Preoperative (Preop) Education

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Study Tools For Preoperative (Preop) Education

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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Final Exam

Concepts Covered:

  • Terminology
  • Urinary System
  • Respiratory Disorders
  • Acute & Chronic Renal Disorders
  • Disorders of the Adrenal Gland
  • Oncology Disorders
  • Integumentary Disorders
  • Preoperative Nursing
  • Musculoskeletal Trauma
  • Integumentary Disorders
  • Respiratory Emergencies
  • Disorders of the Posterior Pituitary Gland
  • Hematologic Disorders
  • Renal Disorders
  • Labor Complications
  • Immunological Disorders
  • Upper GI Disorders
  • Neurological Emergencies
  • Disorders of Pancreas
  • Musculoskeletal Disorders
  • Cardiac Disorders
  • Disorders of the Thyroid & Parathyroid Glands
  • Integumentary Important Points
  • Pregnancy Risks
  • Urinary Disorders
  • Vascular Disorders
  • Central Nervous System Disorders – Brain
  • Nervous System
  • Lower GI Disorders
  • Intraoperative Nursing
  • Eating Disorders
  • Circulatory System
  • Postoperative Nursing
  • Liver & Gallbladder Disorders
  • Emergency Care of the Cardiac Patient
  • Female Reproductive Disorders
  • Shock
  • Respiratory System
  • Substance Abuse Disorders
  • Fetal Development
  • Proteins
  • Noninfectious Respiratory Disorder
  • Newborn Care
  • Statistics
  • Emergency Care of the Neurological Patient
  • Basics of Sociology
  • Bipolar Disorders
  • Infectious Respiratory Disorder

