Preoperative Lec

of 19/19
8/11/2019 Preoperative Lec http://slidepdf.com/reader/full/preoperative-lec 1/19 Chapter 20 Interventions for Preoperative Clients 
  • date post

    03-Jun-2018
  • Category

    Documents

  • view

    224
  • download

    0

Embed Size (px)

Transcript of Preoperative Lec

  • 8/11/2019 Preoperative Lec

    1/19

    Chapter 20

    Interventions forPreoperativeClients

  • 8/11/2019 Preoperative Lec

    2/19

  • 8/11/2019 Preoperative Lec

    3/19

    Collaborative ManagementAssessment

    History and data collection

    Age

    Drugs and substance use

    Medical history, including cardiac and

    pulmonary histories

    Previous surgery and anesthesia

    Blood donations

    Discharge planning

    Elsevier items and derived items 2006 by Elsevier Inc.

  • 8/11/2019 Preoperative Lec

    4/19

    Physical Assessment/ClinicalManifestations

    Obtain baseline vital signs.

    Focus on problem areas identified by the

    clients history on all body systemsaffected by the surgical procedure.

    Report any abnormal assessment findingsto the surgeon and to anesthesiology

    personnel.

    Elsevier items and derived items 2006 by Elsevier Inc.

  • 8/11/2019 Preoperative Lec

    5/19

    System Assessment

    Cardiovascular system

    Respiratory system

    Renal/urinary system

    Neurologic system

    Musculoskeletal system

    Nutritional status Psychosocial assessment

    Elsevier items and derived items 2006 by Elsevier Inc.

  • 8/11/2019 Preoperative Lec

    6/19

    Laboratory Assessment

    Urinalysis Blood type and crossmatchComplete blood count or hemoglobin level and

    hematocritClotting studies Electrolyte levels Serum creatinine level Pregnancy testChest x-ray examination

    Electrocardiogram

    Elsevier items and derived items 2006 by Elsevier Inc.

  • 8/11/2019 Preoperative Lec

    7/19

    Deficient Knowledge Interventions

    Preoperative teaching

    Informed consent

    The surgeon is responsible for obtaining signed consent

    before sedation is given and surgery is performed.

    The nurses role is to clarify facts presented by thephysician and dispel myths that the client or family

    may have about surgery.

    Elsevier items and derived items 2006 by Elsevier Inc.

  • 8/11/2019 Preoperative Lec

    8/19

    Implementing Dietary Restrictions

    Client is given nothing by mouth (NPO) for6 to 8 hours before surgery.

    NPO status decreases the risk foraspiration.

    Failure to adhere can result incancellation of surgery or increase the

    risk for aspiration during or after surgery.

    Elsevier items and derived items 2006 by Elsevier Inc.

  • 8/11/2019 Preoperative Lec

    9/19

    Administering Regularly ScheduledMedications

    Consult the medical physician andanesthesia provider for instructions about

    drugs, such as those taken for diabetes,cardiac disease, glaucoma, regularlyscheduled anticonvulsants,antihypertensives, anticoagulants,

    antidepressants, or corticosteroids.

    Elsevier items and derived items 2006 by Elsevier Inc.

  • 8/11/2019 Preoperative Lec

    10/19

  • 8/11/2019 Preoperative Lec

    11/19

  • 8/11/2019 Preoperative Lec

    12/19

    Preparing the Client

    Possible placement of tubes, drains, andvascular access devices

    Teaching about postoperativeprocedures and exercises:

    Breathing exercises, incentive spirometry,coughing and splinting

    (Continued)

    Elsevier items and derived items 2006 by Elsevier Inc.

  • 8/11/2019 Preoperative Lec

    13/19

    Preparing the Client(Continued)

    Leg procedures and exercises,

    antiembolism stockings and elastic wraps,

    early ambulation, and range-of-motionexercises

    Elsevier items and derived items 2006 by Elsevier Inc.

  • 8/11/2019 Preoperative Lec

    14/19

    Anxiety Interventions

    Preoperative teaching

    Encouraging communication

    Promoting rest

    Using distraction

    Teaching family and significant others

    Elsevier items and derived items 2006 by Elsevier Inc.

  • 8/11/2019 Preoperative Lec

    15/19

    Preoperative Chart Review

    Ensure all documentation, preoperativeprocedures, and orders are complete.

    Check the surgical consent form andothers for completeness.

    Document allergies.

    Document height and weight.

    (Continued)

    Elsevier items and derived items 2006 by Elsevier Inc.

  • 8/11/2019 Preoperative Lec

    16/19

    Preoperative Chart Review(Continued)

    Ensure results of all laboratory anddiagnostic tests are on the chart.

    Document and report any abnormalresults.

    Report special needs and concerns.

    Elsevier items and derived items 2006 by Elsevier Inc.

  • 8/11/2019 Preoperative Lec

    17/19

    Preop Client Prep

    Client should remove most clothing andwear a hospital gown.

    Valuables should remain with familymember or be locked up.

    Tape rings in place if they cant beremoved.

    Remove all pierced jewelry.

    (Continued)

    Elsevier items and derived items 2006 by Elsevier Inc.

  • 8/11/2019 Preoperative Lec

    18/19

    Preop Client Prep(Continued)

    Client wears an identification band.

    Dentures, prosthetic devices, hearing aids, contactlenses, fingernail polish, and artificial nails must beremoved.

    Elsevier items and derived items 2006 by Elsevier Inc.

  • 8/11/2019 Preoperative Lec

    19/19

    Preoperative Medication

    Reduce anxiety.

    Promote relaxation.

    Reduce pharyngeal secretions.

    Prevent laryngospasm.

    Inhibit gastric secretion.

    Decrease amount of anesthetic neededfor induction and maintenance ofanesthesia.

    Elsevier items and derived items 2006 by Elsevier Inc.