PRE OPERATIVE PREPARATION
JENIFER.P.RASU
DEFINITION
PREOPERATIVE CARE IS THE PREPARATION
AND MANAGEMENT OF A PATIENT PRIOR TO
SURGERY. IT INCLUDES BOTH PHYSICAL AND
PSYCHOLOGICAL PREPARATION.
IMPORTANCE
PATIENTS WHO ARE PHYSICALLY AND
PSYCHOLOGICALLY PREPARED FOR SURGERY
TEND TO HAVE BETTER SURGICAL OUTCOME.
PREOPERATIVE EACHING MEETS THE
PATIENTS NEEDS FOR INFORMATION
REGARDING THE SURGICAL EXPERIENCE,
WHICH INTURN MAY ALLEVIATE MOST OF
CLIENTS FEARS.
PRE OPERATIVE
TEACHING
IT HELPS PATIENTS TO COPE BETTER WITH
POSTOPERATIVE PAIN AND DECREASED
MOBILITY.
PRE OPERATIVE PREPARATION
ASSESSMENT-
1. COMPLETE MEDICAL ,
SURGICAL HISTORY AND
PHYSICAL EXAMINATION.
PRESENCE OF
DENTURES, USE IF
CONTACTS OR LOOSE
TEETH SHOULD BE
NOTED
PRE OPERATIVE PREPARATION
2. BLOOD
INVESTIGATIONS LIKE
CBC,BLOOD GROUP,
ELECTROLYTE VALUES,
PROTHROMBIN TIME
3. HISTORY OF ANY
ALLERGIES IN PAST
INCLUDING ANY
ADVERSE REACTIONS
TO ANAESTHESIA
OTHER INVESTIGATIONS
ELECTRO
CARDIOGRAM (ECG)
CHEST X RAY
RISK FACTORS
ASSESSMENT OF RISK FACTORS THAT CAN
HINDER THE HEALING PROCESS LIKE
METABOLIC DISEASE LIKE DIABETES,
NUTRITIONAL DEFICENCY LIKE IRON
DEFICIENCY ANAEMIA, MEDICATIONS LIKE
WARFARIN OR HEPARIN THAT CAN PROLONG
BLEEDING TIME.
PHYSICAL PREPARATION:
1. NIL PER ORAL (NPO) PATIENT SHOULD BE
INSTRUCTED TO BE NPO AS PER DOCTORS
ORDERS
2. ADEQUATE BOWEL CLEARENCE (ENEMA)AS
PER DOCTORS ORDERS ESPECIALLY WHEN
SITE OF OPERATION IS LOWER GASTRO
INTESTINAL TRACT.
SKIN PREPARATION
IN FORMS OF SURGICAL
SCRUBBING OR BATH
WITH ANTI SPECTIC SOAP,
NIGHT BEFORE SURGERY.
ENSURE MARKING OF THE
SURGICAL SITE BY
OPERATING SURGEON AS
PER HOSPITAL PROTOCOL
FOR ABDOMINAL
REMOVAL
OF HAIRS FROM THE SURGICAL SITE.
SURGERIES
SKIN PREPARATIONS
SKIN PREPARATIONS
SKIN PREPARATIONS
CONSENT
DOCTOR WHO WILL PERFORM THE
PROCEDURE MUST EXPLAIN THE RISKS AND
BENEFITS OF THE SURGERY, ALONG WTH
OTHER TREATMENT OPTIONS.
NURSES ROLE HERE IS OF THE WITNESS .
SHE MUST ENSURE THAT THE PATIENT
UNDERSTANDS EVERYTHING THAT HE OR SHE
HAS BEEN TOLD.
IMPORTANT
TO INSPECT THE OPERATIVE SITE FOR
PROPER SKIN PREPARATION.(REMOVAL OF
HAIRS)
4. ENSURING
INFORMED CONSENT
BY THE PATIENT.
THE CLIENT OR
GUARDIANS
WRITTEN CONSENT
IS VITAL PRIOR TO
SURGERY.
SPECIAL CONSIDERATION
1. IF THE CLIENT IS A MINOR OR NOT ABLE TO
TAKE DECISION ON THEIR OWN, LEGAL
GUARDIAN CAN SIGN ON THEIR BEHALF
WITH WITNESS.
2. IN EMERGENCY SURGERIES INFORMED
CONSENT SHOULD BE PROCURED AS SOON
AS POSSIBLE.
MEDICAL AND
ANASTHESIA
CONSENT
5. FITNESS BY PHYSICIAN AND
ANAESTHETIST MUST BE ENSURED
CATHETER AND
MEDICATIONS
6. FOLEYS CATHERIZATION IF ORDERED
7. ADMINISTRATION OF PRE OPERATIVE
MEDICATIONS IF INSTRUCTED.
8. OPERATION ROOM MUST BE INFORMED PRIOR
TO CONFIRM THE DATE AND TIME OF
PROCEDURE (AS PER HOSPITAL PROTOCOL)
BEFORE SURGERY
REMOVAL OF HAIR PINS, NAIL
POLISH,CONTACT LENS
DENTURES ETC. LOOSE TEETH
SHOULD BE DULY INFORMED TO
OPERATING NURSE.
REMOVAL OF ANY ORNAMENTS
BEFORE THE SURGERY.
HANDLING TO RELATIVES WITH
PROPER DOCUMENTATION AND
SIGN
IV CANNULA AND ID TAG
IV CANNULA AND THREE WAY TO BE SECURED
WITH DATE, GAUGE SIZE AND TIME
CLIENT IDENTIFICATION TAG TO BE SECURED
VITALS AND CLEAN DRESSES
CLEAN HOSPITAL GOWN AND
REMOVAL OF ALL INNER WEARS AS
THEY CAN BE A POSSIBLE SOURCE
OF INFECTION.
ADMINISTERING
PRE OPERATIVE MEDICATIONS,
INTRAVENOUS FLUIDS AS
INSTRUCTED.
BASELINE VITALS PARAMETERS TO
BE ESTABLISHED.
ENSURE EMPTYING OF BLADDER
PRIOR TO SHIFTING.
SMOKING ALERT
NO SMOKING OR CAFFINE
24HRS PRIOR TO SURGERY.
SPECIAL CONSIDERATION
ASPIRIN AND ANTI COAGULANTS TO BE STOPPED
ONE WEEK BEFORE SURGERY
INSULIN TO BE WITHHELD BEFORE SURGERY
EYE SURGERY:
USE OF MYDRIATICS EYE DROPS TO DILATATION
OF PUPILS.
CARDIO THORACIC SURGERY:
ADMINISTRATION OF ANTIBIOTICS PRIOR TO
SURGERY
PSYCHOLOGICAL PREPARATION
1. REASSURANCE TO PATIENT
2. EXPLAIN TO CLIENT WHAT CAN BE EXPECTED
AFTER SURGERY AND TEACH PAIN
MANAGEMENT.
3. ENSURE ENOUGH SLEEP PRIOR TO SURGERY
PRE OPERATIVE
TEACHING
4 PURSE LIP BREATHING,
INCENTIVE
SPIROMETRY,
SPLINTING WITH
PILLOW BEFORE
COUGHING & LEG
EXCERCISES.
SPRITUAL NEEDS
4. ALLOW PATIENT TIME FOR SPIRITUAL RITUALS
, IT HELPS PATIENT TO REDUCE ANXIETY.
REVISION.
THANK YOU
JENIFER.P.RASU
AL BADA GENERAL HOSPITAL.
