responsibilities of nurses in pre operative care content preoperative phase phases nursing management physical preparation counselling pre operative assesment reveiw of lab studies assess physical needs

1. PREPARED BY
SUGUNA
NS

2. CONTENTS
1.PRE OPERATIVE PHASE
2.PHASES
3.NURSING MANAGEMENT
4.ROLE OF NURSE
5.PROCEDURE
6.RESOURCES

3. PREOPERATIVE PHASE
PRE OPERATIVE: begin with the decision
to perform surgery and continuous until
the client has reached the operating
area.

4. PHASES
THE Whole surgical
experience is devided in
to 3 parts / phases
Pre operative phase
Intra operative phase
Post operative phase.

5. NURSING MANAGEMENT
Explain about surgical procedure
Reassure the patient
Take informed consent
Complete the pre medication requirements
Keep the patient NPO ( nill per os,means nothing by mouth )
Prepare the patient physically and psychologically
See that all investigations are complete
Monitor vital signs
Explain about regimen after the surgery
Provide psychological therapy
Send the patient to OT with all the records,
Arrange for blood ,if blood transfusion is necessary.

6. ROLE OF NURSE IN THE PRE OPERATIVE CARE
PRE OPERATIVE ASSESSSMENT
OPERATING INFORMED CONSENT
PRE OPERATIVE TEACHING
PHYSICAL PREPARATION OF PATIENT
PSYCHOLOGICAL PREPARATION OF
PATIENT.

7. PRE OPERATIVE ASSESSMENT
1.REVIEW PRE OPERATIVE LABORATORY AND
DAIGNOSTIC STUDIES
2.REVIEW THE CLIENTS HEALTH HISTORY
3.ASSESS PHYSICAL NEEDS
4.ASSESS PSYCHOLOGICAL NEEDS
5.ASSESS CULTURAL NEEDS

8. REVIEW PRE OPERATIVE LAB STUDIES
I. COMPLETE BLOOD COUNT
II. BLOOD TYPE AND CROSS
MATCH
III. SERUM ELECTROLYTES
IV.URINANALYSIS
V. CHEST X RAYS
VI.ECG & BT,CT
VII.VIRAL MARKERS

9. 2.REVIEW THE CLEINTS HEALTH HISTORY
a) History of present illness and reason for
surgery
b) Past medical history
c) Medical conditions ( acute and chronic )
d) History of any past problem with anesthesia
e) Allergies
f) Present medications
g) Substances use :alcohol,tobocco,drugs
h) Review of system.

10. 3.ASSESS PHYSICAL NEEDS
I. Ability to communicate
II. Vital signs
III. Level of consciousness
IV. Confusion
V. Drowsiness
VI. Unresponsiveness
VII. Weight and height
VIII.Ability to move / ambulate
IX. Level of exercise
X. Prosthesis
XI. Circulatory status

11. 4. 4.ASSES PSCHOLOGICAL NEEDS:
Emotional state
Level of understanding of surgical procedure,preoperative
and postoperative instruction
Coping strategies
Support system
5.ASSES CULTURAL NEEDS:
Language need for interpreter.

12. OBTAINING INFORMED
CONSENT
Before surgery , the cleint must sign a surgical consent form or operative permit.
Cleint must sign a consent form for any procedure that requires anesthesia and has risks
of complications.
If an adult cleint is confused ,unconscious ,a family member or guardian must sign the
consent form.
If the cleint is younger than 18 years of age , a parent or legal guardian must sign the
consent form.
In an emergency ,the surgeon may have to operative without consent,healthcare
personnel ,however ,makes every effort to obtain consent by telephone ,or fax.
Each nurse must be familiar with agency policies and state laws regarding surgical
consent forms.
Cleints must sign the consent form before receiving any preoperative sedatives.
The nurse is responsible foe ensuring that all necessary parties have signedthe consent
forms and that it is in the cleints chart before the cleint goes to the operative room .

13. PRE OPERATIVE
COUNSELLING
Teaching cleients about their surgical procedure and expectations before and after
surgery is best done during the preoperative period.
Clients are more alert and free of pain at this time.
Cleints are more alert and free of pain at this time.
Information in a preoperative teaching plan varies with the type of surgery and the
length of the hospitalization.
Pre operative medications
Post operative pain control
Explanation and demonstration.

14. PHYSICAL
PREPARATION
NUTRITION AND FLUIDS”NPO after midnight followed by because it anesthetics depress gastrointestinal functioning and there was a danger the
cleint would vomit and aspirate during the administrattion of GA.
BOWELS AND BLADDER ELIMINATION:Enemas may be ordered if bowel surgery is planned.
Prior surgery an indwelling folly’s catheter may be orderd to ensure that the bladder remains empty.
HYGIENE: the purpose of hygenic mesuresis to reduce the risk of wound infection by reducing the amount of bacteria on the cleints skin.
PRE OPERATIVE MEDICATIONS :pre operative medications are given to the cleint prior to going to the operating room.
SLLEP: nurses should do everything to help the cleint sleep the night before surgery .often a sedative Is ordered .ex: ALPROZOLAM.
Adequate sleep helps the cleint manage the stress of surgery and helps healing.
CARE OF VALUABLES:valuables/money/jewellery cannot sent home , they need to be labeled and placed in a locked storage area per the agency
policy.
CARE PROSTHESIS: all prosthesis ( artificial body parts ) such as partial or complete dentures,contact lenses,artificial eyes,artficial
eyeglasesses.limbs,eyelashes,removed before surgery.
SPECIAL ORDERS: check before surery any orders given by surgeon like insertion of NG TUBE, INSULIN ,EXC
SKIN PREPARATION: REMOVE THE HAIR at the site of surgery.
SAFETY PROTOCOL: Ssurgical site marking.
.

15. RESOURSES

16. THANK YOU