Preoperative (Preop) Education

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Preoperative Care (Picmonic)
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Outline

Overview

  1. Goal of education
    1. Increases patient safety
    2. Prepares patient and family
      1. What to expect before, during, after surgery
    3. Decreases anxiety and fear
      1. Before and after surgery
    4. Decreases length of stay
    5. Decreases postoperative complications
    6. Increases healing time
  2. Importance of education
    1. Increases patient autonomy
    2. Decreases knowledge deficit
  3. Education begins with provider

Nursing Points

General

  1. Patient education specifics
    1. Explain preoperative events
      1. Procedure specifics
        1. Duration
        2. Expected outcome
      2. NPO before surgery
        1. Designated time
          1. Prevent aspiration
      3. Medications
        1. Per provider
          1. What to discontinue
            1. Anticoagulants
          2. When to discontinue
          3. What to continue
      4. Prep for surgery
        1. Bowel
        2. Skin preparation
          1. Bathing
      5. Diagnostic tests
      6. IV Insertion
      7. Anesthesia type
        1. To be explained by anesthesia provider
    2. Explain intraoperative events
      1. Role of circulating nurse
        1. Remain with patient during induction
        2. Patient privacy and dignity
      2. Monitoring equipment application
      3. Administration of anesthesia
        1. Schedule of events
          1. Communication with family during procedure
    3. Explain postoperative events
      1. Expected length of stay
      2. Presence of
        1. Lines
        2. Drains
        3. Catheters
      3. Pain management
        1. Pain medications
        2. Deep breathing
      4. Discharge
        1. Home
        2. Step down
        3. Instructions
          1. Wound care

Nursing Concepts

  1. Comfort
  2. Coping
  3. Patient education
  4. Safety

Patient Education

  1. Teach patient to ask questions
  2. Encourage patient to repeat learning
  3. Encourage patient to involve family with education

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Transcript

Hey guys let’s talk today a little bit about the preoperative education of a surgical patient.

So education of our surgical patients is super important.  I’ve had to say the most important part of patient education is increasing our patients safety, but in addition to that, education is going to prepare the patient and the family for what will come which most definitely reduces the fear and anxiety that surgery can bring.  When our patients are properly educated this can really decrease the time they’re in the hospital, it can decrease any postop issues and can most definitely promote quicker healing.  Patient education occurs during the entire surgical process from admission to discharge by all perioperative team members however, the majority of the education occurs before the surgery with the preoperative RN.

So just to bring home the importance of patient education a little bit further, it really increases patient autonomy, it makes patients feel like they are in control of their own health and well-being.  It helps to answer any and all questions that patients have, knowledge is power for patients, this should be included within the informed consent process.  And guys patient education should begin with the provider!  Make sure you check out the specific lesson on informed consent for more details!

So for me personally being a perioperative nurse for quite some time when I think of preoperative patient education I like to break it down in my mind into the different components that the patient is going to go through. Like I mentioned a few slides ago, the preoperative nurse will do the majority of the education but they’re going to help the patient understand what is going to occur in not only the pre-op area but also in the intraoperative area (during surgery) and after the surgery or the post-operative events.

So the preoperative nurse is going to first teach the patient about things that are critical before surgery.  Patients and families like to be educated on their procedure specifics, like how long the procedure is expected to take and what they can expect afterwards.  It is okay to tell patients you will check with the provider for the best answer to these questions!  A super important part of preoperative education is the NPO status of patients.  This is critical to the surgical patient as aspiration is a risk with patients going under anesthesia.  Please know that preoperative education should start before the day of surgery especially things like when to stop eating or drinking.  Also, the preoperative nurse will discuss (with direction from the provider) the patients current medications and if and when to stop them.  Just like NPO guidelines the patient should have this education prior to the day of surgery.

Continuing with some more specifics of preoperative education the patients are often given instructions as far as preps that are necessary before their procedure.  These can include things like possibly a bowel prep if they are having a colon resection or even bathing with a specific type of soap for an orthopedic procedure.  Obviously this is something that the patient will do before surgery so as the preoperative nurse you will want to confirm with your patient that these things have been completed.  You will also teach the patient about their IV what that will entail, any testing that they may require before the procedure like a pregnancy test or x-ray, and also the type of anesthesia that they are going to have.  Education regarding anesthesia is typically discussed by someone from the anesthesia department. 

