{"id":33809,"date":"2017-10-25T19:13:38","date_gmt":"2017-10-25T19:13:38","guid":{"rendered":"https:\/\/www.mometrix.com\/academy\/?page_id=33809"},"modified":"2026-04-20T12:50:47","modified_gmt":"2026-04-20T17:50:47","slug":"preoperative-nursing","status":"publish","type":"page","link":"https:\/\/www.mometrix.com\/academy\/nclex-exam\/preoperative-nursing\/","title":{"rendered":"Preoperative Nursing"},"content":{"rendered":"\n\t\t\t<div id=\"mmDeferVideoEncompass_LSdyzONZtq4\" style=\"position: relative;\">\n\t\t\t<picture>\n\t\t\t\t<source srcset=\"https:\/\/www.mometrix.com\/academy\/wp-content\/uploads\/2023\/01\/circle-play-duotone.webp\" type=\"image\/webp\">\n\t\t\t\t<source srcset=\"https:\/\/www.mometrix.com\/academy\/wp-content\/uploads\/2023\/01\/circle-play-duotone.png\" type=\"image\/jpeg\"> \n\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" loading=\"eager\" id=\"videoThumbnailImage_LSdyzONZtq4\" data-source-videoID=\"LSdyzONZtq4\" src=\"https:\/\/www.mometrix.com\/academy\/wp-content\/uploads\/2023\/01\/circle-play-duotone.png\" alt=\"Preoperative Nursing Video\" height=\"464\" width=\"825\" class=\"size-full\" data-matomo-title = \"Preoperative Nursing\">\n\t\t\t<\/picture>\n\t\t\t<\/div>\n\t\t\t<style>img#videoThumbnailImage_LSdyzONZtq4:hover {cursor:pointer;} img#videoThumbnailImage_LSdyzONZtq4 {background-size:contain;background-image:url(\"https:\/\/www.mometrix.com\/academy\/wp-content\/uploads\/2023\/08\/129-preoperative-nursing-64ca9c780f85c-1.webp\");}<\/style>\n\t\t\t<script defer>\n\t\t\t  jQuery(\"img#videoThumbnailImage_LSdyzONZtq4\").click(function() {\n\t\t\t\tlet videoId = jQuery(this).attr(\"data-source-videoID\");\n\t\t\t\tlet helpTag = '<div id=\"mmDeferVideoYTMessage_LSdyzONZtq4\" style=\"display: none;position: absolute;top: -24px;width: 100%;text-align: center;\"><span style=\"font-style: italic;font-size: small;border-top: 1px solid #fc0;\">Having trouble? <a href=\"https:\/\/www.youtube.com\/watch?v='+videoId+'\" target=\"_blank\">Click here to watch on YouTube.<\/a><\/span><\/div>';\n\t\t\t\tlet tag = document.createElement(\"iframe\");\n\t\t\t\ttag.id = \"yt\" + videoId;\n\t\t\t\ttag.src = \"https:\/\/www.youtube-nocookie.com\/embed\/\" + videoId + \"?autoplay=1&controls=1&wmode=opaque&rel=0&egm=0&iv_load_policy=3&hd=0&enablejsapi=1\";\n\t\t\t\ttag.frameborder = 0;\n\t\t\t\ttag.allow = \"autoplay; fullscreen\";\n\t\t\t\ttag.width = this.width;\n\t\t\t\ttag.height = this.height;\n\t\t\t\ttag.setAttribute(\"data-matomo-title\",\"Preoperative Nursing\");\n\t\t\t\tjQuery(\"div#mmDeferVideoEncompass_LSdyzONZtq4\").html(tag);\n\t\t\t\tjQuery(\"div#mmDeferVideoEncompass_LSdyzONZtq4\").prepend(helpTag);\n\t\t\t\tsetTimeout(function(){jQuery(\"div#mmDeferVideoYTMessage_LSdyzONZtq4\").css(\"display\", \"block\");}, 2000);\n\t\t\t  });\n\t\t\t  \n\t\t\t<\/script>\n\t\t\n<p><script>\nfunction War_Function() {\n  var x = document.getElementById(\"War\");\n  if (x.style.display === \"none\") {\n    x.style.display = \"block\";\n  } else {\n    x.style.display = \"none\";\n  }\n}\n<\/script><\/p>\n<div class=\"moc-toc hide-on-desktop hide-on-tablet\">\n<div><button onclick=\"War_Function()\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.mometrix.com\/academy\/wp-content\/uploads\/2024\/12\/toc2.svg\" width=\"16\" height=\"16\" alt=\"show or hide table of contents\"><\/button><\/p>\n<p>On this page<\/p>\n<\/div>\n<nav id=\"War\" style=\"display:none;\">\n<ul>\n<li class=\"toc-h2\"><a href=\"#Preoperative_Assessment_and_Education\" class=\"smooth-scroll\">Preoperative Assessment and Education<\/a><\/li>\n<li class=\"toc-h2\"><a href=\"#Preop_Checklist_and_Safety_Measures\" class=\"smooth-scroll\">Pre-op Checklist and Safety Measures<\/a><\/li>\n<li class=\"toc-h2\"><a href=\"#Legal_and_Ethical_Considerations\" class=\"smooth-scroll\">Legal and Ethical Considerations<\/a><\/li>\n<\/ul>\n<\/nav>\n<\/div>\n<div class=\"accordion\"><input id=\"transcript\" type=\"checkbox\" class=\"spoiler_button\" \/><label for=\"transcript\">Transcript<\/label>\n<div class=\"spoiler\" id=\"transcript-spoiler\">\n<p>Welcome to this video on preoperative nursing!<\/p>\n<p>You may have heard the term <em>perioperative nursing<\/em>. This encompasses the preoperative, intraoperative, and postoperative phases of the patient&#8217;s surgical experience.<\/p>\n<p>This video will focus on the preoperative phase. We will look at getting a history and physical, patient education, pre-op checklist, and legal and ethical issues.