Chapter 1 (Part 5) Flashcards
Routine of Preoperative Screening Test
- CBC
- Blood Grouping and Cross making
- Serum Electrolytes
- Prothrombin Time (PT); Partial Prothrombin Time (PPT)
- Fasting Blood Glucose
- Blood Urea Nitrogen, Creatinine
- Bilirubin, Alanine Transaminase (ALT), Alkaline Phosphate Aminotransferase (AST)
- Total Albumin, Total Protein (CHON)
- Urinalysis
- X-ray
- ECG
An important oxygen carrying capacity of blood
RBC count, Hemoglobin, Hematocrit
They are active substance in plasma, which forms a clot that allows wound to heal
Platelet
Indicator of immune function
WBC
Determine incase a blood transfusion is required during or after surgery
Blood grouping and cross making
To evaluate fluid and electrolytes
Serum electrolytes
Measure time required for clotting to occur
Prothrombin Time (PT), Partial Prothrombin Time (PPT)
High level may indicate undiagnosed Diabetes Mellitus
Fasting Blood Glucose
To evaluate renal function
Blood Urea Nitrogen, Creatinine
To evaluate liver function
Bilirubin, Alanine Transaminase (ALT), Alkaline Phosphate Aminotransferase (AST)
SGPT & SGOT
To evaluate nutritional status
Total Albumin, Total Protein (CHON)
Determine urine composition
Urinalysis
Respiratory status, Heart size
X-Ray
Identify cardiac problems and check for arrythmias
ECG
PREOPERATIVE NURSING INTERVENTION
- Prepare pt. physically & psychologically & maintain safety
- Patient education
- Deep breathing, coughing exercises, incentive spirometry
- Mobility and Active Body movement
- Pain management
- Nursing Care
- Administering preop medication
- Maintaining the preop checklist
- Pre-operative patient warning
- Transporting the patient to presurgical area
- Attending to family needs
Mobility and Active Body movement
- Passive range of motion
- Active range of motion
- Passive-assistive range of motion
Pain management
- Breathing exercises
- Positioning
- Guided Imagery
EDUCATION FOR PATIENT UNDERGOING AMBULATORY SURGERY
- Avoiding physiological Intervention
- Reducing anxiety and decreasing fear
- Respecting cultural, spiritual, and religious belief
- Maintaining patient’s safety
- Managing nutrition and fluids
- Preparing the bowel
- Preparing the skin
ASA
American Society of Anesthesiologists Guidelines for Pre-Operative Fasting
ASA minimum fasting period for Clear liquids
2 hours
ASA minimum fasting period for Breast Milk
4 hours
ASA minimum fasting period for Nonhuman milk
6 hours
ASA minimum fasting period for Light meal
6 hours
ASA minimum fasting period for Regular/heavy meals
8 hours
Evening Before surgery
- Prep skin
- Full bath to lessen microorganisms
- Prepare the GI tract
- Prepare for Anesthesia
- Promoting rest & sleep
How to prepare GI tract
NPO
Cleansing enema
How to prepare for anesthesia
Avoid alcohol and cigarette smoking for at least 24 hours before surgery
How to promote rest and sleep
Administer Sedative
Early Morning Care
- Wakeup 1 hr before preop meds
- Morning bath, mouthwash
- Clean gown
- Remove hairpins, braid long hair and cover with cap
- Remove dentures, colored nail polish, Hearing aids, contact lenses, jewelries
- Take vital sign before preop medication
- Check ID band and skin prep
- Check for special order - Enema, IV line
- Check NPO
- Void before preop meds
- Continue to support emotionally
- Accomplished preop checklist
Commonly used preop meds
- Tranquilizers and Sedatives
- Midazolam
- Diazepam
- Lorazepam
- Diphenhydramine
- Analgesics
- Nalbuphine (Nubain)
- Atropine Sulfate
- Proton Pump Inhibitors
Transporting Patient to the OR
- Adhere to principles of maintaining comfort and safety to the patient
- Accompany OR attendants to the patient’s bedside for introduction and Identification
- Assist in transferring
Patient’s Family
- Direct Proper waiting room
- Surgeon will probably contact them after surgery
