Pre & post operative care

1) The preoperative phase Definition:

This phase begins when the decision for surgical intervention is made and ends with transfer of the client
to the operating room bed. Nursing activities range from a baseline assessment of the patient at clinic or
at home & continues with assessment in surgical suite on the day of surgery.

Importance of preoperative care:

1. Protect patient and enable him to arrive at OR in best possible physical and psychological condition.

2. Facilitate patient recovery from surgery.

3. Prevent post-operative complications.

Preoperative care: I. Assessment: General preoperative assessment: a.

A) History taken:
• Review patient past/ present medical & surgical history.
• Review drugs, anesthetic related problems in patient and in immediate family circle, alcohol,
nicotine, recreational drug use.

B) Physical assessment: Physical examination

*A complete physical examination should be performed, paying special attention to cardiac and
respiratory.

*Assessment of organ / system and the airway head to toe assessment and focus assessment.

*Baseline vital signs are obtained.

*Special consideration of elderly includes cardiac, renal and musculoskeletal.

C) Appropriate lab investigations and diagnostic studies:

*Hematologic tests, ABGs, Biochemical tests. *Cardiac tests. *Carotid Doppler.

*Imaging: CXR, C spine x ray. *Spirometry. *Diseases relevant tests.

II. Physical preparation:

• Preparing skin.
• Maintain normal fluid and electrolyte.
• Promote rest, comfort and sleep.
• Prevention of bowel and bladder incontinence.

The Intraoperative Phase:

Intraoperative care refers to the care provided to a patient during a surgical procedure, from the
time they enter the operating room until they are transferred to the post-anesthesia care unit
(PACU) or recovery area.Here are some key aspects of intraoperative care:

1-Patient Preparation: Before surgery, the patient is prepared for the procedure, which may involve
administering anesthesia, positioning the patient on the operating table, and ensuring the surgical
site is clean and sterile.

2-Anesthesia Administration

3-Monitoring: Throughout the surgery, the patient's vital signs, such as heart rate, blood pressure,
oxygen saturation, and temperature.

4-Surgical Assistance: Nurses and surgical technicians assist by handing instruments, managing
supplies, and maintaining a sterile environment in the operating room.

5-Communication and Documentation:Healthcare professionals communicate with each other to

relay important information about the patient's condition, surgical progress, and any changes in the
plan of care.

Intraoperative care requires collaboration, attention to detail, and the ability to adapt to changing
circumstances. The goal is to ensure the patient's well-being throughout the surgery and facilitate a
successful outcome.

Post-Operative Care In the Hospital:

At the end of the surgical procedure, the patient will be moved to a recovery room where they will stay
for a couple of hours. Upon waking up from anesthesia, the patient may feel groggy and even nauseous.
 In the recovery room, staff will:

• Monitor the patient’s temperature, breathing, blood pressure, and pulse

• Ask the patient to take deep breaths to assess their lung function
• Check the surgical site for signs of bleeding or infection
• Watch for signs of an allergic reaction

Once the patient is fully away and stable, they’ll either be moved to a hospital room or begin the
discharge process. This will depend on the type of surgery and the patient’s unique condition.

Post-Operative Care At Home

After surgery, patients will need to:

• Follow post-operative instructions.

• Take medications as prescribed.
• Be on the lookout for potential complications
• Attend follow-up appointments.
• Patients who have been instructed to rest should rest. Patients who need to engage in mild physical
activity should do so. In most cases, patients should gradually resume normal activities.