preoperative

[pre-op´er-ah-tiv] preceding an operation.preoperative care the psychologic and physiologic preparation of a patient before an operation. The preoperative period may be extremely short, as with an emergency operation, or it may encompass several weeks during which diagnostic tests, specific medications and treatments, and measures to improve the patient's general well-being are employed in preparation for surgery. (See accompanying tables.)Psychologic Aspects. Although patients react in their own unique ways to the news that they are going to have surgery, all patients experience some degree of anxiety and fear—fear of the unknown, worry over disability or death, and apprehension about the insecurity of their own and their family's future.
Much of this anxiety can be relieved if the various aspects of preoperative and postoperative care and the type of surgery planned are explained to the patient. The surgeon usually explains the surgical procedure and assists the patient in planning rehabilitation. The anesthesiologist usually reviews the type of anesthesia to be used and the general effects it will have on the patient. The nursing staff explains the hospital routine, specific nursing procedures necessary, the purpose of diagnostic tests required, and the types of equipment that will be used during the preoperative and postoperative periods. The nurse can demonstrate interest in the patient and family by answering questions (or referring them to the surgeon), and giving them a general idea of how long the patient will be away from his or her room during surgery and recovery from anesthesia. It is reassuring for patients to know, for example, that oxygen administration, blood transfusions, and the use of a nasogastric tube or catheter do not necessarily indicate a critical situation. The use of various pieces of equipment that seem “routine” to the hospital staff may be extremely upsetting to patients and their families if they do not understand why the equipment is necessary.
Spiritual reinforcement during this period may be very important to some patients, and without giving the impression of prying into the patient's private affairs, the nurse must also show a willingness to assist patient and family in obtaining a spiritual advisor if they indicate such a desire. The nurse must always respect the individual patient's beliefs and convictions whether sharing them or not, and must support patients in their search for spiritual reassurance and guidance.Legal Aspects. Any patient undergoing surgery, whether it is expected to be major or minor surgery, must sign an operative permit. Patients have the right to know the type of surgery intended and its expected outcome, aftereffects, and possible complications. If an individual is underage, mentally incompetent, or unconscious, the permit is signed by a relative or guardian. The permit protects the patient against unwanted surgery and operative procedures the patient does not understand. It protects the hospital staff and surgeon from legal claims that the surgery was done without the patient's permission or knowledge of what was to be done. The signed operative permit is placed in the patient's chart and is sent to the operating room with the patient.Preventive Aspects. During the preoperative period the patient is instructed in coughing, turning, deep breathing, and exercises of the extremities. These techniques can be most effective in preventing many of the complications of surgery. Exercises to strengthen specific muscles in preparation for rehabilitation, as following amputation, for example, are begun well in advance so that the patient is in optimal condition to begin a program of rehabilitation as soon after surgery as possible. Other topics of instruction will depend on the anticipated needs of the patient during recovery from surgery.Physiologic Aspects. Except in emergency situations every effort is made to have the patient in a state of optimal health before surgery is performed. Specific diets, protein and vitamin supplements, and other measures to improve the nutritional status may be employed. Intravenous infusions and transfusions of whole blood or plasma may be necessary to improve the fluid and electrolyte status and blood volume. Infections should be brought under control before surgery if they cannot be eliminated completely. Accurate records of the patient's vital signs, blood pressure, and urinary output will assist the surgeon in diagnosing and correcting conditions that may adversely affect the patient's physiologic response to an operative procedure.Physical Preparation. Hospital protocol and the preference of the surgeon dictate the procedures for physical preparation prior to surgery. Although studies have repeatedly shown that the removal of hair is not effective in preventing infection and actually may contribute to it by damaging the skin, some surgeons still order removal of hair from the operative site.
Restriction of food and fluids varies. Usually the patient is allowed a light evening meal and then given nothing by mouth after midnight the night before surgery. Other procedures for preparation of the gastrointestinal tract may include enemas and insertion of a nasogastric tube.Preoperative Medications. Generally there are three types of drugs used prior to surgery: sedatives, such as one of the barbiturates, to promote relaxation and rest and to stabilize the blood pressure and pulse; drying agents, such as atropine and scopolamine, which decrease secretion of mucus in the mouth and throat; and narcotics, such as morphine and meperidine hydrochloride (Demerol), which promote relaxation and enhance the effects of the anesthetic.
Preoperative medications must be given at the exact time ordered because their strength, action, and duration are planned according to the type of anesthesia used.Immediate Preoperative Care. Most institutions use a check list or clearance record for surgical procedures. This eliminates the danger of overlooking some aspect of the immediate preoperative preparation. Such an omission might delay surgery or result in legal problems. The operative permit must be signed by the patient or guardian or legal representative. This permit is necessary to protect the surgeon against claims of unauthorized surgery, and to protect the patient against surgery he would not willingly endorse.
The preoperative check list includes such items as laboratory tests and their findings, history and physical examination records, disposal of valuables, removal of dentures and their disposition, vital signs and blood pressure of the patient immediately before going to the operating room, and other specific information such as consultation for sterilization.
Unless a urinary catheter has been inserted, the patient is offered the bedpan just before being taken to the operating room. Hairpins, bobby pins, and combs are removed from the hair and the head is covered with a cap or scarf.

pre·op·er·a·tive

(prē-op'ĕr-ă-tiv), Preceding an operation.

preoperative

(prē-ŏp′ər-ə-tĭv, -ŏp′rə-, -ŏp′ə-rā′-)adj. Occurring before surgery: preoperative preparations.

pre·op′er·a·tive·ly adv.

pre-op

adjective Referring to the logistics of preparing for a surgical procedure/operation.

noun
(1) A popular term for all forms of care (e.g., medication) provided to a patient prior to a surgical intervention, as in “Has the pre-op been done on this patient?”
(2) The ward where patients are held before surgery, as in, “Patient X is in pre-op.”

pre·op·er·a·tive

(prē-op'ĕr-ă-tiv) Preceding an operation.

preoperative

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Words related to preoperative

adj happening or done before and in preparation for a surgical operation

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