(3)
Pain.
(4)
Death.
(5)
Separation from family.
(6)
Effects of surgery on home and employment.
(7)
Exposure of his body to strangers.
c.
Managing Preoperative Fears. Psychological preparation of the patient
before surgery can not be overlooked. Along with other members of the health care
team, the practical nurse must show warmth, sensitivity, and caring to the patient. Each
patient may express his fears in different ways. You may find that a patient may not talk
about his fears. He may be quiet and withdrawn, cry, or talk constantly. Some patients
may prefer pacing, be extremely cheerful, or, on the other hand, exhibit unusual
behavior. You, as a practical nurse, must recognize these fears and deal with them
properly. You can help to manage preoperative fears by:
(1)
Providing an opportunity for the patient to describe his reactions and
feelings in the stressful situation.
(2)
Providing or reinforcing patient teaching.
(3)
Arranging for a clergy to visit if the patient desires. (Religious faith
can be a strong source of strength.)
(4)
Being truthful and honest when answering patient questions. If there
are questions that you should not or are unable to answer, refer them to the Charge
Nurse or physician.
1-5.
PREOPERATIVE TEACHING PRINCIPLES
a.
The value of preoperative instruction to the patient is very important. Each
patient should be taught as an individual, in terms of his anxieties, need, and hope.
Patients should be taught postoperative exercises they will be required to do and their
role in preventing complications. The postoperative exercises include turning, deep
breathing, coughing, and extremity movement.
(1)
Turning. Turning in bed and early ambulation helps patients
maintain blood circulation, stimulate respiratory functions, and decrease the stasis of
gas in the intestines and resulting discomfort. Practice before surgery usually makes it
easier for the patient to do it postoperatively. In some instances, the patient may need
special aids, such as a pillow between the legs, to help maintain body alignment. See
Figure 1-2.
MD0915
1-5