preoperative care


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care

 [kār]
the services rendered by members of the health professions for the benefit of a patient. See also treatment.
acute care see acute care.
admission care in the nursing interventions classification, a nursing intervention defined as facilitating entry of a patient into a health care facility.
adult day care a health care service provided for adults with a disability or illness who need partial or supplemental care and companionship during the day, when family members are working or otherwise unable to stay at home with a disabled relative. Among the services that may be offered at an adult day care center are nursing services (e.g., medication administration and health monitoring); nutritional and health education, health counseling; physical, speech, and occupational therapy; and socialization.
ambulatory care health services or acute care services that are provided on an outpatient basis.
amputation care in the nursing interventions classification, a nursing intervention defined as the promotion of physical and psychological healing after amputation of a body part.
bed rest care in the nursing interventions classification, a nursing intervention defined as promotion of comfort and safety and prevention of complications for a patient unable to get out of bed. See also bed rest.
bladder care activities and interventions designed to maintain urinary bladder function, including bladder retraining, catheter change, and catheter irrigation.
bowel care activities and interventions designed to maintain bowel function, including enema, bowel training, diet, and medication.
bowel incontinence care in the nursing interventions classification, a nursing intervention defined as promotion of bowel continence and maintenance of perianal skin integrity.
bowel incontinence care: encopresis in the nursing interventions classification, a nursing intervention defined as promotion of bowel continence in children.
cardiac care in the nursing interventions classification, a nursing intervention defined as the limitation of complications resulting from an imbalance between myocardial oxygen supply and demand for a patient with symptoms of impaired cardiac function.
cardiac care: acute in the nursing interventions classification, a nursing intervention defined as the limitation of complications for a patient recently experiencing an episode of an imbalance between myocardial oxygen supply and demand resulting in impaired cardiac function.
cardiac care: rehabilitative in the nursing interventions classification, a nursing intervention defined as the promotion of maximal functional activity level for a patient who has suffered an episode of impaired cardiac functon which resulted from an imbalance between myocardial oxygen supply and demand.
cast care activities and interventions designed to protect and maintain an immobilized body part, including relief of pain, pressure or constriction of circulation. See also hazards of immobility.
cast care: maintenance in the nursing interventions classification, a nursing intervention defined as care of a cast after the drying period.
cast care: wet in the nursing interventions classification, a nursing intervention defined as care of a new cast during the drying period.
cesarean section care in the nursing interventions classification, a nursing intervention defined as the preparation and support of a patient delivering a baby by cesarean section.
circulatory care: arterial insuficiency in the nursing interventions classification, a nursing intervention defined as promotion of arterial circulation.
circulatory care: mechanical assist device in the nursing interventions classification, a nursing intervention defined as temporary support of the circulation through the use of mechanical devices or pumps.
circulatory care: venous insufficiency in the nursing interventions classification, a nursing intervention defined as promotion of venous circulation.
contact lens care in the nursing interventions classification, a nursing intervention defined as the prevention of eye injury and lens damage by proper use of contact lenses.
continuing care the level of care in the health care system that consists of ongoing care of the physically handicapped, mentally retarded, emotionally retarded, and those suffering from chronic incapacitating illness.
cord care specialized care of the remnants of a newborn's umbilical cord until it falls off, consisting of cleaning and precautions to prevent infection. Cleansing protocols continue until the site is completely healed.
critical care intensive care.
culture-specific care those assistive, supportive, or facilitative acts toward or for an individual or group with evident or anticipated needs that are congruent with the values and lifestyles of an individual, family, or group of a specific culture, as used in the cultural care diversity and universality theory.
day care/respite in the omaha system, the providing by an individual or institution of supervision for a dependent child or adult in the abscence of the usual caregiver or parent.
developmental care in the nursing interventions classification, a nursing intervention defined as structuring the environment and providing care in response to the behavioral cues and states of the preterm infant.
direct care the provision of services to a patient that require some degree of interaction between the patient and the health care provider. Examples include assessment, performing procedures, teaching, and implementation of a care plan.
