4. Pre operative phase
Preoperative: begin with the decision to perform
surgery and continues until the client has reached the
operating area
5. Preoperative care
Preoperative care refers to the physical and
psychosocial care that prepares a patient to undergo
surgery safely. The preoperative period begins when the
patient is booked for surgery and ends with their
transfer to the theatre or surgical suite.
6. Role of nurse in the preoperative phase
1. Pre-operative Assessment
2. Obtaining Informed Consent
3. Preoperative Teaching
4. Physical Preparation of Patient
5. Psychological Preparation of Patient.
7. 1. Preoperative Assessment
I. Review
preoperative
laboratory and
diagnostic studies
II. Review the
client’s health
history
III. Assess
physical needs
IV. Assess
psychological
needs
V. Assess
cultural needs
8. I. Review preoperative laboratory and
diagnostic studies
• CBC (WBC, Hgb, Hct, plts).
• Blood type and cross match.
• Serum electrolytes.
• Urinalysis.
• CXR and ECG.
• Glucose.
• Other tests related to procedure or client’s medical condition, such as:
prothrombin time (PT),partial thromboplastin time (PTT), blood urea
nitrogen (BUN), creatinine, and other radiographic studies.
9. II. Review the client’s health history
•History of present illness and reason for surgery (HPI).
•Past medical history (PMH).
•Medical conditions (acute and chronic).
•Previous hospitalization and surgeries(PSH).
•History of any past problem with anesthesia.
•Allergies.
•Present medications.
•Substance use: alcohol, tobacco, drugs and smoking.
•Review of system.
10. III. Assess physical needs
•Ability to communicate.
•Vital signs.
•Level of consciousness: Confusion, Drowsiness, Unresponsiveness
•Weight and height.
•Ability to move / ambulate.
•Level of exercise.
11. IV. Assess psychological needs
•Emotional state.
•Level of understanding of surgical procedure, preoperative and
postoperative instruction.
•Coping strategies.
•Support system.
12. V. Assess cultural needs
• Asses what client's culture agree with and not
• Forbiddens according cultures and religion
• Language-need for interpreter.
13. 2.Obtaining Informed Consent
Anyone undergoing surgery must sign an operative permit. It
protects the health care facility staff from legal action
14. Deep breathing and coughing exercises To prevent pneumonia
• Incentive spirometer
• Turning & moving, leg exercise to prevent DVT
• Getting out of bed
• Pain assessing methods
3.Pre-operative teaching
17. 4. Physical Preparation of Patient
• Hygienic care ( bathing or scrubbing ).
• Skin preparation (shaving).
• Document observation of the surgical site. (note cuts or breaks).
• Restricting food & fluid eight to ten hours preop. NPO after midnight.
• Intravenous infusions may receive for debilitated or malnourished patient.
• Enemas not routinely ordered except for G.I.T s.
• NG tube sometimes is inserted the evening before or the morning of surgery.
* Preparing the person the evening before surgery
18. • Remove colored nail polish.
• Assist the person in donning a hospital gown, cap.
• Check for laboratory record.
• Blood available.
• Pre-anesthetic medication such as Midazolam
19. 5. Psychological Preparation of Patient.
Careful preoperative teaching can reduce fear and anxiety of the clients
