Chapter 14: Preoperative Nursing Management

Practice flashcards covering the phases of perioperative nursing, patient assessment, medication risks, legal requirements for informed consent, and preoperative nursing interventions.

What timeframe defines the preoperative phase?

It begins when the decision to proceed with surgical intervention is made and ends with the transfer of the patient onto the operating room (OR) bed.

When does the intraoperative phase begin and end?

It begins when the patient is transferred onto the OR bed and ends with admission to the PACU (postanesthesia care unit).

What is the duration of the postoperative phase?

It begins with the admission of the patient to the PACU and ends with a follow-up evaluation in the clinical setting or home.

How is surgery classified based on the degree of urgency?

Emergent, urgent, required, elective, and optional.

What are the primary functions of preadmission testing?

Initiates the nursing assessment process, collects admission data (demographics, health history, surgical info), verifies completion of diagnostic testing, and begins discharge planning.

Which medication classification must be assessed preoperatively because it can cause an electrolyte imbalance during surgery?

Diuretics (which may cause excessive respiratory depression from the imbalance).

What is the potential surgical risk for a patient taking corticosteroids?

Corticosteroids can cause cardiovascular collapse if discontinued suddenly.

How do phenothiazines potentially affect the surgical experience?

They may increase the hypotensive action of anesthetics.

What physiological changes in gerontologic patients must be considered preoperatively?

Lower cardiac reserves, depressed renal and hepatic functions, reduced gastrointestinal activity, respiratory compromise, and decreased subcutaneous fat (increased susceptibility to temperature changes).

What are the requirements for informed consent before a nonemergent surgery?

It should be in writing, the surgeon must explain the procedure, benefits, risks, and complications, and the nurse clarifies information and witnesses the signature.

Under what condition is a signed consent form considered valid?

Consent is valid ONLY when signed before administering psychoactive premedication.

Besides legal protection, what is the purpose of voluntary and written informed consent?

It protects the patient from unsanctioned surgery and helps the patient prepare psychologically by ensuring they understand the surgery.

What are the key respiratory topics included in preoperative patient education?

Deep breathing, coughing, and incentive spirometry.

Which nursing intervention must be performed first before administering a sedative or amnesic premedication?

Have the patient void to prevent falls and injury.

What are the expected outcomes for the patient at the conclusion of the preoperative period?

Relief of anxiety, decreased fear, understanding of the surgical intervention, and no evidence of preoperative complications.