dying care in the nursing interventions classification, a nursing intervention defined as promotion of physical comfort and psychological peace in the final phase of life. See also dying.
ear care in the nursing interventions classification, a nursing intervention defined as prevention or minimization of threats to ear or hearing.
embolus care: peripheral in the nursing interventions classification, a nursing intervention defined as limitation of complications for a patient experiencing, or at risk for, occlusion of peripheral circulation. See also embolus.
embolus care: pulmonary in the nursing interventions classification, a nursing intervention defined as limitation of complications for a patient experiencing, or at risk for, occlusion of pulmonary circulation. See also embolus.
emergency care in the nursing interventions classification, a nursing intervention defined as providing life-saving measures in life-threatening situations. See also emergency.
episodic care interventions aimed at patient cure or restoration to previous level of functioning.
eye care in the nursing interventions classification, a nursing intervention defined as the prevention or minimization of threats to eye or visual integrity.
family-centered maternity care a pattern of caring for infants and their families used by Health and Welfare Canada. It is characterized by a great deal of flexibility and parental choice, and health care professionals are encouraged to individualize care. Breast feeding and rooming in are encouraged and grandparent and sibling visits are permitted.
foot care see foot care.
hair care in the nursing interventions classification, a nursing intervention defined as the promotion of neat, clean, and attractive hair.
health care see health care system.
high-risk pregnancy care in the nursing interventions classification, a nursing intervention defined as identification and management of a high-risk pregnancy to promote healthy outcomes for mother and baby.
home health care see home health care.
incision site care in the nursing interventions classification, a nursing intervention defined as cleansing, monitoring, and promotion of healing in a wound that is closed with sutures, clips, or staples.
indirect care services that are related to patient care but do not require interaction between the health care provider and the patient. Examples include charting and scheduling.
infant care in the nursing interventions classification, a nursing intervention defined as the provision of developmentally appropriate family-centered care to the child under one year of age.
intensive care the care of seriously ill patients in a special hospital unit; see intensive care unit. Called also critical care.
intrapartal care in the nursing interventions classification, a nursing intervention defined as the monitoring and management of stages one and two of the birth process. See labor.
intrapartal care: high-risk delivery in the nursing interventions classification, a nursing intervention defined as assisting vaginal birth of multiple or malpositioned fetuses.
kangaroo care in the nursing interventions classification, a nursing intervention defined as promoting closeness between parent and physiologically stable preterm infant by preparing the parent and providing the environment for skin-to-skin contact.
kinlein care kinlein.
long-term care health care services required for an extended period of time by individuals unable to fully execute activities of daily living; it can be provided by a variety of agencies in outpatient settings as well as on an inpatient basis.
managed care a method of health care delivery that focuses on collaboration among and coordination of all services to avoid overlap, duplication, and delays and to reduce costs. There is an emphasis on efficacy and timeliness of interventions to prevent unnecessary delays in discharge from the hospital or agency.
medical/dental care in the omaha system, diagnosis and treatment by a physician or dentist.
mouth care see mouth care.
nail care in the nursing interventions classification, a nursing intervention defined as promotion of clean, neat, attractive nails and prevention of skin lesions related to improper care of nails.
newborn care in the nursing interventions classification, a nursing intervention defined as management of the neonate during the transition to extrauterine life and the subsequent period of stabilization.
nursing care in the omaha system, therapeutic activities in addition to intermittent service, including private duty nursing.
ostomy care in the nursing interventions classification, a nursing intervention defined as maintenance of elimination through a stoma and care of surrounding tissue. See also ostomy.
ostomy care (omaha) in the omaha system, management of elimination through artificial openings, including colostomy and ileostomy.
palliative care supportive care.
perineal care in the nursing interventions classification, a nursing intervention defined as maintenance of perianal skin integrity and relief of perineal discomfort.
peripherally inserted central catheter care in the nursing interventions classification, a nursing intervention defined as insertion and maintenance of a peripherally inserted central catheter.