<\/p>\n<p>The preoperative phase begins when the decision is made for surgical intervention. The pre-op nurse is responsible for assessing the patient\u2019s physical, psychologic, and social states; preparing the patient for surgery; and implementing nursing interventions. The pre-op phase ends when the patient is transported to the operating room and care is transferred to the operating room nurse.<\/p>\n<h2><span id=\"Preoperative_Assessment_and_Education\" class=\"m-toc-anchor\"><\/span>Preoperative Assessment and Education<\/h2>\n<p>\nThe preoperative history and physical done by the nurse may be completed in the doctor\u2019s office, hospital preadmission area, inpatient hospital unit, outpatient surgery facility, or on the phone. It is important for the nurse to identify individuals at risk for intraoperative and postoperative complications, in order to implement interventions that will improve surgical outcomes.<\/p>\n<p>Patient assessments should be individualized and include:<\/p>\n<ul>\n<li>Identification of the patient with two identifiers, such as name and date of birth<\/li>\n<li>Mental and physiological status of the patient<\/li>\n<li>Functional status (patient\u2019s ability to perform ADLs)<\/li>\n<li>Cardiovascular and respiratory status<\/li>\n<li>Skin condition<\/li>\n<li>Nutritional status (how long the patient has not been eating or drinking [NPO])<\/li>\n<li>Range of motion and mobility<\/li>\n<li>Pain<\/li>\n<li>Any prosthetics or corrective devices<\/li>\n<li>Sensory impairments, language barriers, cultural\/spiritual needs<\/li>\n<li>Anxiety<\/li>\n<li>Previous surgeries and anesthesia experience<\/li>\n<li>Allergies<\/li>\n<li>Medications, herbs, nutritional supplements, and drug abuse<\/li>\n<\/ul>\n<h3><span id=\"Patient_and_Family_Education\" class=\"m-toc-anchor\"><\/span>Patient and Family Education<\/h3>\n<p>\nThe nurse should identify the patient\u2019s support system\u2014their significant other, family, or friends that are present. The key nursing intervention during the preoperative period is patient and family education.<\/p>\n<p>Take every opportunity during the patient assessment and preparation for surgery to provide information that will increase the patient\u2019s familiarity with the procedure, which will decrease anxiety. Give instructions on activities that will promote healing and prevent postoperative complications. Assess and address individual learning needs, and involve patients in decision-making concerning their care. This allows them to maintain some control over events.<\/p>\n<p>During the pre-op assessment, teach the patient about postoperative pain control. Fear of pain is a common source of anxiety and should be addressed before surgery to decrease anxiety and add to the patient\u2019s sense of control.<\/p>\n<h2><span id=\"Preop_Checklist_and_Safety_Measures\" class=\"m-toc-anchor\"><\/span>Pre-op Checklist and Safety Measures<\/h2>\n<p>\nA pre-op checklist is a way for the nurse to summarize patient data and ensure the patient is ready for surgery. The patient should remove all personal clothing and put on a hospital gown. Jewelry is removed according to hospital policy. The patient\u2019s personal belongings, including eyeglasses, dentures, or prostheses, are identified and secured. Confirm the patient\u2019s name and date of birth on the ID band; confirm that consent forms are completed and signed and that X-rays, lab results, and EKG are on the chart; and verify the availability of an implant if needed, and the availability of blood.<\/p>\n<h3><span id=\"Universal_Protocol_and_Premedication\" class=\"m-toc-anchor\"><\/span>Universal Protocol and Premedication<\/h3>\n<p>\nTo ensure patient safety, the Universal Protocol is a mandatory Joint Commission quality standard that verifies correct patient identity, correct procedure, and correct surgical site. At least two patient identifiers are used to verify patient identity, such as asking the patient to state their full name and date of birth. The patient should verbally confirm the surgical procedure, and the surgeon should mark the surgical site with the patient\u2019s involvement. The pre-procedure verification and surgical site marking are performed in the pre-op area, then the \u201ctimeout\u201d is done in the OR immediately prior to surgery.