PERIOPERATIVE NURSING (PRE-OP)

Summary

In this video, the nurse discusses preoperative nursing, explaining the essential tasks performed before surgery. Topics include obtaining consent, reviewing patient history, ensuring NPO status, conducting vital checks, and preparing the patient for surgery, including IV insertion, Foley catheter placement, and administering medications. The nurse emphasizes the importance of patient education, addressing emotional concerns, and assessing understanding. The video also covers the types of surgeries, risk factors, and preoperative protocols, focusing on teamwork and communication. This is the first video in a three-part series, with subsequent videos covering intraoperative and postoperative nursing.

Takeaways

• 😀 Make sure the patient's consent is signed and witnessed, but the nurse is not responsible for explaining the risks or benefits of surgery—that's the surgeon's role.
• 😀 Verify the patient's NPO status (nothing by mouth) and ensure they have fasted for the required amount of time (usually 8 hours).
• 😀 Review or draw labs for baseline values, including hemoglobin, platelet count, white blood cell count, and electrolytes, depending on the surgery type.
• 😀 Administer preoperative medications, including IV fluids, antibiotics, and other prescribed drugs like sedatives or antiemetics.
• 😀 Ensure the patient's safety by performing fall risk precautions, such as placing side rails up and securing personal items (jewelry, dentures, glasses) with family members.
• 😀 Educate the patient about what will happen before, during, and after surgery. Explain the procedures being done and address any emotional concerns.
• 😀 Perform a comprehensive preoperative assessment, including reviewing health, surgical, and family histories, as well as any allergies or current medications.
• 😀 Use the STOP-BANG assessment tool to evaluate the patient's risk for sleep apnea, including factors like snoring, daytime fatigue, and obesity.
• 😀 Understand the different types of surgery: diagnostic, ablative, reconstructive, palliative, and cosmetic, and be aware of their purposes and risks.
• 😀 Recognize the risk factors for surgery, including extremes in age (young and elderly), obesity, and comorbid conditions like diabetes, which increases the risk for postoperative infections.
• 😀 Differentiate between types of surgical urgency: emergent (immediate need), urgent (needs to be done soon), and elective (scheduled in advance), with varying levels of risk and urgency.

Q & A

What is the nurse's role in obtaining patient consent for surgery?

The nurse's role is to witness the patient's consent after the surgeon has explained the benefits and risks of the surgery. The nurse ensures that the consent form is signed correctly, but it is not the nurse's responsibility to explain the procedure or risks.

Why is it important to review the patient's NPO status before surgery?

It is crucial to review the patient's NPO (nothing by mouth) status to prevent complications such as aspiration during surgery. Ideally, the patient should have refrained from eating or drinking for at least 8 hours prior to surgery.

What types of medications might be given to a patient preoperatively?

Preoperative medications typically include IV fluids, prophylactic antibiotics, antiemetics, steroids, and sedatives. These medications help prepare the patient for surgery and reduce the risk of infection and other complications.

When is it necessary to administer bowel prep before surgery?

Bowel prep is required for surgeries or procedures that involve the gastrointestinal tract, such as colorectal surgeries. It helps clear the bowel to reduce the risk of infection and complications.

What should be included in the nurse's baseline assessment before surgery?

The nurse should perform a head-to-toe assessment, review the patient's medical history, allergies, and current medications, and take baseline vital signs. This helps establish the patient's starting point for comparison during and after surgery.

Why is it important to check for latex allergies before surgery?

Latex allergies are a significant concern during surgery, as exposure to latex-containing items (e.g., gloves, catheters) can cause severe allergic reactions. It's crucial to identify and document any latex allergies to avoid potential harm.

What is the STOP-BANG assessment, and why is it used in perioperative nursing?

The STOP-BANG assessment is a tool used to evaluate a patient's risk for sleep apnea and related complications during surgery. It involves a series of yes/no questions related to snoring, daytime drowsiness, observed apnea, blood pressure, BMI, neck circumference, age, and gender.

What are some common risk factors for complications during surgery?

Common risk factors include extremes in age (young and elderly), obesity (higher BMI), comorbidities such as diabetes (which increases the risk of post-op infections), and the use of certain medications like blood thinners.

What is the difference between emergent, urgent, and elective surgeries?

Emergent surgeries are performed immediately to save life or limb. Urgent surgeries must be done soon, usually within 24 hours, to prevent severe complications. Elective surgeries can be scheduled in advance and may or may not be necessary, depending on the patient's condition.

Why is teamwork essential in the preoperative stage?

Teamwork is vital because multiple nurses and healthcare professionals often work together to perform different tasks like inserting IVs, obtaining consent, and preparing the patient. Coordination ensures that all steps are completed efficiently and that the patient is well-prepared for surgery.