Week 12- Pre-op Flashcards
What is important in pre-op care?
Patient history important
Medications
Reactions to anesthesia
Etoh or drug use
previous surgeries
*Diabetes – and the affect on body & insulin – stress etc.
Heart issues
HTN
Pregnancy
Why do we care about pre-op care?
- patient’s health baseline
- identify & manage potential risks
- Prepare pt on what to expect
- identify red flags to avoid catastrophes (ie) Diabetes & Insulin
What do we want to consider with psychosocial history?
Anxiety
common fears
What allergies are we concerned about?
Drug (intolerance or true allergy)
Latex - more exposures= increase chance of allergy
Why do we care if someone has a history of etoh ?
withdrawl may need to be considered
What medication do we want to watch for specifically before surgery in someone’s history?
Blood thinners
When should someone start NPO pre - surgery?
Tailor it to the specific surgery/time for each patient
what are the 9 things we go over with the patient pre-surgery?
- Nutrition/nausea
- Skin prep- be naked- no lotions & metal
- Meds- discuss with doc & surgeon
- Pain control - epidural, PCA
- Dressings/drains/tubing- what to expect
- Safety - call bell - bed rails
- Pre- op info like parking, arrival, waiting areas, length of time in surgery , etc
- DB& C / spirometer
- Ambulation/leg exercises/ DVT prophylaxis (TED stockings/SCDs)
what are frequently used pre-op meds?
-Benzodiazepines – sedative & amnesia
-Narcotics
-H2 Receptor Antagonists – stress but they don’t do it as much anymore
-Antacids
-Antiemetics
-Others- depends on the patient
Who’s responsibility is it to ensure patients go down to surgery in a safe state?
The nurse - make sure we check if something doesn’t seem quite right! call the OR doc first!
What is the purpose of the nursing assessment pre-op?
- decrease surgical delays d/t surprises in health history
- clear communication w/ patient
- educate and discuss meds, NPO, Pain, discharge/care
What are routine/common pre-op lab tests?
Blood tests – CBC, WBC, electrolytes, glucose
Coags: PTT, INR (coumadin)
Blood type & screen – so can get some quickly to pt if needed
U/A, crea, BUN
LFTs
CXR
Pulmonary tests
EKG
Why do we need to get labs/tests pre-surgery?
baseline - compare to post surgery
When do we want to encourage people to VOID (pee)?
BEFORE sedation meds given
When is legal informed consent required?
- ALL elective surgery
