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Lecture

BIOC33H3 Lecture Notes - Nursing Assessment, Cholecystectomy, Barbiturate


Department
Biological Sciences
Course Code
BIOC33H3
Professor
Stephen Reid

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Chapter 18: Preoperative Care
Surgery is performed to diagnose, cure, palliate, prevent, explore, and/or provide
cosmetic improvement.
Ambulatory surgery is generally preferred by patients, physicians, and third-party
payers.
The preoperative nursing assessment is performed to:
o Determine the patient’s psychologic and physiologic factors that may contribute
to operative risk factors
o Establish baseline data
o Identify and document the surgical site
o Identify prescription and over-the-counter (OTC) drugs and herbal products
o Confirm laboratory results
o Note cultural and ethnic factors that may affect the surgical experience
o Validate that the consent form has been signed and witnessed
Common fears associated with surgery include the potential for death, permanent
disability resulting from surgery, pain, change in body image, or results of a diagnostic
procedure.
In the nursing assessment, information should also be obtained about the patient’s family
concerning any history of adverse reactions to or problems with anesthesia.
All findings on the medication history should be documented and communicated to the
intraoperative and postoperative personnel.
Patients should also be screened for possible latex allergies.
The preoperative assessment of the older person’s baseline cognitive function is
especially crucial for intraoperative and postoperative evaluation.
The patient with diabetes mellitus is especially at risk for adverse effects of anesthesia
and surgery.
Obesity stresses both the cardiac and pulmonary system and makes access to the surgical
site and anesthesia administration more difficult.
Preoperative teaching involves the following:
o Three types of information: sensory, process, and procedural.
o Different patients, with varying cultures, backgrounds, and experiences, may want
different types of information.
o All teaching should be documented in the patient’s medical record.
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