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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Study Plan for Study Skills, Test Taking for the NCLEX® Using Med-Surg (Lewis 10th ed.) designed for Westmoreland County Community College

Concepts Covered:

  • Concepts of Population Health
  • Factors Influencing Community Health
  • Community Health Overview
  • Substance Abuse Disorders
  • Upper GI Disorders
  • Renal Disorders
  • Newborn Care
  • Integumentary Disorders
  • Tissues and Glands
  • Central Nervous System Disorders – Brain
  • Digestive System
  • Urinary Disorders
  • Urinary System
  • Musculoskeletal Trauma
  • Concepts of Mental Health
  • Health & Stress
  • Developmental Theories
  • Fundamentals of Emergency Nursing
  • Communication
  • Basics of NCLEX
  • Test Taking Strategies
  • Prioritization
  • Delegation
  • Emotions and Motivation
  • Integumentary Disorders
  • Legal and Ethical Issues
  • Basic
  • Preoperative Nursing
  • Labor and Delivery
  • Fetal Development
  • Newborn Complications
  • Postpartum Complications
  • Postpartum Care
  • Labor Complications
  • Pregnancy Risks
  • Prenatal Concepts
  • Circulatory System
  • Cardiac Disorders
  • Emergency Care of the Cardiac Patient
  • Vascular Disorders
  • Shock
  • Postoperative Nursing
  • Intraoperative Nursing
  • Oncology Disorders
  • Neurological Emergencies
  • Respiratory Disorders
  • Female Reproductive Disorders
  • Acute & Chronic Renal Disorders
  • Liver & Gallbladder Disorders
  • Lower GI Disorders
  • Disorders of Pancreas
  • Disorders of the Thyroid & Parathyroid Glands
  • Disorders of the Adrenal Gland
  • Disorders of the Posterior Pituitary Gland
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  • EENT Disorders
  • Integumentary Important Points
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  • Renal and Urinary Disorders
  • Cardiovascular Disorders
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  • Childhood Growth and Development
  • Adulthood Growth and Development
  • Medication Administration
  • Nervous System
  • Dosage Calculations
  • Learning Pharmacology
  • Prefixes
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Study Plan Lessons

