Providing

Preoperative
Care
Day of Surgery
Sherwyn Hatab

3/1/2022 Sherwyn Hatab 1

 Providing Preoperative
Care Day of Surgery
• Check the patient’s chart for the type of
surgery and review the medical orders.
Review the nursing database, history,
and physical examination. Check that the
baseline data are recorded; report those
that are abnormal
• Check that diagnostic testing has been
completed and results are available;
identify and report abnormal results
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 Providing Preoperative Care
Day of Surgery
• Check that preoperative consent forms are
signed, witnessed, and correct; and that
the patient’s chart is in order.
• Check vital signs. Notify primary care
provider and surgeon of any pertinent
changes (e.g., rise or drop in blood
pressure, elevated temperature, cough,
symptoms of infection.

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Providing
Preoperative
Care Day of Surgery

• Provide skin
preparation
• Ask the patient to
bathe or shower with
the antiseptic solution.
Remind the patient to
clean the surgical site.
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 Providing Preoperative Care Day
of Surgery
• Provide hygiene and oral care.
Assess for loose teeth and caps.
Remind patient of food and fluid
restrictions before surgery
• Instruct the patient to remove all
personal clothing, including
underwear, and put on a hospital
gown.

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 Providing Preoperative Care
Day of Surgery

• Ask patient to remove

cosmetics, jewelry including
bodypiercing, nail polish, and
prostheses (e.g., contact
lenses, false eyelashes,
dentures)
• If possible, give valuables to
family member or place
valuables in appropriate area,
such as the hospital safe, if
this is not possible
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Providing
Preoperative Care
Day of Surgery

• Have patient empty

bladder and bowel
before surgery
• Attend to any special
preoperative orders,
such as starting an IV
line
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 Intestinal preparation

• In certain situations, the bowel will

need to be prepared through the
administering of enemas or laxatives to
evacuate the bowel and to reduce the
intestinal bacteria.
• As needed, provide explanation of the
purpose of enemas or laxatives before
surgery. If patient will be
administering an enema, clarify the
steps as needed
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 Providing Preoperative Care
Day of Surgery

• Complete preoperative checklist and

record of patient’s
preoperative preparation.
• Administer preoperative medication
as prescribed by
physician/anesthesia provider

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Commonly used preoperative
medications

• Sedatives and
tranquilizers such as
lorazepam (Ativan) are
administered IV 15 to
20 minutes prior to
surgery or by IM route
2 hours prior to
procedure (Adams &
Urban, 2013) to reduce
anxiety and ease
anesthetic induction
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 Lorazepam
• Premedication in surgery
(PARENTERAL)
• Adult: 0.05 mg/kg given 30-45
minutes before surgery via IV or
60-90 minutes before surgery via
IM.
Child: <12 years Not
recommended.
Elderly: Reduce to lower doses
(half the usual adult dose or less)

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 • Premedication in
surgery (ORAL)
Lorazepam • Adult: 2-3 mg given the
night before the
operation followed by 2-
4 mg 1-2 hours before
the procedure.
Child: 5-13 years 0.5-2.5
mg at 0.05 mg/kg to the
nearest 0.5 mg based on
weight, not less than 1
hour before operation.
Elderly: Reduce to lower
doses (half the usual
adult dose or less).

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Commonly used
preoperative medications

• Narcotic analgesics such as morphine,

Meperidine, Fentanyl provide client
sedation and reduce the required amount
of anesthetic.
• Fentanyl
• Premedication before anaesthesia
• Adult: 50-100 mcg may be given 30-60
minutes prior to induction
of anaesthesia or
surgery. Elderly: Dose reduction may be
needed.

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 Meperidine
(Pethidine, Demerol)
• Preoperative medication
• Adult: 50-100 mg via IM or SC inj 30-90 minutes
before surgery.
• Child: 1-2 mg/kg via IM or SC inj 30-90 minutes
before surgery.
• Elderly: Use the lower end of the dosing range.

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 Common Preoperative
Medications
• Atropine
• Pre-anaesthetic medication
• Adult: 0.3-0.6 mg via IM/SC inj 30-60
minutes prior to anaesthesia induction.
Alternatively, 0.3-0.6 mg via IV inj
immediately before anaesthesia induction.
• Child: <3 kg: 0.1 mg; 7-9 kg: 0.2 mg; 12-16
kg: 0.3 mg; >20 kg: 0.4-0.6 mg. All doses to
be given via IM/SC inj administered 30-60
minutes before anaesthesia.
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 Common Preoperative
Medications
• Histamine-receptor antihistamines
such ranitidine (Zantac) reduce gastric
fluid volume and gastric acidity.
• Ranitdine
• Prophylaxis of acid aspiration during
general anaesthesia
• Adult: 50 mg via IM or slow IV inj 45-
60 minutes prior to induction of
anaesthesia
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Common Preoperative
Medications

• Neomycin
• Surgical (perioperative)
prophylaxis: Oral: 1 g at 1 PM, 2
PM, and 11 PM on the day
preceding 8 AM surgery as an
adjunct to mechanical cleansing
of the intestine in combination
with oral erythromycin or in
combination with erythromycin
or metronidazole, and IV
antibiotics on the day of surgery
(Bratzler 2013).
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Providing Preoperative
Care Day of Surgery

• Help move the patient

from the bed to the
transport stretcher, if
necessary. Reconfirm
patient identification
and ensure that all
preoperative events
and measures are
documented.

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 • Document that the
preoperative checklist was
completed, time of patient’s
last void, preoperative
Documentation medications administered, and
any special interventions that
were ordered before sending
the patient to the operating
room.

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 • Record if there were any abnormal
results that were communicated to
Documentation the surgeon or OR nurse.
• Document that the patient was
safely transferred onto the stretcher
and escorted to the operating room
without incident

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 Providing Preoperative
Care Day of Surgery

• Tell the patient’s family

where the patient will be
taken after surgery and
the location of the
waiting area where the
surgeon will come to
explain the outcome of
the surgery. If possible,
take the family to the
waiting area.

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 Providing Preoperative Care
Day of Surgery

• After the patient leaves

for the operating room,
prepare the room and
make a postoperative bed
for the patient. Anticipate
any necessary equipment
based on the type of
surgery and the patient’s
history.

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 Thank You

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