<\/p>\n<p>Depending on the anesthesiologist\u2019s preference, premedication may be given by the pre-op nurse to:<\/p>\n<ul>\n<li>Decrease anxiety and provide sedation<\/li>\n<li>Prevent or decrease nausea and vomiting<\/li>\n<li>Decrease gastric volume and acidity<\/li>\n<li>Decrease secretion of saliva and gastric juices<\/li>\n<li>Relieve pain and discomfort<\/li>\n<\/ul>\n<p>Once premedication has been given, ensure patient safety by keeping the patient in bed with side rails up.<\/p>\n<h2><span id=\"Legal_and_Ethical_Considerations\" class=\"m-toc-anchor\"><\/span>Legal and Ethical Considerations<\/h2>\n<p>\nThere are certain legal and ethical issues that need to be addressed when a patient is going to have surgery. &#8220;Informed consent&#8221; refers to the process in which the patient is informed of the nature, consequences, harms, benefits, risks, and alternatives to the proposed medical treatment. Before surgery, the physician asks the patient to sign a statement consenting to the surgical procedure.<\/p>\n<p>The physician is legally responsible for providing the patient with sufficient information to weigh the risks and benefits of the surgery, which includes the disease process and diagnosis; nature of the surgery with its benefits, risks, and prognosis if treatment is withheld; and alternative treatment options. The informed consent must include the patient\u2019s full legal name; surgeon\u2019s name; specific procedure(s) to be performed; signature of the patient, next of kin, or legal guardian; witness (which is usually the nurse); and the date.  <\/p>\n<p>The nurse\u2019s role is that of patient advocate. The nurse assesses the patient\u2019s decision-making capacity, confirms that the patient has received the necessary information to give informed consent, and clarifies any misunderstandings. The nurse should also support the patient\u2019s decision, should the patient decide to withdraw informed consent and refuse the surgical procedure. <\/p>\n<h3><span id=\"Advance_Directives\" class=\"m-toc-anchor\"><\/span>Advance Directives<\/h3>\n<p>\nHealthcare providers are required to inform patients of their rights in decision-making regarding healthcare choices. Advance directives allow the individual to specify their preferences for treatment, should they become unable to make independent health care decisions. Examples of advance directives include a living will and durable power of attorney.<\/p>\n<p>A living will outlines the patient\u2019s wishes regarding medical treatment, life support, and resuscitation measures. The durable power of attorney identifies the person who is authorized to make health care decisions on the patient\u2019s behalf if the patient becomes incapacitated.<\/p>\n<p>The perioperative nurse must be aware of a patient\u2019s decisions regarding advance directives.<\/p>\n<p>The pre-op nurse will document the patient care and teaching given during the preoperative phase. Pertinent data will be communicated to the OR nurse as care is transferred over.<\/p>\n<p>Thank you for watching this video on preoperative nursing!<\/p>\n<\/div>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":188642,"parent":18038,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":{"0":"post-33809","1":"page","2":"type-page","3":"status-publish","4":"has-post-thumbnail","6":"page_type-video","7":"subject_matter-nursing"},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.mometrix.com\/academy\/wp-json\/wp\/v2\/pages\/33809","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.mometrix.com\/academy\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.mometrix.com\/academy\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.mometrix.com\/academy\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.mometrix.com\/academy\/wp-json\/wp\/v2\/comments?post=33809"}],"version-history":[{"count":5,"href":"https:\/\/www.mometrix.com\/academy\/wp-json\/wp\/v2\/pages\/33809\/revisions"}],"predecessor-version":[{"id":291887,"href":"https:\/\/www.mometrix.com\/academy\/wp-json\/wp\/v2\/pages\/33809\/revisions\/291887"}],"up":[{"embeddable":true,"href":"https:\/\/www.mometrix.com\/academy\/wp-json\/wp\/v2\/pages\/18038"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.mometrix.com\/academy\/wp-json\/wp\/v2\/media\/188642"}],"wp:attachment":[{"href":"https:\/\/www.mometrix.com\/academy\/wp-json\/wp\/v2\/media?parent=33809"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}