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Preoperative Nursing Assessment and Preparation: A Comprehensive Guide, Exams of Nursing

A comprehensive overview of preoperative nursing assessment and preparation, covering essential aspects such as health history, medication history, diagnostic screening, and pre-operative teaching. It delves into the purpose of pre-operative assessment, the importance of informed consent, and the various types of anesthesia used in surgical procedures. The document also highlights key considerations for patient care, including monitoring vital signs, managing potential complications, and ensuring patient safety throughout the pre-operative phase.

Typology: Exams

2024/2025

Available from 02/23/2025

Smartsolutions
Smartsolutions šŸ‡ŗšŸ‡ø

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NSE 221 WEEK 8 WITH COMPLETE SOLUTIONS 100% VERIFIED!!
purpose of surgery
- diagnosis
- cure or repair
- palliation
- prevention
- exploration
- cosmetic
types of surgery
- inpatient
- ambulatory (same day)
> shorter stays
> pts discharged the day of
purpose of preop assessment
1. decrease surgical delays/cancellations
2. evaluate and reduce pt anxiety
> provide explanations
> clear misconceptions
> support perspectives
3. educate and allow questions
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NSE 221 WEEK 8 WITH COMPLETE SOLUTIONS 100 % VERIFIED!!

purpose of surgery

  • diagnosis
  • cure or repair
  • palliation
  • prevention
  • exploration
  • cosmetic

types of surgery

  • inpatient
  • ambulatory (same day)

shorter stays pts discharged the day of

purpose of preop assessment

  1. decrease surgical delays/cancellations
  2. evaluate and reduce pt anxiety

provide explanations clear misconceptions support perspectives

  1. educate and allow questions

preop nursing assessment

  1. health history
  2. med history
  • past med illnesses
  • reason for seeking care
  • med conditions that may cause complications
  • risk factors
  1. preconceptions/understanding
  2. medication history
  3. allergies
  4. smoking/alcohol use
  5. family support

whats included in preop diagnostic screening

  • bloodwork and imagining
  • needs based on:

pt history + physical assessment OR surgical procedur

common preop diagnostic tests include

  • hepatic disease
  • cardiovascular disease
  • pulmonary disease
  • CNS disease
  • medications (diruetics, steroids, anticoagulants)
  • urinary/renal disease
  • lab and diagnostic tests (urea and creatinine

what does renal dysfunction contribute to

  • fluid and electrolyte imbalances
  • increased risk of infection
  • coagulopathies
  • impaired wound healing
  • altered response to drugs

hepatic system

  • presence of liver disease:

jaundice, hepatitis, alcohol abuse

  • liver function tests

ALT, ASP, ALP, bilirubin

integumentary system

  • history of skin/musculoskeletal problems
  • pressure injuries

musculoskeletal system

  • joint immobilities
  • mobility restrictions affecting positioning and ambulation
  • bringing mobility aids to surgery

endocrine system

  • pre-existing
  • diabetes

what are pts with diabetes at risk for

  • hypo/hyperglycemia
  • cardiovascular alterations
  • delayed wound healing
  • infection

immune system

  • history of immunocompromised systems
  • using immunospressive drugs

delayed wound healing increased risk of infection

goal of preop teaching client is able to describe:

  • post op monitoring and therapies

effects of benzodiazepines/barbiturates

  • reduce anxiety
  • sedation

effects of anticholinergics

  • reduce resp and oral secretions

effects of opiods

  • decreased intraop anaesthetic
  • pain

effects of antiemetics

  • decreased nausea and vomiting after surg

effects of antacids increase gastric pH

what is included in preop prep

  • diagnostic tests
  • allergies

- NPO

  • blood type and crossmatching
  • identification band
  • legal prep

whats included in legal prep of preop prep

  • gain informed consent
  • consent for blood transfusions
  • advanced directive (codes status, organ/tissue donor, will)
  • power of attorney

transportation of patients Inpatients

  • by stretcher to OP room

Outpatients

  • by stretcher/wheelchair/walk

where do family members wait

  • in waiting area
  • holding area (depending on hosp policy)

classification of anaesthesia

what is closely monitored in the induction phase vitals

  • need to determine appropriate dose for unconsciousness

what is the goal of the maintenance phase

  • keep the pt in a stable state of unconsciousness
  • ensure vitals remain stable

adverse effects of general anaesthesia

  • cardiovascular depression
  • irritability
  • resp depression
  • hepatic and renal damage

describe regional anaesthesia

  • loss of sensation in an area of the body
  • given through local application/infiltration

T or F: there is loss of consciousness in regional anaesthesia FALSE: no loss

administrative techniques of regional anaesthesia

  • nerve blocks
  • intrathecal (spinal)
  • epidural
  • IV regional

describe procedural sedation aka conscious sedation

  • depresses lvl of consciousness

procedural sedation is a combination of which drugs

  • sedative-hypnotic and opioid

effects of procedural sedation

  • analgesia
  • relieves anxiety
  • can cause amnesia

T or F: pt maintains their own airway in procedural sedation TRUE