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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Concepts Covered:

  • Cardiac Disorders
  • Acute & Chronic Renal Disorders
  • Disorders of Pancreas
  • Neurological Emergencies
  • Noninfectious Respiratory Disorder
  • Pregnancy Risks
  • Postpartum Complications
  • Gastrointestinal Disorders
  • Musculoskeletal Trauma
  • Hematologic Disorders
  • Respiratory Disorders
  • Legal and Ethical Issues
  • Preoperative Nursing
  • Basic
  • Factors Influencing Community Health
  • Fundamentals of Emergency Nursing
  • Integumentary Disorders
  • Emotions and Motivation
  • Delegation
  • Prioritization
  • Test Taking Strategies
  • Basics of NCLEX
  • Communication
  • Concepts of Mental Health
  • Health & Stress
  • Urinary Disorders
  • Urinary System
  • Digestive System
  • Central Nervous System Disorders – Brain
  • Integumentary Disorders
  • Tissues and Glands
  • Developmental Theories
  • Renal Disorders
  • Newborn Care
  • Upper GI Disorders
  • Substance Abuse Disorders
  • Prenatal Concepts
  • Fetal Development
  • Labor and Delivery
  • Labor Complications
  • Postpartum Care
  • Newborn Complications
  • Childhood Growth and Development
  • Adulthood Growth and Development
  • Hematologic Disorders
  • Oncologic Disorders
  • Endocrine and Metabolic Disorders
  • EENT Disorders
  • Cardiovascular Disorders
  • Renal and Urinary Disorders
  • Neurologic and Cognitive Disorders
  • Musculoskeletal Disorders
  • Infectious Disease Disorders
  • Eating Disorders
  • Oncology Disorders
  • Vascular Disorders
  • Intraoperative Nursing
  • Postoperative Nursing
  • Circulatory System
  • Emergency Care of the Cardiac Patient
  • Shock

Study Plan Lessons

Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Postpartum Hemorrhage (PPH)
Pediatric Gastrointestinal Dysfunction – Diarrhea
Fractures
Nursing Care and Pathophysiology for Anemia
Asthma
Advance Directives
Legal Considerations
HIPAA
Brief CPR (Cardiopulmonary Resuscitation) Overview
Fire and Electrical Safety
Fall and Injury Prevention
Isolation Precaution Types (PPE)
Maslow’s Hierarchy of Needs in Nursing
Delegation
Prioritization
Triage
Overview of the Nursing Process
Therapeutic Communication
Defense Mechanisms
Abuse
Patient Positioning
Complications of Immobility
Urinary Elimination
Bowel Elimination
Pain and Nonpharmacological Comfort Measures
Hygiene
Overview of Developmental Theories
Intake and Output (I&O)
Blood Glucose Monitoring
Specialty Diets (Nutrition)
Enteral & Parenteral Nutrition (Diet, TPN)
Head to Toe Nursing Assessment (Physical Exam)
Menstrual Cycle
Family Planning & Contraception
Gestation & Nägele’s Rule: Estimating Due Dates
Gravidity and Parity (G&Ps, GTPAL)
Fundal Height Assessment for Nurses
Maternal Risk Factors
Physiological Changes
Discomforts of Pregnancy
Antepartum Testing
Nutrition in Pregnancy
Chorioamnionitis
Gestational Diabetes (GDM)
Disseminated Intravascular Coagulation (DIC)
Ectopic Pregnancy
Hydatidiform Mole (Molar pregnancy)
Gestational HTN (Hypertension)
Infections in Pregnancy
Fetal Development
Fetal Environment
Fetal Circulation
Process of Labor
Mechanisms of Labor
Leopold Maneuvers
Fetal Heart Monitoring (FHM)
Prolapsed Umbilical Cord
Placenta Previa
Abruptio Placentae (Placental abruption)
Preterm Labor
Precipitous Labor
Dystocia
Postpartum Physiological Maternal Changes
Postpartum Discomforts
Breastfeeding
Mastitis
Initial Care of the Newborn (APGAR)
Newborn Physical Exam
Body System Assessments
Newborn Reflexes
Babies by Term
Meconium Aspiration
Transient Tachypnea of Newborn
Hyperbilirubinemia (Jaundice)
Newborn of HIV+ Mother
Care of the Pediatric Patient
Vitals (VS) and Assessment
Growth & Development – Infants
Growth & Development – Toddlers
Growth & Development – Preschoolers
Growth & Development – School Age- Adolescent
Eczema
Impetigo
Pediculosis Capitis
Burn Injuries
Sickle Cell Anemia
Hemophilia
Nephroblastoma
Fever
Dehydration
Vomiting
Celiac Disease
Appendicitis
Intussusception
Constipation and Encopresis (Incontinence)
Conjunctivitis
Acute Otitis Media (AOM)
Tonsillitis
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Cystic Fibrosis (CF)
Congenital Heart Defects (CHD)
Defects of Increased Pulmonary Blood Flow
Defects of Decreased Pulmonary Blood Flow
Obstructive Heart (Cardiac) Defects
Mixed (Cardiac) Heart Defects
Nephrotic Syndrome
Enuresis
Cerebral Palsy (CP)
Meningitis
Spina Bifida – Neural Tube Defect (NTD)
Autism Spectrum Disorders
Attention Deficit Hyperactivity Disorder (ADHD)
Scoliosis
Rubeola – Measles
Mumps
Varicella – Chickenpox
Pertussis – Whooping Cough
ABGs Nursing Normal Lab Values
ABG (Arterial Blood Gas) Interpretation-The Basics
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
Base Excess & Deficit
Isotonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Hypertonic Solutions (IV solutions)
Potassium-K (Hyperkalemia, Hypokalemia)
Sodium-Na (Hypernatremia, Hyponatremia)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Red Blood Cell (RBC) Lab Values
Hemoglobin (Hbg) Lab Values
Hematocrit (Hct) Lab Values
White Blood Cell (WBC) Lab Values
Platelets (PLT) Lab Values
Coagulation Studies (PT, PTT, INR)
Albumin Lab Values
Cholesterol (Chol) Lab Values
Ammonia (NH3) Lab Values
Blood Urea Nitrogen (BUN) Lab Values
Creatinine (Cr) Lab Values
Urinalysis (UA)
Glucose Lab Values
Hemoglobin A1c (HbA1C)
X-Ray (Xray)
Computed Tomography (CT)
Magnetic Resonance Imaging (MRI)
Cerebral Angiography
Cardiovascular Angiography
Echocardiogram (Cardiac Echo)
Ultrasound
Biopsy
Informed Consent
Preoperative (Preop)Assessment
Preoperative (Preop) Education
Preoperative (Preop) Nursing Priorities
General Anesthesia
Local Anesthesia
Moderate Sedation
Malignant Hyperthermia
Post-Anesthesia Recovery
Postoperative (Postop) Complications
Discharge (DC) Teaching After Surgery
Hemodynamics
Preload and Afterload
Performing Cardiac (Heart) Monitoring
Normal Sinus Rhythm
Sinus Bradycardia
Sinus Tachycardia
Atrial Fibrillation (A Fib)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Pacemakers
Nursing Care and Pathophysiology of Hypertension (HTN)
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