobronchial secretions to prevent complications (e.g., Atropine).
Final Preparation and Transportation
- Document all preparations and emotional states before surgery.
- Use woolen/synthetic blankets with caution due to static electricity risks during transport to the OR.
- Clients should be positioned 30-60° in the holding area.
Surgical Checklist
- Verify consent for surgery and anesthesia.
- Confirm NPO status and completion of lab exams.
- Ensure clearance and necessary imaging is completed.
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Description
This quiz covers essential aspects of the preoperative phase, focusing on assessing and correcting physiologic and psychologic conditions that may heighten surgical risk. It also emphasizes the importance of informed consent and offers guidelines for teaching patients and their significant others about the surgical procedure. Additionally, the module includes post-operative exercise instruction and discharge planning.
