Preoperative and Postoperative Nursing Care Standards

Preoperative Care and Patient Preparation

Preoperative care starts when the decision to operate is made. It involves planning specific care and observing the patient for signs that may require delaying surgery.

Signs to Observe Before Surgery

• Cold or cough
• Respiratory difficulties
• Fever
• Menstruation (the rule)
• Chest pain
• Signs of skin eruptions
• Auditory or visual problems
• Intense anxiety

Preparation Days Prior to Intervention

During the days leading up to the surgery, the following steps are essential:

• Compilation of all necessary medical tests.
• Collaborating with and helping the patient with their personal hygiene.
• Performing shaving or enemas if indicated.
• Applying cleansing agents to the area before operating.
• Assessing hydration and nutritional status.
• Listening to the patient and their family to address concerns and anxiety.
• Instructing the patient that they must remain NPO (Nothing by Mouth) and stay fasting.

Day of Surgical Intervention

• Identify the patient correctly.
• Instruct the patient to wash their mouth with antiseptic soap and remove dentures.
• Remove all personal items and jewelry.
• Weigh and measure the patient (especially important for children).
• Recommend that the patient defecates and voids (urinates) before going to the operating room.
• Accompany the patient wearing clean clothes and ensure hair is tied back (collected).
• Inform the patient of all acts to be performed.

Urgent Surgical Preparation

If possible, all preoperative steps should be followed. The area is washed with water and soap, the surgical site is shaved, and all prosthetics and personal objects are removed.

Surgical Shaving Technique

Shaving is important to avoid the risk of surgical infectious diseases. Generally, the area to be operated on is shaved. For female patients, the shaving is typically performed by female staff.

Required Materials:

• Disposable gloves
• Cotton batting
• Sponge with soap
• Disposable shaving razor
• Basin of warm water
• Towel and scissors

Perineal Shaving Technique

The material used is the same as the standard technique. The patient should be positioned appropriately on a cot or in the lithotomy position.

Postoperative Care and Recovery

Postoperative care is designed to ensure the patient does not encounter problems following the surgical intervention. It focuses on safety, comfort, relaxation, and teaching the patient about the care they must observe during recovery.

Immediate Postoperative Care

The patient will stay in the recovery room until the effects of anesthesia disappear and vital signs are stabilized.

Critical Signs to Monitor

• Thirst and paleness
• Cyanosis or altered/slow breathing
• Moans of pain or excessive sleepiness
• Noises caused by secretions
• Convulsions or sweating
• Feeling of cold
• Extravasation of the intravenous drip
• Vomiting

Signs in Post-Surgical Convalescence

During convalescence, staff must monitor vital signs, specifically focusing on respiration, including tachypnea and bradypnea. Other factors include:

• Hydration status
• Levels of consciousness and motility
• Hemorrhages
• Characteristics of urine and feces
• Skin condition (checking for ulcers)
• Weight and constant vitals

Convalescent Stage and Rehabilitation

The patient is moved from the recovery room to the ICU or a standard room. The room must be prepared with all necessary apparatus. The patient may still be drowsy; do not leave them alone and continue to observe for symptoms. The convalescence period will be longer and more traumatic depending on the primary operation. Rehabilitation is necessary when physical harm or functional loss has occurred.

Common Surgical Positions

• Lateral
• Lithotomy
• Prone
• Trendelenburg
• Reverse Trendelenburg
• Supine