So the preoperative nurse will begin to explain to the patient what will occur during surgery or when they are brought into the operating room.  The circulating RN will continue the education and explain to the patient that they will protect their privacy and safety during the procedure.  I’ve found that explaining what will happen in the OR, applying monitors, the timeline of anesthesia before the patient is brought into the OR helps to ease anxiety.  And finally we want to educate our patients as far as how we will communicate with their family during the procedure.

Explaining to the patient what will occur after surgery preoperatively is super important because after anesthesia patients do not tend have the best memory or comprehension!  So teach your patient what they can expect in the postop area like if they might wake up with any drains or catheters, the plan for pain control, and the steps that will be taken to get the patient discharged and on their way home.

So as always with patient education you’re just going to want to really encourage your patients to ask questions especially if they are unsure or confused about anything related to their surgery.  It is also a good idea to encourage the patient to repeat what they learned in a subtle way to promote their understanding.  Finally we want patients, if they are ok with it, to involve their family or support person with education for support after the procedure.

Ok guys the nursing concepts that can be applied to preoperative patient education are most definitely comfort, coping, and safety.  Remember surgery can be scary for patients so education will help them cope with the situation as well as comfort them.  Education of the surgical patient is first and foremost for their safety. 

Okay guys some key points for preoperative education, the goal is always to increase patient safety by preparing the patient, decrease anxiety and complications to help increase healing time.  Patient education is very important because it increases patient autonomy and decreases any knowledge deficits.  So to make preoperative education a little less daunting so we break the preoperative education down into the different sections, preop, intraop, and postop events.  You explain the procedure specifics, NPO status medications, any preps that they may require, diagnostic tests before the procedure, insertion of their IV and the anesthesia type.  As far as during the procedure explain the role of team members specifically the circulating RN, the application of monitoring devices that will be applied when they go into surgery, the events of the anesthesia administration, and how and when their families will be updated.  Finally guys explain the events that will occur after surgery, their expected length of stay, if they will wake up with any drains or catheters, help them understand their pain management plan, and the events that will lead up to their discharge and thereafter. 

Okay guys I hope you enjoyed this lesson on the preoperative education of a surgical patient!  Make sure you check out all the resources attached to this lesson, as well as the rest of the lessons in this course. Now, go out and be your best self today. And, as always, happy nursing!

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Med-Surg Study Plan

Concepts Covered:

  • Shock
  • Cardiac Disorders
  • Vascular Disorders
  • Pregnancy Risks
  • Emergency Care of the Cardiac Patient
  • Medication Administration
  • Acute & Chronic Renal Disorders
  • Central Nervous System Disorders – Brain
  • Cardiovascular Disorders
  • Disorders of Pancreas
  • Disorders of the Thyroid & Parathyroid Glands
  • Postoperative Nursing
  • Intraoperative Nursing
  • Preoperative Nursing
  • Perioperative Nursing Roles
  • Circulatory System
  • Urinary System
  • Integumentary Disorders
  • Labor Complications
  • Eating Disorders
  • Respiratory System
  • Respiratory Disorders
  • Noninfectious Respiratory Disorder
  • Renal Disorders
  • Hematologic Disorders
  • Oncology Disorders
  • Immunological Disorders
  • Disorders of the Adrenal Gland
  • Disorders of the Posterior Pituitary Gland
  • Respiratory Emergencies
  • Infectious Respiratory Disorder
  • Oncologic Disorders
  • Neurological Trauma
  • Neurologic and Cognitive Disorders
  • Nervous System
  • Central Nervous System Disorders – Spinal Cord
  • Peripheral Nervous System Disorders
  • Emergency Care of the Neurological Patient
  • Neurological Emergencies