Study Plan Lessons

Diagnostic Testing Course Introduction
Fluid & Electrolytes Course Introduction
X-Ray (Xray)
X-Ray (Xray)
X-Ray (Xray)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Addisons Disease
Computed Tomography (CT)
Computed Tomography (CT)
Computed Tomography (CT)
Fluid Pressures
Informed Consent
Nursing Care and Pathophysiology for Cushings Syndrome
Fluid Shifts (Ascites) (Pleural Effusion)
Magnetic Resonance Imaging (MRI)
Magnetic Resonance Imaging (MRI)
Magnetic Resonance Imaging (MRI)
Preoperative (Preop)Assessment
Pressure Ulcers/Pressure injuries (Braden scale)
CT & MR Angiography
CT & MR Angiography
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Nursing Care and Pathophysiology of Glomerulonephritis
Isotonic Solutions (IV solutions)
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology for Pancreatitis
Preoperative (Preop) Education
Cerebral Angiography
Cerebral Angiography
Cerebral Angiography
Hypotonic Solutions (IV solutions)
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology for Peptic Ulcer Disease (PUD)
Preoperative (Preop) Nursing Priorities
Thrombocytopenia
Blood Transfusions (Administration)
Cardiovascular Angiography
Cardiovascular Angiography
Cardiovascular Angiography
Fractures
Nursing Care and Pathophysiology for Hyperthyroidism
Hypertonic Solutions (IV solutions)
Integumentary (Skin) Important Points
Preload and Afterload
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Echocardiogram (Cardiac Echo)
Echocardiogram (Cardiac Echo)
Echocardiogram (Cardiac Echo)
Nursing Care and Pathophysiology for Hypothyroidism
Performing Cardiac (Heart) Monitoring
Ultrasound
Ultrasound
Interventional Radiology
Interventional Radiology
Nuclear Medicine
Cardiac Stress Test
Cardiac Stress Test
Pulmonary Function Test
Pulmonary Function Test
Endoscopy & EGD
Endoscopy & EGD
Colonoscopy
Colonoscopy
Mammogram
Biopsy
Biopsy
Electroencephalography (EEG)
Electroencephalography (EEG)
Electromyography (EMG)
Electromyography (EMG)
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology for Appendicitis
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
General Anesthesia
Leukemia
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Diabetes Management
Dialysis & Other Renal Points
Local Anesthesia
Lymphoma
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Moderate Sedation
Oncology Important Points
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Malignant Hyperthermia
Phosphorus-Phos
Nursing Care and Pathophysiology for Ulcerative Colitis(UC)
Nursing Care and Pathophysiology for Crohn’s Disease
Normal Sinus Rhythm
Post-Anesthesia Recovery
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Cholecystitis
Nursing Care and Pathophysiology for Heart Failure (CHF)
Postoperative (Postop) Complications
Sinus Bradycardia
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Sinus Tachycardia
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Discharge (DC) Teaching After Surgery
Pacemakers
Atrial Fibrillation (A Fib)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
Nursing Care and Pathophysiology for Pelvic Inflammatory Disease (PID)
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology for Endometriosis
Nursing Care and Pathophysiology for Menopause
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Distributive Shock
ABG (Arterial Blood Gas) Interpretation-The Basics
ABG (Arterial Blood Gas) Oxygenation
ABG Course (Arterial Blood Gas) Introduction
ABGs Nursing Normal Lab Values
ABGs Tic-Tac-Toe interpretation Method
Absolute Neutrophil Count (ANC) Lab Values
Absolute Reticulocyte Count (ARC) Lab Values
Alanine Aminotransferase (ALT) Lab Values
Albumin Lab Values
Alkaline Phosphatase (ALK PHOS) Lab Values
Alpha-fetoprotein (AFP) Lab Values
Ammonia (NH3) Lab Values
Anion Gap
Antinuclear Antibody Lab Values
Base Excess & Deficit
Beta Hydroxy (BHB) Lab Values
Bicarbonate (HCO3) Lab Values
Blood Urea Nitrogen (BUN) Lab Values
Brain Natriuretic Peptide (BNP) Lab Values
C-Reactive Protein (CRP) Lab Values
Carbon Dioxide (Co2) Lab Values
Carboxyhemoglobin Lab Values
Cardiac (Heart) Enzymes
Cholesterol (Chol) Lab Values
Coagulation Studies (PT, PTT, INR)
Congestive Heart Failure (CHF) Labs
COPD (Chronic Obstructive Pulmonary Disease) Labs
Cortisol Lab Vales
Creatine Phosphokinase (CPK) Lab Values
Creatinine (Cr) Lab Values
Creatinine Clearance Lab Values
Cultures
Cyclic Citrullinated Peptide (CCP) Lab Values
D-Dimer (DDI) Lab Values
Direct Bilirubin (Conjugated) Lab Values
Dysrhythmias Labs
Erythrocyte Sedimentation Rate (ESR) Lab Values
Fibrin Degradation Products (FDP) Lab Values
Fibrinogen Lab Values
Fluid Compartments
Free T4 (Thyroxine) Lab Values
Gamma Glutamyl Transferase (GGT) Lab Values
Glomerular Filtration Rate (GFR)
Glucagon Lab Values
Glucose Lab Values
Glucose Tolerance Test (GTT) Lab Values
Growth Hormone (GH) Lab Values
Hematocrit (Hct) Lab Values
Hemodynamics
Hemoglobin (Hbg) Lab Values
Hemoglobin A1c (HbA1C)
Hepatitis B Virus (HBV) Lab Values
Homocysteine (HCY) Lab Values
Ionized Calcium Lab Values
Iron (Fe) Lab Values
Ischemic (CVA) Stroke Labs
Lab Panels
Lab Values Course Introduction
Lactate Dehydrogenase (LDH) Lab Values
Lactic Acid
Lipase Lab Values
Lithium Lab Values
Liver Function Tests
Mean Corpuscular Volume (MCV) Lab Values
Mean Platelet Volume (MPV) Lab Values
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
Methemoglobin (MHGB) Lab Values
Myoglobin (MB) Lab Values
Order of Lab Draws
Pediatric Bronchiolitis Labs
Phosphorus (PO4) Blood Test Lab Values
Platelets (PLT) Lab Values
Pneumonia Labs
Potassium-K (Hyperkalemia, Hypokalemia)
Prealbumin (PAB) Lab Values
Pregnancy Labs
Procalcitonin (PCT) Lab Values
Prostate Specific Antigen (PSA) Lab Values
Protein (PROT) Lab Values
Protein in Urine Lab Values
Red Blood Cell (RBC) Lab Values
Red Cell Distribution Width (RDW) Lab Values
Renal (Kidney) Failure Labs
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
ROME – ABG (Arterial Blood Gas) Interpretation
Sepsis Labs
Shorthand Lab Values
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Thyroid Stimulating Hormone (TSH) Lab Values
Thyroxine (T4) Lab Values
Total Bilirubin (T. Billi) Lab Values
Total Iron Binding Capacity (TIBC) Lab Values
Triiodothyronine (T3) Lab Values
Troponin I (cTNL) Lab Values
Urinalysis (UA)
Urine Culture and Sensitivity Lab Values
Vitamin B12 Lab Values
Vitamin D Lab Values
White Blood Cell (WBC) Lab Values