PREOPERATIVE NURSING CARE – Nurse Info PREOPERATIVE NURSING CARE – Purpose, Preparation of the Patient before Surgery, Obtain Informed Consent, Preoperative Teaching, Preparation of Patient (evening and day of surgery) and Sending the Patient to Operating Room

PREOPERATIVE NURSING CARE – Purpose, Preparation of the Patient before Surgery, Obtain Informed Consent, Preoperative Teaching, Preparation of Patient (evening and day of surgery) and Sending the Patient to Operating Room

UPDATED 2024

Preoperative
nursing is based on the nurses understanding of several important
characteristics including high quality multidisciplinary teamwork, effective
and therapeutic, communication, and collaboration with the client, client’s
family and the surgical team.

PURPOSE

• Preoperative nursing care is the care
  given to the patient before surgery
• Preoperative period for different
  type surgery is different, e.g. for emergency surgery preoperative period is
  very short; for a planned surgery time for surgery, is fixed with the mutual
  consent of the surgeon and the patient
• Preoperative care of the patient begins as soon as the surgeon make with diagnosis and decides that an operation is necessary for the patient

PREPARATION OF THE PATIENT BEFORE SURGERY

Psychological
Preparation

The patient may
tensed about his surgery because of ignorance, feet, etc. the nurses should
give psychological support to the patient.

Discuss with
the patient to give feel information about the surgery such as:

• Type of surgery
• Consequence of surgery
• The problems to be faced
• Expected duration of hospitalization
• Expected time of resuming duty
• Cost of surgery
• Treatment done before surgery and if
  purpose

Eradicate
Fear of Operation from the Patient

The means
surgery/operation itself make fear to the patient so for reducing that fear the
nurses should:

• Allow the patient to ask questions
  and clear all his doubts
• Introduce the patient to some ones
  who has similar surgeries and successfully recovered from the symptoms
• Explain how to get rid of pain after
  surgery
• Tell the patient when he can have
  meals
• Answer all questions soaked by the
  patients in a language he can understand
• Let the patient see the persons,
  places and equipment involved in the operation
• Always short the procedures with an
  example
• For many patients, their admission to
  the hospital is an experience in their times. In such situation, the nurses
  should make them feel at home in by eradicating their fear

OBTAIN INFORMED CONSENT

• The nurses should get an informed
  consent from patient/guardian for each operation
• Never compel them to give their
  consent
• They should understand the language
  used in the consent form
• Explain the complications that may
  occur in the period of anesthesia

BUILD UP THE GENERAL HEALTH OF THE PATIENT AND CORRECTION OF THE DISEASE PROCESS FOR SPEEDY RECOVERY

• Assist the doctor to carry out
  thorough physical examination
• Collect all baseline dates
• Arrange for the blood donors
• Diet may be adjusted to correct
  underweight/overweight of the patient

PREOPERATIVE TEACHING

We should
teach the patient to increase his health by giving advices like (a) stop
smoking, (b) maintain personal hygiene, (c) deep breathing and coughing
exercises: active and passive exercise

Surgical Preparation of the Skin

Skin
preparation helps reduce the number of microorganism present on skin and thus
reduce the possibility of wound infection. Shave the area and clean the area
will spirit/swab

PREPARATION OF THE PATIENT ON THE EVENING BEFORE OPERATION

• Remove all jewelry and hand over them
  to the relatives
• Remove the lipstick and nail polish
• Shave the area to be operated
• Ask shaving, ask the patient to have
  a through bath and dress in clean clothes
• The patient should be reassured to
  prevent anxiety and fear of operation

PREPARATION OF THE PATIENT ON THE DAY OF SURGERY

• Help the patient to go to toilet and
  for mouth care
• Remove hair pins, clips, ornaments,
  false teeth, etc
• Comb and tie hair with a ribbon
• Remind the patient and his relative
  about the fasting before surgery
• Check the orders for bowel
  preparation
• Clean the operation site with soap
  and water thoroughly, dry the area with clean towel
• Cover the site with sterile towel and
  fix it by means of bandages
• Introduce nasogastric tube, urinary
  catheter if ordered
• Stop all medications unless
  specifically ordered by the surgeon

SENDING THE PATIENT TO OPERATING ROOM

• Administer the premedication to the
  patient one hour before surgery
• Check the vital signs
• Write the patients name, age, sex,
  ward, bed no, diagnosis, hospital number etc., on a identification card and
  fasten it on to the dress or as on arm to prevent mistaken identify
• Ask the patient on to void just
  before sending to operating room
• Transfer the patient on to a patient
  trolley and cover him with clean sheets to prevent draught
• Never leave the patient alone on
  trolley
• Always send the patients charts with
  all reports
• Always send the patient with an
  attended up to the operation theater