Question

Case Study, Preoperative Nursing Management Joan Arnold, 67 years of age, is a female patient who underwent a coronary angiogram that diagnosed severe coronary artery disease in three of her coronary arteries, the left anterior descending, the left circumflex, and the right coronary artery. She is scheduled for a coronary artery bypass graft operation tomorrow. The nurse provides patient education for Mrs. Amold and her husband, which includes watching a hospital video on the operation, the intensive care environment, what to expect after the surgery, the recovery period, and cardiac rehabilitation. The video also covered the importance of ng an incentive spirometer, splinting, early ambulation. pain medication, and how to position oneself safely. The video stressed the importance of not rolling onto the side that the chest tube may be in place postoperatively. The video also discussed the preoperative preparation. The nurse also provided a booklet on the subject material. The nurse had a session with the patient and her husband to assess their understanding and to answer any questions they may have had. a. What specific preoperative nursing measures should the nurse review with the patient to help decrease the risk for postoperative complications? b. Explain the role of the nurse when implementing the immediate preoperative preparation the day before surgery and the morning of the surgery?

Answer 1

a.Some of the measure which the nurse has to review in preoperative stage to receive the risk of post op complications are

• Assessing the patient for any other medical conditions (diabetes) under control to enhance faster healing and reduce the risk in poor prognosis
• Assess the patient for any infectious disease which can increase the risk of infection post operatively
• Know the allergic status, to ensure and preventing fron administering it
• Assess the patient for any respiratory illness which can hamper the use of spirometry
• Assess for any allergy towards medications like blood thinners because it is the first line medication post operatively.

b.The role of the nurse in immediate preoperative day before the surgery and in the morning are

• Make sure a written consent is taken after thorough explanation to prevent legal consequences in the future
• Blood test,urine test,x rays, etc., all investigations has to be carried out as per the order
• Cross match blood and reserve the requested number of pints for usage in surgery
• Make sure the nail paint is removed ,to assess capillary circulation
• Shave the surgical site (chest ,back ,perianal area(catheterize) , lower limbs (take veins)
• Keep NBM from midnight or as oer order
• Administer any oral medication with sips of water in the morning
• Administer preoperative medication an hour before or before shifting as per order
• Remove all metal items,dentures ,don with hospital gown ,hair tied to top and a surgical cap to be applied