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Preoperative Nursing Management (Post-operative Nursing Managemet (Begins…

- - - - Nutritional, fluid status
        • Dentition
        • Drug or alcohol use
        • Respiratory status
        • Cardiovascular status
        • Hepatic, renal function
        • Endocrine function
        • Immune function
        • Previous medication use
        • Psychosocial factors
        • Spiritual, cultural beliefs
    - - •  Valid consent must be freely given, without coercion
        •  Patient must be at least 18 years of age (unless emancipated minor)
        •  Consent must be obtained by physician
        •  Patient’s signature must be witnessed by professional staff member
      - •  Individual who is not autonomous
        •  Cannot give or withhold consent
        –  Cognitively impaired
        –  Mentally ill
        –  Neurologically incapacitated
      - •  Should be written
        •  Contain the following:
        –  Explanation of procedure and risks
        –  Description of benefits and alternatives
        –  Offer to answer questions about procedure
        –  Instructions that patient may withdraw consent
        –  Statement informing patient if protocol differs from customary procedure
    - - •  Have preoperative assessment
        • Have teaching session appropriate to patient’s needs
        •  Involves family members in interview
        •  Verifies completion of preoperative diagnostic testing -this involves CBC, CXR, U&E, GXM, and ECG.  
        Verifies understanding of surgeon-specific preoperative orders
        •  Discusses, reviews advanced-directive document
        •  Begins discharge planning by assessing patient’s need for postoperative transportation, care.
    - - Deep breating exercise- to decrease risk for atelectasis and pneumonia
        Coughing Exercise help mobilize mucus in the lungs and prevent preoperative respiratory complication. This exercise must be performed 3-5 times every hour. Extremity Exercises client should be taught how to perform range of motion exxercise to prevent post-operative circulatory complications such as DVT. Encourage client to excersie atleast every 2 hours. Ambulation and Movement advise client to turn every two hours in bedd to prevent muscle tone loss and venous status.