Pre-Operative Care Flashcards
pre-op
from when the decision for surgical intervention is made to when the patient is transferred to the OR table
intra-op
from when the pt is transferred to the OR table to when they are admitted to PACU
post-op
admission into PACU to follow up evaluation at home or clinical setting
peri-op
the full surgical experience (pre,intra,post- op)
emergency surgery
emergent
urgent surgery is within 24 hrs
elective
pre-planned
ambulatory surgery
“same day surgery”
surgery takes less than 2 hours and the pt is discharged on the same day
informed consent
- voluntary
- mental capacity
- properly informed
nursing responsibilities of informed consent
witness:
- provider giving pt the necessary info
- ensure the pt is competent and understands the info
- notify the provider if pt has questions
pre-op admission clinic (PAC) assessment
interview:
- obtain diagnostic results
- emotional status and medication regimen
- arrange family pick-up/transportation
pre-op pt education
pt education:
- medication protocol
- what meds to stop taking prior to surgery
- NPO instructions
- infection prevention/wound care
- discharge details
common lab pre-op testing
ABGs/oximetry blood glucose RBC, Hb, Hct, platelets, WBC blood type and cross match BUN chest radiograph creatinine ECG Electrolytes Liver Function Tests pregnancy INR/prothrombin pulmonary function studies urinalysis
benzodiazepines
sedative and anxiety reducing meds
anticholinergics
reduce PNS activity to decrease oral secretions
opioid
pain and anesthesia
antiemetics
nausea and vomiting (aspiration risk)
antacids
combat acidity in GI
Antibiotics
given prophylactically to decrease risk of infection
smokers
smokers should be advised to stop 5 weeks before the surgery. At the very least, 24 hours before surgery. increased risk for pulmonary complications
diabetes risk
diabetic pt who needs surgery is at risk for:
- hyperglycemia
- hypoglycemia
- ketosis
- cardiovascular alterations
- delayed wound healing
- infection
renal system
renal function tests
males esp should be assessed for enlarged prostate as this can impair catheter insertion during surgery
thyroid disorders
hyper/hypothyroidism causes alterations to metabolic rate, which puts the pt at risk when metabolizing surgical drugs /anesthetics
the older adult
- many surgical pts are >65 yrs old
- age related changes to hepatic and renal function may alter clearance of anesthetic drugs/opioids
- greater risk for adverse reactions
- co-morbidities are more present
