preoperative care, the preparation and management of a patient before surgery. The patient’s nothing-by-mouth (NPO) status, nutritional state, medical and surgical history, allergies, current medication, physical handicaps, signs of infection, and elimination habits are recorded. The patient’s understanding of the operative, preoperative, and postoperative procedures; the patient’s ability to verbalize anxieties; and the family’s knowledge of the planned surgery are ascertained and education provided. The accuracy of patient’s signed informed consent is verified, requests in the physician’s preoperative orders are fulfilled, and the patient’s identification bands and blood type are checked. Vital signs are recorded, and any abnormalities of the electrocardiogram, chest x-ray, or laboratory tests are reported to the surgeon and anesthesiologist. If needed, the number of matched blood units required to be held for a possible blood transfusion is determined. When ordered, an enema is given, a bowel preparation is completed, a nasogastric tube or indwelling catheter is inserted, and parenteral fluids are administered. If preoperative sedation is administered, the side rails of the bed are raised. Before transfer to the operating room with the completed chart, the patient voids, and any dentures, contact lenses, jewelry, and valuables are removed for safekeeping. ▪ INTERVENTIONS: The nurse performs and explains the preoperative procedures; reinforces the physician’s explanation of the operation; provides instruction and emotional support; answers the patient’s questions as honestly as possible, avoiding standard cliches in responding to any anxiety; and reassures the patient that medication will be available to relieve postoperative pain. Depending on the surgical procedure, the nurse shows the patient how to turn, cough, deep breathe, and support the incision during coughing. Instructions on leg exercises are also given. The nurse informs the patient and the patient’s family about the postoperative period in the postanesthesia care unit or the intensive care unit, if indicated. ▪ OUTCOME CRITERIA: The patient who is carefully prepared for an operation, psychologically and physically, experiences less anxiety and is more likely to make an uneventful recovery.
