Preoperative Management and Nursing Care Using The Nursing Process

4. Routine Preoperative Teaching for the Adult Patient

PURPOSE

To provide consistent teaching content for nursing personnel instructing the preoperative patient and provide standards for documentation in the medical record.

POLICY 

  1. Inform outpatients during preoperative visit that they should:
    • Avoid taking aspirin or aspirin-containing products for 2 weeks prior to surgery unless approved by physician
    • Discontinue nonsteroidal anti-inflammatory medications 48 to 72 hours before surgery
    • Bring a list or container of current medications
    • Bring an adult escort who can drive if they are having an outpatient procedure with sedation or general anesthesia
    • Wear loose clothing that can easily be removed (eg, avoid clothing that pulls on and off over the head)
  2. Discuss the type of anesthesia planned (local or general). The anesthesiologist will evaluate all patients receiving general anesthesia preoperatively.
  3. Instruct the patient to bathe/shower/shampoo the evening before or morning of surgery. Men should be cleanly shaved.
  4. Instruct the patient on oral intake restrictions and medication schedule as ordered:
    • NPO after midnight (including water)
    • NPO after clear liquid or light breakfast if permitted
    • AM meds with sip of water if ordered by physician/anesthesiologist
  5. Instruct patient to perform oral hygiene (brush teeth and rinse mouth) the morning of surgery. Remind patient not to swallow the rinse.
  6. Inform patient that before going to the operating room he/she will have to remove:
    • Dentures/partial plates
    • Glasses/contact lenses
    • Appliances/prosthesis
    • Makeup/nail polish
    • Hairpins/hairpiece
    • Undergarments
  7. Inform the patient that valuables and jewelry should be given to a family member or friend or locked in the cashier's office or patient locker. Wedding rings may remain on fingers and will be secured with tape. (Exception: patients having major head and neck resection must remove all rings.)
  8. Inform patient's family of the Day of Surgery Lounge and other designated waiting areas.
  9. Inform patient of postoperative recovery destination.
  10. Inform the patient of postoperative care:
    • Vital signs monitored frequently
    • Activity/diet restrictions
    • Nursing personnel must assist with first ambulation
    • Medications available for pain and nausea upon request
    • Discharge criteria if anticipate same-day discharge
  11. Document routine preoperative teaching completed and patient understanding in the medical record.