Encourage communication have pt express feelings

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Encourage communication: have pt express feelings Promote rest: important for body to heal Use distraction: especially day of surgery Teach family members External Pneumatic Compression Devices Devices used while in bed Teds: off 1x a day for hygiene and assessment Leg exercises: teach in preop Hydration: loosen secretions, keep blood flow* Want to ambulate PT ASAP Patients at Risk for VTE Venous thromboembolism Obese pt Age 40/older Lab and Diagnostic Assessment Baseline/anything abnormal Urinalysis (kidney) Blood type and cross match (Renal) Preoperative Chart Review Ensure all documentation, preop procedures, orders are complete Check surgical consent form and others for completeness Inform pt area will be marked and hv pt verify mark before procedure begins Document allergies, ht, wt Ensure all lab and diagnostic test results are in chart and abnormal results noted Ask pt what they're here for; don't say “you’re here for…” in case you’re wrong Skin Preparation Break in skin inc risk for infection Skin prep=first step to reduce surgical site infection Shower using antiseptic solution Hair removal by electric clippers, depilatories Shaving of hair creates risk for infection! Hair removal done in surgical suite Pt needs clean PJ and S.O. has to shower w/ antiseptic too Intestinal Prep Performed to o Prevent injury to colon and reduce # of intestinal bacteria o Also to avoid spillage of contents into abdomen Used with abdominal, pelvic, perineal, perianal surgeries, colonoscopy procedures Orders vary per surgeon o Enema (only if necessary) o Laxative (potent) ***Any pt with bowel prep=dehydrated and exhausted o Cosider fall risk (postural HTN) Dietary Restrictions Usually for pt undergoing general anesthesia NPO Patient not to ingest anything by mouth for 6-8hr before surgery o Some allow clear liquids up to 2 hr before No eating, drinking, smoking o Dec risk for aspiration o Give pt written/oral directions to stress adherence o Surgery can be canceled if instructions not followed Admin Regularly Scheduled Meds Overview Begins when pt is scheduled for surgery Ends at time of transfer to surgical suite Nurse role: o Educator o Advocate o Promoter of health and safety
Preoperative Period Cont’d Intraoperative Period Postoperative Period Older Adults: Considerations for Pre Op Chronic illness Malnutrition Impaired ADL Inadequate support systems Stress from surgery/anesthesia Cardiopulmonary complications after surgery Mental status change (new env, under stress, new meds) Risk for falls Preop Meds Informed consent must be complete b4 administering pre op meds Reduce anxiety (anxiolytics) Promote relaxation (sedatives, hypnotics) Reduce nasal/oral secretions (anticholinergic agents) Prevent laryngospasm Reduce vagal-induced bradycardia Inhibit gastric secretion (H2 histamine blockers) Dec amount of anesthetic needed for induction and maintenance (opioids)

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