Preoperative Care Flashcards
Preoperative
period of time from when the decision for surgical intervention is made to when the patient is transferred to the operative room table
Intraoperative
Period of time from when the patient is transferred to the operating room table or when he/she is admitted to the PACU
Postoperative
period of time that begins with the admission of the patient to the PACU and ends after the follow-up evaluation in the clinical setting or home
Perioperative
Period of time that constitutes the surgical experience; includes the preoperative, intraoperative, and postoperative phases of nursing care
Types of Surgery (3)
Emergency
Urgent (within 24 hours)
Elective (planned)
Purposes of Surgery (6)
Diagnostic
Cure or repair
Palliative
Exploration
Prevention
Cosmetic improvement
Informed Consent
Informed surgical consent is an active process between the surgeon and the patient that allows the patient to assess information and make an informed decision
ENSURE that informed consent has been signed before administering psychoactive premedication b/c pt not able to give mentally sound consent
In all provinces and territories except Quebec there is no chronological age of consent it is determined by level of maturity. children and youth are allowed to consent if they fully comprehend the consequences of their decisions
If the patient is unconscious, or incompetent permission must be obtained from a responsible family member
FOLLOW THE AGENCY POLICY
In an emergency, a surgeon may operate as a lifesaving measure without the patient’s consent. Every effort must be made to contact the patient’s family
According to the Canadian Medical Protective Association for consent to be considered valid it must have the 3 following elements:
- Mental capacity
- Voluntary
- Properly Informed
Responsibilities of the provider (surgeon) in informed consent include:
Description of the treatment/procedure
The professionals who will be performing the treatment
Risk of anesthesia
Description of the benefits of the treatment/procedure
Description of the potential harm, pain, and/or dis-comfort that can occur
Options of other treatment
The right to refuse treatment
Nursing responsibilities in informed consent:
witness informed consent by doing the following:
- ensure that the provider gave the patient the necessary information
- ensure that the patient is competent and understood the information
- notify the provider if the patient has more questions or appears to not understand the information
Assessment
Before any surgical treatment begins, a history and physical exam are performed. BASELINE vitals are obtained, databases established, indicated tests are completed. These preliminary contacts with the health care team provide the patient with opportunities to ask questions.
Nursing Assessment of the Client Before Surgery (9) Overall goals
confirm and identify changes to physical status
determine psychological status
establish baseline data
review medications
ensure preoperative lab and diagnostic tests are completed and documented
support the client and family
determined informed decision to have surgery
understand discharge plan
Allergies (drug and non drug)
Pts that report the following are at a high risk for a latex allergy (3)
Hx of contact dermatitis or atopic immunological reactions
Allergies to fruits, nuts, bananas, avocados, figs, chestnuts, papayas
Repeated exposure to latex
Health History: What is important to know?
- Diagnosed medical conditions
- Current Health issues
- Health history
- family health history, e.g., heart, diabetes
- woman - menstrual and obstetrical history
- malignant hyperthermia - Does patient understand the reason for surgery?
Psychosocial Assessment
Stress directly influences body functioning
Address anxiety and fears, concerns and “loss” (job, burdens, responsibilities), and previous hospital experiences (positive and/or negative)
