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PREOPERATIVE PHASE
` The primary goal of preoperative nursing care is
to place the client in the best possible condition
for surgery through careful assessment and
thorough preparation
` Assessment of the client·s status before surgery
establishes baseline data to direct interventions
throughout the perioperative phases
2HAT IS ENDORSEMENT
 A report given to all nurses receiving a patient
 Maybe written or given orally

 Its purpose is to provide continuity of care for


clients providing the new caregivers a
quick summary of client needs and details of care
to be given.
rEY ELEMENTS
 Follow a particular order
 Provide basic identifying information for each
client.
 For new clients, provide the reason for admission
or medical diagnosis.
 Include significant changes in the client's
condition and present information.
 Provide exact information.

 Include current orders.

 Clearly state priorities of care.


2HO ARE INVOLVE?
 2ard Nurse ² he/she must endorse clearly the
patient·s condition and data to the receiving
nurse in the operating room
 OR Nurse - he/she must received the
endorsement and clarify things if necessary and
ensures that documents are complete and
properly filled up
2HO ARE INVOLVE?
 Anesthesiologist ² he/she must be also present
upon time of endorsement to know more updates
about the patient·s condition
 Patient ² should have knowledge of the operation
to be performed. He should be prepared prior to
procedure
2HAT·S NEEDED
 File with clearly written hospital number
 Consent

 Pre ² Operative Checklist

 Blood works(ex. CBC, Serology)

 Xray plates

 Proper endorsement
HO2 TO ENDORSE?
 state patient·s data (name,age, sex, race)
 State history of the patient

 Check and confirm consent is taken for operation

 Verify data in checklist

 Verify laterality (right or left)


CONSENT
 An informed consent is signed by the patient or
legal designee with the presence of a witness
after the surgeon have explained the surgery
procedure and its risks, benefits and possible
complications
 Information on the form must be correct
PREOPERATIVE CHECrLIST
 The preoperative evaluation concludes with a review of all
pertinent studies and information obtained from
investigative tests. Documentation of this review is made in
the chart, which represents an opportunity to ensure that all
necessary and pertinent data have been obtained and
appropriately interpreted. Informed consent after discussion
with the patient and family members regarding the
indication for the anticipated surgical procedure, as well as
its risks and proposed benefits, are documented in the chart.
PRE-OPERATIVE CHECrLIST
1. Identification Band on hand
2. Surgical consent signed
3. Consultation
4. History and physical on chart
5. Allergies to drugs
6. Surgical prep done and checked
7. Chest x-ray
8. Urinalysis
¢. CBC , Serology
10. All ordered Lab work and reports in
chart
11. ECG
12. TPR + BP
13. Time Voided
14. Prosthesis removed
15. Valuables and Jewelry Removed
16. Hairpins, Makeup, Nail Polish removed
17. Clean gown, cap on, clean blanket
18. Pre ² op medication administered
1¢. Side rails
20. Pre-op teaching
21. Blood transfusion requisition
PERIOPERATIVE CARE
PREOPERATIVE PHASE- ASSESSMENT
 
age, nutritional, health status, fluid and electrolyte
imbalances, radiation, cardiopulmonary,
chemotherapy, meds, family history, prior surgical
experiences (positive/negative), type of surgery,
location site
PERIOPERATIVE CARE
PREOPERATIVE PHASE-
ASSESSMENT
  
i past & present, meds, diet, allergies (latex),
personal habits, occupation, finances, family
support, knowledge of surgery, attitude
 m
  
i CBC, electrolytes, creatinine, urinalysis, x-ray
exams, ErG, Blood Type, PTT, PT, Platelet
i Blood donations
PERIOPERATIVE CARE
PREOPERATIVE CARE
 Psychological Response
 Informed Consent - Nurse witness

 Mentally competent

 If minor, a guardian, parent, or court order will


sign permit; state will dictate age.
 DNR
NURSING PROCESS ²
PREOPERATIVE CARE
 Assessment
i History, Physical Exam, Lab/Radiology, Health
Status, Risk Factors, Meds
 Nursing Diagnosis
 Planning
i Goal statement
i EOC (expected outcome criteria)
PERIOPERATIVE CARE
PREOPERATIVE -IMPLEMENTATION
 Informed Consent  Vital Signs
 Nutrition/fluids - IV ;  Height/ 2eight
NPO after MN  Special orders -(insert
 Elimination -enemas, tubes, medications)
foley  Promote Comfort -
 Hygiene - skin scrub; Anti-anxiety meds
remove nail polish,  Skin preparation
hair pins, hospital
gown
PERIOPERATIVE CARE
PREOPERATIVE CARE - NURSING CARE

 !"  -
i leg and deep breathing exercises; ROM exercises
i Moving patient ; coughing and splinting
PERIOPERATIVE CARE
PREOPERATIVE - IMPLEMENTATION
 # - complete pre-op checklist
sheet in medical record, VS, skin prep removal of
prosthetics, hair pins, dentures, bowel and
bladder prep, IV, NG Tube, ID band, and pre-op
medications.
THANr YOU!