PreOp Flashcards
preoperative phase
begins when pt is scheduled for surgery and ends at time of transfer
assessments
age, general status of health, illnesses, review of systems, surgical hx, drug use, pt preferences, allergies, blood donations, discharge planning
preparation of surgery and ensuring safety includes
pt understanding, knowledge/educational needs, decrease anxiety, minimize complications, post op adherence
malignant hyperthermia
poor reaction to anestheisa causing increase metabolic rate/temp, acidosis and arrhythmias that lead to death
cardiac assessment
heart sounds, HR, BP, VTE/DVT hx, edema, cap refill, skin temp, circulation, chest pain or SOB, pacemakers
renal assessment
frequency, dysuria, oliguria, hesitancy, color, smell, amount
resp assessment
RR, O2 sat, chronic illness, smoking, lung sounds, obesity/obstructive sleep apnea, clubbing, cyanosis
neuro assessment
A/O x 4, motor or sensory defects, muscle strength/reflexes, gait
musculoskeletal assessment
prothestics, positioning issues, pain
psychosocial assessment
anxiety/fear, coping, support
skin assessment
lesions, open wounds, piercing/tattoos
nutrition assessment
diet, obese or undernourished, BMI
urinalysis lab
assess kidney function, note if it contains blood or glucose
blood type/screen
done where bleeding in surgery will occur
CBC/hemoglobin/hematocrit
make sure a good amount is present, good WBC to fight infection
clotting studies, PT, INR, PTT
make sure body has the ability to clot
pregnancy test
done for women to ensure no harm is done to a fetus
metabolic panel
assess electrolyte balances
CT/MRI
only done for specific surgeries (spine)
ECG
monitor any heart issues during surgery
priority problems for pre op patients are
need for health teaching due to unfamiliarity, anxiety due to fear of unknown experience and outcomes
need for health teaching
information, informed consent, implement diet, discuss drugs, explain any tubes/drains, minimize anxiety, promote rest, teach fam
informed consent for surgery includes
reason for surgery, who is present, all treatment options with benefits/risks, outcomes, anesthesia risks, blood products benefits/risks, alternatives
diet restrictions for surgery include
NPO, allergies, last time they ate/drank, restrictions per surgery, not smoking or most meds
skin prep
chlorahexadine shower to prevent bacterial growth, clip hair
preventing cardiac and resp complications of surgery
incentive spirometer, cough/deep breathe, chest physiotherapy, splinting abdomen for straining, stockings
Electronic health record
ensure all documentation, procedures and order complete with consent, pt information, lab tests, site marking and notification of special needs
patient pre op prep
remove most clothing, leave valuables with family, ID band/allergy, follow procedure with dentures, eyeglasses, aids, prosthetics
pre operative drugs
follow agency for admin, antibiotics given within 1 hr of cut to prevent infection and sedatives to decrease anxiety
pt transfer to surgical suite
review EHR, teaching, administer preop drugs