Study Plan Lessons

Norepinephrine (Levophed) Nursing Considerations
Vasopressin (Pitressin) Nursing Considerations
Nitroglycerin (Nitrostat) Nursing Considerations
Nitroprusside (Nitropress) Nursing Considerations
Hydralazine (Apresoline) Nursing Considerations
Verapamil (Calan) Nursing Considerations
Nifedipine (Procardia) Nursing Considerations
Losartan (Cozaar) Nursing Considerations
Lisinopril (Prinivil) Nursing Considerations
Propranolol (Inderal) Nursing Considerations
Metoprolol (Toprol XL) Nursing Considerations
Heparin (Hep-Lock) Nursing Considerations
Streptokinase (Streptase) Nursing Considerations
Procainamide (Pronestyl) Nursing Considerations
Warfarin (Coumadin) Nursing Considerations
Epinephrine (EpiPen) Nursing Considerations
Enoxaparin (Lovenox) Nursing Considerations
Enalapril (Vasotec) Nursing Considerations
Diltiazem (Cardizem) Nursing Considerations
Digoxin (Lanoxin) Nursing Considerations
Captopril (Capoten) Nursing Considerations
Atorvastatin (Lipitor) Nursing Considerations
Atenolol (Tenormin) Nursing Considerations
Amlodipine (Norvasc) Nursing Considerations
Amiodarone (Pacerone) Nursing Considerations
Adenosine (Adenocard) Nursing Considerations
Hypoglycemia
Nursing Care and Pathophysiology for Hyperparathyroidism
Discharge (DC) Teaching After Surgery
Surgical Incisions & Drain Sites
Postoperative (Postop) Complications
Post-Anesthesia Recovery
Intraoperative Nursing Priorities
Intraoperative (Intraop) Complications
Intraoperative Positioning
Sterile Field
Surgical Prep
Malignant Hyperthermia
Moderate Sedation
Local Anesthesia
General Anesthesia
Intubation in the OR
Preoperative (Preop) Nursing Priorities
Preoperative (Preop) Education
Preoperative (Preop)Assessment
Informed Consent
Perioperative Nursing Roles
Perioperative Nursing Course Introduction
Hypoparathyroidism
Nursing Care and Pathophysiology for Hashimoto’s Thyroiditis
Pressure Line Management
Hanging an IV Piggyback
Spiking & Priming IV Bags
IV Push Medications
Central Line Dressing Change
Drawing Blood
Starting an IV
Fluid & Electrolytes Course Introduction
Fluid Compartments
Fluid Pressures
Fluid Shifts (Ascites) (Pleural Effusion)
Isotonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Hypertonic Solutions (IV solutions)
Potassium-K (Hyperkalemia, Hypokalemia)
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Phosphorus-Phos
ABG Course (Arterial Blood Gas) Introduction
ABGs Nursing Normal Lab Values
ABG (Arterial Blood Gas) Interpretation-The Basics
ROME – ABG (Arterial Blood Gas) Interpretation
ABGs Tic-Tac-Toe interpretation Method
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
ABG (Arterial Blood Gas) Oxygenation
Lactic Acid
Base Excess & Deficit
Hematology Module Intro
Nursing Care and Pathophysiology for Anemia
Nursing Care and Pathophysiology for Sickle Cell Anemia
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Thrombocytopenia
Oncology Module Intro
Leukemia
Lymphoma
Oncology Important Points
Immunology Module Intro
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Lyme Disease
Systemic Lupus Erythematosus (SLE)
Metabolic & Endocrine Module Intro
Addisons Disease
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Hypothyroidism
Diabetes Mellitus (DM) Module Intro
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Diabetes Management
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Respiratory Course Introduction
Respiratory A&P Module Intro
Lung Sounds
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Respiratory Infections Module Intro
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology of Pneumonia
Isolation Precautions (MRSA, C. Difficile, Meningitis, Pertussis, Tuberculosis, Neutropenia)
Oxygen Delivery Module Intro
Hierarchy of O2 Delivery
Artificial Airways
Airway Suctioning
Blunt Chest Trauma
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Chest Tube Management
Respiratory Procedures Module Intro
Bronchoscopy
Thoracentesis
Neuro A&P Module Intro
Neuro Anatomy
Impulse Transmission
Cerebral Metabolism
Blood Brain Barrier (BBB)
Neuro Assessment Module Intro
Levels of Consciousness (LOC)
Routine Neuro Assessments
Adjunct Neuro Assessments
Brain Death v. Comatose
Intracranial Pressure ICP
Cerebral Perfusion Pressure CPP
Neuro Disorders Module Intro
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Parkinsons
Brain Tumors
Encephalopathies
Miscellaneous Nerve Disorders
Stroke (CVA) Module Intro
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Stroke Assessment (CVA)
Stroke Therapeutic Management (CVA)
Stroke Nursing Care (CVA)
Seizure Causes (Epilepsy, Generalized)
Seizure Assessment
Seizure Therapeutic Management
Nursing Care and Pathophysiology for Seizure
Neurological Fractures
Spinal Cord Injury
Nursing Care and Pathophysiology for Meningitis
Cardiovascular Disorders (CVD) Module Intro
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Aortic Aneurysm
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Cardiac Course Introduction
HMG-CoA Reductase Inhibitors (Statins)
Cardiac Glycosides
Calcium Channel Blockers
Angiotensin Receptor Blockers
ACE (angiotensin-converting enzyme) Inhibitors
Renin Angiotensin Aldosterone System