8-4.
PREPARING THE PATIENT FOR SURGERY
a. Preoperative preparation may extend over a period of several days. The patient
may undergo tests, radiographic studies, and laboratory procedures. A medical history is
taken and a physical examination performed before surgery. Patients scheduled for
elective surgery may have laboratory tests such as urinalysis, complete blood count,
hemoglobin, and hematocrit done as an outpatient. The nurse plays an important role in
explaining the necessity for preoperative tests and in carrying out preparations for these
tests. The immediate preparation for surgery usually starts the evening before surgery.
Nursing implications related to the preoperative preparation of a patient are:
(1)
Assist the patient with personal hygiene and related preoperative care.
(a) The evening before surgery, the patient should take a bath or shower,
and shampoo hair to remove excess body dirt and oils. The warm water will also help to
relax the patient. Sometimes plain soap and water are used for cleansing the skin, but a
topical antiseptic may be used.
(b) Remove all makeup and nail polish. Numerous areas (face, lips, oral
mucosa, and nail beds) must be observed for evidence of cyanosis. Makeup and nail
polish hide true coloration.
(c) Jewelry and other valuables should be removed for safe keeping.
The patient may wear a wedding band to surgery, but it must be secured with tape and
gauze wrapping. Do not wrap tightly; circulation may be impaired. Do not leave valuables
in the bedside stand or store in the narcotics container. If possible, send these items
home with a relative until the patient has need of them. Chart what has been done with
the valuables.
(2)
Provide information concerning surgery.
(a) The patient is told about the risks and benefits of surgery, the likely
outcome if surgery is not performed, and alternative methods of treatment by his doctor.
However, the nurse can help the patient cope with the upcoming surgery by taking the
time to listen to the patient and others who are concerned about his well being, and
answering other questions.
(b)
Explain each preoperative nursing measure.
(c) Provide an opportunity for the patient to express his feelings. Ask
about spiritual needs and whether he wishes to see a Chaplain.
(d) Provide family members with information concerning their role the
morning of the surgery. Give them the surgical waiting room location, and the probable
time that they can visit the patient after surgery. Explain the rationale for the patient's stay
in the recovery room. Inform them of any machines or tubes that may be attached to the
patient following surgery.
MD0906
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