Preoperative Nursing Care
Preoperative nursing care is essential to ensure that patients are physically and psychologically prepared for surgery. Nurses play a vital role in the preoperative phase by informing patients of what to expect in the surgical room. Go through this blog to learn what preoperative nursing care entails, the steps for preparation, nurses’ responsibility, and diagnosis.
What is preoperative nursing care?
Preoperative care is interventions nurses provide before surgery, from when the patient decides to have surgery to when the surgery begins. It involves the physical and psychological preparation of the patient. The purpose of preoperative care is to inform the patient about the surgical experience they are about to have to relieve their fear and achieve better outcomes.
Preoperative care is essential before any procedure, whether it’s major or minor surgery. It decreases mobility and helps patients cope with pain since they are enlightened about the goals and expectations of surgery. Patients must have nursing care before surgery, even in an emergency. If the patient is unresponsive, the family should receive the preparations instead.
Preoperative care should target individual patients since some may require as much information as possible while others may require little to avoid anxiety. Nurses should assess patients’ literacy levels if they want to use printed materials. Preoperative care may include many aspects and may be done a day before surgery.
Preoperative nursing diagnosis
Nurses ensure that they achieve preoperative goals by taking detailed patient histories, offering patient education, and nursing diagnoses. The following are nursing diagnoses in the preoperative phase;
- Assess for anxiety associated with surgical outcomes and experience such as anesthesia or pain
- Risk of unsuccessful therapeutic management due to lack of knowledge of preoperative procedure and postoperative expectations
- The fear associated with the distinguished threat of surgical procedure and separation from family
- Insufficient knowledge of the surgical process
- The fear associated with the risk of death
- Disturbance of sleep pattern due to psychological stress and hospital routine
The preoperative evaluation aims to reduce surgery cost and mobility, return the patient to normal body functioning, and increase care. The following diagnostic tests may be done during the preoperative phase;
- Blood analysis includes sedimentation rate, blood count, serum protein, c-reactive protein, alkaline phosphate, calcium, etc.
- MRI and CT scan
- Bone scan
- Stool studies
- Tissue biopsy
What are the nursing responsibilities during the preoperative phase?
Nursing care in the preoperative phase starts when patients agree to have surgery until they are in the surgical room. Nursing plays a vital role in surgical success by assessing patients’ pre-existing health conditions, establishing new medical issues, and ensuring that patients are physically and psychologically prepared for the surgery.
The following are nurse responsibilities during the preoperative phase;
- Evaluating and correcting psychological issues that may increase surgical risk
- Patient assessments such as physical and psychological
- Plan of care according to patient’s needs
- Promoting the cardiovascular and respiratory status
- Instructing and illustrating exercises that will help the patient after surgery
- Teaching the patients about any changes in lifestyle due to surgery
- Inspect the patients’ fear, concerns, and worry
- Explain remedies to reduce pain after surgery
- Managing nutrition and fluids, which include time to have meals after surgery
- Give psychological support to patients
- Supporting renal or hepatic function
- Encouraging mobility and active body movement after surgery
- Explain to the patient what to expect in the surgery room
- Teaching patients to take deep breaths and coughing exercises after surgery
- Obtain informed consent from the patient once they have understood all the risks and benefits of the surgery
What is involved in pre-operative care?
Preoperative care begins once the patient agrees to have surgery until the transfer to the operating room. That period intends to examine whether the patient can withstand the operation. Preoperative preparations involve general preparations you must ensure in each surgical procedure and certain practices depending on the operation type and diagnosis. Patient assessment should include the following;
- Identification of patients, such as name and date of birth
- The psychological and mental status of the patient
- Functional status, such as the patient’s ability to perform daily duties
- Respiratory and cardiovascular status
- Skin condition
- Nutritional status
- Assess for sensory impairment, cultural needs, language barrier, etc.
