Relevant Patient Data Review

Guidelines:

• Know risk populations
  • ASA classifications
    • Risk of adverse anesthetic event
  • Braden scale
    • Risk for pressure injury
  • Hypothermia
• Vitals, IV access, NPO status
• Imaging
• HCG!
• Family history
  • Malignant hyperthermia!

Considerations:

• Medical history is king
  • Hysterectomy
  • Implanted metal
  • Renal function
• Mouth opening
• Patient fear
  • PTSD
    • Boxing gloves
• Braden Scale
  • Sensory, Moisture, activity, mobility, nutrition, friction 1-4 higher better
  • Surgery scores 1 on 3 of them by default!

Nurse’s role:

• Preoperative interview
  • Before block!
  • Proper SBAR if transferring
• Patient safety
  • Boxing gloves
  • Warm safe snuggle sheet
• Patient comfort
  • Joint/back pain significant increase
• Discharge dispo
  • Ride home?

Pitfalls:

• Secret piercings
  • Young adults
• Fluid overload
• Improper report
• No preoperative comparison

Examples:

• 35F no surgical history but has mirena (still HCG, U-ter-us = pee for us)
• ASA 4 with planned same-day PACU recovery (consider SDS candidacy, ICU bed availability,time of day)
• 6/10 preoperative pain unrelated (May worsen and not reflective of post op recovery)
• NICU transfer to OR (warmer!)

Linchpins (Key Points):

• Rn must actively engage with patient unique needs and identify risks