Registered Nurse (RN)
Fundamentals of Nursing
Perioperative Care
Preoperative Care

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Preoperative Care

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Preoperative Care

Preparing patients for surgical procedures is an important nursing role. It includes preoperative education to inform the patient of what to expect and measures that can be taken to prevent complications.
Surgical Procedure
Surgeon explaining Procedure

Providing the patient with education on what to expect before, during, and after surgery promotes compliance and reduces anxiety. Assess the patient’s prior experiences with surgery to anticipate for needs, address fears or concerns, and providing teaching.


NPO stands for nothing by mouth, which instructs the patient to withhold oral food and fluids prior to surgery. Patients undergoing general anesthesia, regional anesthesia, or sedation are often placed on NPO status the night before the surgery in order to prevent aspiration pneumonia.

Turn, Cough, Deep Breathe, Incentive Spirometer
Turn Coughing Coffee-pot, Deep Breathe, with Incentive Spirometer

To prevent respiratory problems from occurring after surgery, educate the patient on the importance of using techniques such as “turn, cough, deep breathe,” and the incentive spirometer at least every 2 hours. These interventions help to clear and expand the lungs throughout the recovery process.

Lower Extremity Exercises
Lower Leg Exercise

Lower extremity exercises are important to help prevent blood clots and circulation problems following surgery. Two common exercises include asking the patient to point and flex their toes or rotate their ankles one at a time 10 times per hour.

Compression Stockings or SCD's
Stocking and SCD

Along with leg exercises, the patient may be ordered to wear elastic stockings (TEDs) or sequential compression devices (SCDs) until they are able to ambulate. These devices help promote blood flow and prevent the formation of clots.

Pain Management

Pain management may be explained preoperatively, which includes teaching learned techniques, pain rating scales, and explaining how pain will be controlled. Patient controlled analgesia (PCA) provides immediate pain relief that is controlled by the patient via self-administration of pre-set doses of pain medication.

Informed Consent
Informed Consent signature

It is the responsibility of the surgeon to explain the surgical procedure and obtain an informed consent. A patient must understand the need for the procedure, risks involved, expected results, and alternative options before a surgery can legally and ethically be performed.

Physical Preparation
Being Physically Prepared

Physical preparation depends on the surgery to be performed, the patient’s health status, and preferences of the surgeon. Obtaining baseline vital signs, providing IV fluids, emptying the bladder, and preparing the skin may all be included.

Preop Checklist
Preop Check-list

The preop checklist includes tasks such as administering preoperative medications, safeguarding valuables (such as jewelry), and ensuring proper allergies have been documented.

Handoff to Surgery
Handing off to Surgeon staff

The handoff of the patient to the surgery staff provides a standard communication process to ensure patient safety. The preoperative checklist, signed informed consent, patient’s chart, and the patient identification card are components communicated during the handoff.

Universal Precautions
Universal Time-out

The Joint Commission established Universal Protocol guidelines in an effort to prevent wrong site and wrong procedure surgeries from occurring. The 3 principles include (1) conduct a pre-procedure verification process (2) mark the procedure site and (3) perform a time-out.


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