Session 5 - Review

Question 1

Pre-op orders may consist of the following:

Answer 1

• lab orders
• diagnostic orders
• dietary orders
• skin prep orders
• bowel prep orders
• pre-op medication orders
• consult orders

Question 2

List the most common pre-op laboratory tests ordered.

Answer 2

• CBC
• Lytes
• Urea
• Creatinine
• INR
• PTT
• Urinalysis
• Group & Screen, Crossmatch

Question 3

What type of diagnostic tests may be ordered pre-op?

Answer 3

• CXR
• US
• X-ray

Question 4

Why is an IV started prior to surgery?

Answer 4

• To ensure the patient does not become depleted during surgery
• To ensure IV site access is obtained prior to surgery for administration of pre-op medications
• For any IV medications that may need to be administered during surgery by the Anesthetist

Question 5

Why does the doctor order skin prep before surgery and where is it transcribed on the Kardex?

Answer 5

To prevent post-op infections

Recorded under personal hygiene section or treatment section of the Kardex

Question 6

Why is a patient limited to food/fluid intake prior to a surgical procedure?

Answer 6

To prevent regurgitation or aspiration during surgery

Question 7

Why are sedatives ordered pre-op?

Answer 7

Help the patient sleep and relax

Question 8

Why are anti-reflux/anti-emetics ordered pre-op?

Answer 8

Help prevent regurgitation and aspiration

Question 9

What other types of medications may be ordered pre-op?

Answer 9

Regular medications from home

Pre-op antibiotics

Question 10

List 3 guidelines for anesthesia for most surgical procedures.

Answer 10

• All patients with diabetes who are over 40
• All patients with signs or symptoms of cardiovascular disease
• All patients over 40 who smoke or have a significant family history of cardiovascular disease
• Patients with any significant medical condition
• Patients on medication with cardiac toxicity
• All patients coming in for intrathoracic, intraperitoneal or major orthopaedic surgery over 40
• All patients over 60 years for general anesthesia

Question 11

Name 3 miscellaneous pre-op orders and where are they recorded?

Answer 11

Old chart - recorded on Kardex in misc. section

Glucometer - recorded on Kardex under glucometer

Insert foley - recorded on Kardex under foley (elimination)

IV start - recorded on Kardex in IV/parenteral section

Question 12

What pre-op orders are reordered after surgery?

Answer 12

All pre-op orders are discontinued after surgery and must be reordered prn

Question 13

What must the Unit Clerk ensure is done prior to surgery?

Answer 13

• That surgical chart pack is addressographed and clipped to the inside of the chart
• That the consent form is completed and clipped to chart
• That all pre-op orders have been processed
• That the surgery with date and time has been recorded on the Kardex and whiteboard
• That the OR date and time is written on any requisitions prn
• That the old chart has been received from Health Records, if requested

Question 14

What must the Unit Clerk ensure is done the morning of surgery?

Answer 14

• That all diagnostic reports are filed in patient’s chart
• That the consent form is signed
• That the addressograph/patient labels are attached to the chart
• That current, old, and thinned charts are collected and sent to OR with patient
• That all pre-op orders have been processed
• That current MAR is attached to patient’s chart
• That a line is drawn after Physician’s Order and write “TO OR”
• That diagonal lines are drawn through remainder of order form
• That there are several blank PO’s in the chart

Question 15

What must the Unit Clerk ensure is done when the OR calls for the patient?

Answer 15

Advise the patient’s RN