- Previous experience in surgery and anesthetics
- Medication, nutrition supplements, herbs, and drug abuse
Preoperative care aims to reduce anesthetic and surgical mortality and help patients recover quickly. The following are the goals of preoperative care;
- Documentation of the patient’s situation that needs surgery
- Assessment of the patient’s health status
- Identifying health states that could cause complications during and after surgery
- Determining preoperative risk
- Improving patients’ medical condition to minimize surgical and anesthetic mortality
- Coming up with a suitable preoperative care plan
- Educating patients about intraoperative care, surgery, anesthesia, and postoperative pain treatment to reduce anxiety.
- Cutting hospital costs, reducing hospital stays, and enhancing patients’ satisfaction
What are the steps in pre-operative preparations?
Patients who approve surgery depend on nurses’ skills, knowledge, and integrity. The scope of the preoperative phase includes patients’ assessment, interviews, and patient preparation for anesthetic and surgery. The following are types of pre-operative nursing care;
- Physical preparation
Physical preparation involves obtaining a patient’s history, such as anesthetic and surgical history. The nurse should find out if the patient has ever reacted to anesthesia or whether there is a family history of hyperthermia. Various lab tests are done for urinalysis, prothrombin time, partial thromboplastin time, electrolyte, or CBC.
Nurses should do EKG if a patient is over 50 years old or has a history of cardiac disease. If the patient has a record of respiratory disease, take a chest X-ray. Examine the patients for risk elements that might hinder healing, such as steroid use, nutritional deficit, radiotherapy, metabolic disorders, and alcohol abuse or drugs.
The patient should lay out all vitamins, medication, food supplements, and herbal that they use. It would be best if you also evaluated every patient for latex allergy to know the best intervention.
- Psychological preparation
Patients are often anxious about having surgery. The nurse can help reduce anxiety by confirming their validity, listening to their concern, and answering their questions. This kind of conversation can help patients with high-risk procedures or chronic illnesses. Preoperative care should also include family members or guardians.
If a patient fears dying during surgery, inform the surgeon, and in some cases postponing the procedure would be best. Children are fearful and should be allowed to have their parents with them. They should also bring their favorite toys to make them feel comfortable. Preparations help patients to cope with pain and receive favorable outcomes.
- Informed consent
Written consent is vital in preoperative care. The nurse should explain to the patients about the risk and benefits of the surgery and other treatment options. The patient should then sign the consent form having understood and agreed to carry out the procedure. Patients who are mentally impaired, critically ill, or heavily sedated cannot consent; next of kin should provide on their behalf.
- Preoperative teaching
Preoperative teaching involves teaching about preoperative, surgery, and postoperative period. Preoperative instructions should be about when to arrive for surgery, where to go, and how to prepare. For example, teach patients about the time frame for the last meal before surgery and medication to take or bring, e.g., an inhaler.
Instructions about the surgery, including what to expect in the surgery room and how long it will take. Nurses should inform the family members about where to wait during surgery, how long it will take, and who to give them progress information.
It would be best if you informed the patients about postoperative expectations, such as coughing and deep breathing exercises. Nurses should teach patients to do early leg exercises to reduce the risk of blood clots. They should also explain the tubes and equipment, such as drainage tubes, monitoring devices, IV lines, and dressing.
- Pain management
Preoperative instructions should also include pain management. Nurses should inspire patients to take or ask for pain medication in advance before it becomes unbearable. They should also apply other pain control methods such as positioning, distractions, imagery, music therapy, and meditation. You also discuss with the patients about the time to be discharged, to take solid food, and when to return to work.
Postoperative preparations involve confirming that all supplies are available. Practices for teaching include giving patients a handout or video. The consent form should be ready for the patient to sign. The patients have the right to include or omit items on the consent form. Enough time should be scheduled before surgery so as not to rush the patient.
Preoperative nursing care is essential before any procedure, whether it’s a major or minor surgery. It involves physical and psychological preparation of the patient, which informs them about the surgical experience they are about to have to relieve their fear. Use the information provided in this blog to practice the best nursing care for patients in the preoperative phase to achieve the best patient outcome.
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