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pre-op care
approaches to patient care in pre operational environment
Question | Answer |
---|---|
what pages in the Adult and Health Nursing are pre op knowledge pooled from? | ch 42 p 1253-1294 |
Preoperative phase begins with? | The decision to perform surgery and continues until the client has reached the operating area. |
what labs are included in preoperative laboratory and diagnostic studies: | 1) Complete blood count, 2) Blood type and crossmatch, 3) Serum electrolytes, 4) Urinalysis, 5) Chest x-ray, 6) Electrocardiogram, PT, PTT, BUN, creatinine, and other radiographic studies |
what is included in a pre operative assessment? | varies with urgency of surgery, special instructions, diet restrictions, skin preparations, notify physician of pt noncompliance, more thorough hx & physical when surgery is not urgent |
Reviewing the client's health history view hx of present illness, reason for surgery and past medical hx, which includes: | acute & chronic conditions, prior hospitalizations/surgery, problems with anesthesia, allergies, present medications, substance use. |
what are physical needs in assessment? | ability to communicate, VS, LOC, ht/wt, skin integrity, ability to ambulate, prosthesis, circulatory status |
what are psychological needs in assessment? | Emotional-allowing pt to vent thoughts/feelings, level of understanding 0f procedure, coping strategies, support system, roles and responsibilities |
what exercises will the pt need being taught to prevent complications | Turning, coughing, deep breathing, incentive spirometry, leg exercises, early ambulation, pain mgm |
when are exercises taught to pt? | 1 to 2 days prior to surgery (ie afternoon, or evening before) hours before surgery if surgery is minor |
How does Turning prevent complication? | improves venous return, resp function, gi peristalsis |
how does coughing prevent complication? | facilitates removal of retained mucus from resp., should sit or lying down, might place strain on incision if in chest or abdomen, splint the incision by lacing fingers, pillow, towel tightly across the incision, deep breath exhale, before coughing |
Deep breathing- | helps expand alveoli prevent pneumonia, atelectasis, inhale slow via nose & exhale slow via pursed lips 5-10 min q hr |
Early Ambulation does what for the pre op pt? | stimulates circulation, decreasing DVT, relieve urine retention, constipation, abdominal distention, regain appetite, better sleep |
Pain Mgm requires what teaching? | is ordered as needed with a time restiction, by injection initially, then po once pt is able to eat and pain levels subside. |
what pt care is needed for Antiembolism stockings? | examine legs and at-risk conditions-pigmentation, pitting edema, peripheral cyanosis, Homan's sign, apply in suppine, stocking inside out as far as heel, slip stockiing on until alligned, gather fabric over ankle, pull leg portion over foot |
Applying Sequential Compression Devices (SCD) | |
List the points that should be included for incentive spirometer patient teaching: | head of bed elevated 45 degrees,2-3 normal breaths and then insert the spirometer, inhale through the mouth and hold their breath for 3-5 seconds,Exhale slowly and fully, Repeat the sequence 10 times during each waking hour for the first 5 days after |
what is on the pre surgical checklist for pt care? | space for pt id, pertinent clinical records list, current VS space, allergies space, nursing measures space, special comments (hearing, prosthesis, etc), RN release signature block. |