Monday, October 16, 2006

#12

12) Describe the procedure to prepare the client for surgery.
The nursing responsiblity immediately before surgery includes final preoperative teaching, assessment and communication of pertinent findings, and ensuring that all preoperative preparation orders have been completed and that records and reports are present and complete to accompany the patient to the OR. It is especially important to vertify the presence of a signed operative consent, laboratory data, a history and physical examination report, a record of any consultations, baseline vitals signs, and nurses' notes complete to that point. Nail polish should be removed to monitor oxygenation. An ID band is put on the client and allergy band if applicable. Client should void shortly before surgery and before the administration of any preoperative medication. The nurse should determine that all preoperative preparations have been completed and that the signed consent for surgery is present before giving any preoperative medications.
Lewis pg 371-372
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1 comment:

Whiskey.in.a.teacup said...

Adding to the above from ATI book

Most agencies have a pre-op checklist prior to surgery to make sure all necessary prep has been done. Other considerations are:
- Routine preop screening tests include: complete blood count, serum electrolyte analysis, coagulation studies, serum creatinine and blood urea nitrogen, urinalysis, chest x-ray, electrocardiogram, blood typing and cross matching, and blood glucose
- Nutrition and hydration (usually clients are NPO; I & O are measured)
- Elimination (client may need a urinary catheter or enema)
- Rest and sleep (a sedative may be ordered night before surgery)
- Hygiene (remove hair pins, have client bathe)
- Medications (routine meds may be discontinued, anticholinergics or sedatives may be administered)
- Antiembolism stockings
- Personal valuables sent for safekeeping
- Prosthesis removed (denture, contact lenses)
- Special skin prep (scrubbing with antibacterial soap, shaving the site)
- CONSENT The client must sign a consent before surgery. The surgeon is legally responsible for obtaining informed consent; the nurse may witness the client’s signature and nurse checks to be sure that a signed consent form is included in the chart. Consent is informed only when 1) the client understands the information and 2) the client is not a minor.
-EMOTIONAL SUPPORT
Therapeutic communication with client/family; encourage client to verbalize fears/concerns; use active listening skills to identify anxiety/fear; use touch, as appropriate, to show caring; be informed about the client’s surgery and be prepared to answer questions (“When can I go back to work?” “How long before I can eat?” “What will the scar look like?”) AVOID false reassurance; do not say, “I’m sure you will be fine.” THIS DENIES THE CLIENT’S EMOTIONAL NEEDS AND BLOCKS THERAPEUTIC COMMUNICATION – AND IT MAY NOT BE TRUE!

11:34 AM

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