Communicable Diseases
Disasters & Bioterrorism
Cultural Care
Environmental Health
Technology & Informatics
Epidemiology
Health Promotion & Disease Prevention
Head to Toe Nursing Assessment (Physical Exam)
Enteral & Parenteral Nutrition (Diet, TPN)
Specialty Diets (Nutrition)
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Intake and Output (I&O)
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Pain and Nonpharmacological Comfort Measures
Bowel Elimination
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Defense Mechanisms
Overview of Developmental Theories
Abuse
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Overview of the Nursing Process
Triage
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Maslow’s Hierarchy of Needs in Nursing
Isolation Precaution Types (PPE)
Fall and Injury Prevention
Fire and Electrical Safety
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Process of Labor
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Newborn of HIV+ Mother
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Transient Tachypnea of Newborn
Meconium Aspiration
Babies by Term
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Postpartum Hemorrhage (PPH)
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Breastfeeding
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Dystocia
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Abruptio Placentae (Placental abruption)
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Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
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Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology of Angina
Pacemakers
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Nursing Care and Pathophysiology for Cardiomyopathy
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Nursing Care and Pathophysiology for Hypovolemic Shock
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Nursing Care and Pathophysiology for Distributive Shock
Discharge (DC) Teaching After Surgery
Postoperative (Postop) Complications
Post-Anesthesia Recovery
Malignant Hyperthermia
Moderate Sedation
Local Anesthesia
Preoperative (Preop)Assessment
General Anesthesia
Preoperative (Preop) Nursing Priorities
Preoperative (Preop) Education
Informed Consent
Biopsy
Ultrasound
Echocardiogram (Cardiac Echo)
Cardiovascular Angiography
Cerebral Angiography
Magnetic Resonance Imaging (MRI)
X-Ray (Xray)
Computed Tomography (CT)
Nursing Care and Pathophysiology for Menopause
Nursing Care and Pathophysiology for Endometriosis
Nursing Care and Pathophysiology for Pelvic Inflammatory Disease (PID)
Dialysis & Other Renal Points
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Cholecystitis
Nursing Care and Pathophysiology for Crohn’s Disease
Nursing Care and Pathophysiology for Ulcerative Colitis(UC)
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Nursing Care and Pathophysiology for Appendicitis
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Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Addisons Disease
Nursing Care and Pathophysiology for Anaphylaxis
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Nursing Care and Pathophysiology of Osteoporosis
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Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Miscellaneous Nerve Disorders
Nursing Care and Pathophysiology for Parkinsons
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Cerebral Perfusion Pressure CPP
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Adjunct Neuro Assessments
Levels of Consciousness (LOC)
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Platelets (PLT) Lab Values
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Hematocrit (Hct) Lab Values
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Chloride-Cl (Hyperchloremia, Hypochloremia)
Sodium-Na (Hypernatremia, Hyponatremia)
Potassium-K (Hyperkalemia, Hypokalemia)
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Base Excess & Deficit
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Respiratory Alkalosis
Respiratory Acidosis (interpretation and nursing interventions)
ABG (Arterial Blood Gas) Interpretation-The Basics
ABGs Nursing Normal Lab Values
Chest Tube Management
Nursing Care and Pathophysiology of Pneumonia
Artificial Airways
Airway Suctioning
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Lung Sounds
Alveoli & Atelectasis
Gas Exchange
Nursing Care and Pathophysiology for Asthma
Suicidal Behavior
Eating Disorders (Anorexia Nervosa, Bulimia Nervosa)
Alcohol Withdrawal (Addiction)
Grief and Loss
Paranoid Disorders
Personality Disorders
Cognitive Impairment Disorders
Mood Disorders (Bipolar)
Depression
Schizophrenia
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Post-Traumatic Stress Disorder (PTSD)
Somatoform
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Varicella – Chickenpox
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Autism Spectrum Disorders
Spina Bifida – Neural Tube Defect (NTD)
Meningitis
Enuresis
Nephrotic Syndrome
Cerebral Palsy (CP)
Mixed (Cardiac) Heart Defects
Obstructive Heart (Cardiac) Defects
Defects of Decreased Pulmonary Blood Flow
Defects of Increased Pulmonary Blood Flow
Congenital Heart Defects (CHD)
Cystic Fibrosis (CF)
Asthma
Acute Otitis Media (AOM)
Bronchiolitis and Respiratory Syncytial Virus (RSV)
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Intussusception
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Vomiting
Hemophilia
Nephroblastoma
Fever
Dehydration
Sickle Cell Anemia
Burn Injuries
Pediculosis Capitis
Impetigo
Eczema
Growth & Development – School Age- Adolescent
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Growth & Development – Infants
Care of the Pediatric Patient
Vitals (VS) and Assessment
Vasopressin
TCAs
SSRIs
Proton Pump Inhibitors
Vancomycin (Vancocin) Nursing Considerations
Ciprofloxacin (Cipro) Nursing Considerations
Metronidazole (Flagyl) Nursing Considerations
Anti-Infective – Penicillins and Cephalosporins
Parasympatholytics (Anticholinergics) Nursing Considerations
NSAIDs
Nitro Compounds
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Hydralazine (Apresoline) Nursing Considerations
Insulin
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Epoetin Alfa
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Parasympathomimetics (Cholinergics) Nursing Considerations
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Autonomic Nervous System (ANS)
Atypical Antipsychotics
Angiotensin Receptor Blockers
ACE (angiotensin-converting enzyme) Inhibitors
Renin Angiotensin Aldosterone System
Complex Calculations (Dosage Calculations/Med Math)
IV Infusions (Solutions)
Injectable Medications
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Basics of Calculations
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
The SOCK Method – K
The SOCK Method – C
The SOCK Method – O
The SOCK Method – S
The SOCK Method – Overview
6 Rights of Medication Administration
Essential NCLEX Meds by Class
12 Points to Answering Pharmacology Questions
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
54 Common Medication Prefixes and Suffixes