personal care the management of hygiene, including bathing, shampooing, shaving, nail trimming, dressing, and so on.
point of care the location at which patient services are delivered.
postanesthesia care in the nursing interventions classification, a nursing intervention defined as monitoring and management of the patient who has recently undergone general or regional anesthesia.
postmortem care in the nursing interventions classification, a nursing intervention defined as providing physical care of the body of an expired patient and support for the family viewing the body.
postoperative care see postoperative care.
postpartal care in the nursing interventions classification, a nursing intervention defined as monitoring and management of the patient who has recently given birth.
pregnancy termination care in the nursing interventions classification, a nursing intervention defined as the management of the physical and psychological needs of the woman undergoing a spontaneous or elective abortion.
prenatal care
1. care of the pregnant woman before delivery of the infant. See also pregnancy.
2. in the nursing interventions classification, a nursing intervention defined as monitoring and management of the patient during pregnancy to prevent complications of pregnancy and promote a healthy outcome for both mother and infant.
preoperative care see preoperative care.
pressure ulcer care in the nursing interventions classification, a nursing intervention defined as facilitation of healing in pressure ulcers.
preventive care the level of care in the health care system that consists of public health services and related programs such as school health education.
primary care the routine outpatient care that a patient receives at first contact with the health care system.
prosthesis care in the nursing interventions classification, a nursing intervention defined as the care of a removable appliance worn by a patient and the prevention of complications associated with its use. See also prosthesis.
respiratory care see respiratory care.
respite care
1. services provided by a health care agency that permit a primary caregiver temporary relief from caring for an ill individual.
2. in the nursing interventions classification, a nursing intervention defined as the provision of short-term care to provide relief for a family caregiver.
restorative care the level of care in the health care system that consists of follow-up care and rehabilitation to an optimal functional level.
secondary care
1. treatment by specialists to whom a patient has been referred by primary care facilities; see also health care system.
self care the performance of basic activities of daily living; see also under assistance and deficit.
sickness/injury care in the omaha system, the appropriate responses to illness or accidents, including first aid, taking temperature, and seeking medical care.
skilled nursing care the services provided by a registered nurse in a skilled nursing facility. It currently includes observation during periods of acute or unstable illness; administration of intravenous fluids, enteral feedings, and intravenous or intramuscular medications; short-term bowel and bladder retraining; and changing of sterile dressings.
skin care activities and interventions designed to maintain integrity of integument, including care of pressure ulcers and massage.
skin care: topical treatments in the nursing interventions classification, a nursing intervention defined as the application of topical substances or manipulation of devices to promote skin integrity and minimize skin breakdown.
spiritual care see spiritual care.
subacute care comprehensive goal-oriented inpatient care designed for a patient who has had an acute illness, injury, or exacerbation of a disease process; it is rendered either immediately after or instead of acute care hospitalization, to treat specific active or complex medical conditions or to administer any necessary technically complex medical treatments in the context of the person's underlying long-term condition.
supportive care interventions that help the patient achieve comfort but do not affect the course of a disease. Called also palliative care or treatment.
tertiary care the level of care in the health care system that consists of complex procedures given in a health care center that has highly trained specialists and often advanced technology.
total patient care a method of organizing care of patients such that one practitioner carries out all care requirements.
traction/immobilization care in the nursing interventions classification, a nursing intervention defined as management of a patient who has traction and/or a stabilizing device to immobilize and stabilize a body part.
tube care in the nursing interventions classification, a nursing intervention defined as management of a patient with an external drainage device exiting the body.
tube care: chest in the nursing interventions classification, a nursing intervention defined as management of a patient with an external water-seal drainage device exiting the chest cavity.
tube care: gastrointestinal in the nursing interventions classification, a nursing intervention defined as management of a patient with a gastrointestinal tube.
tube care: umbilical line in the nursing interventions classification, a nursing intervention defined as management of a newborn with an umbilical catheter.
tube care: urinary in the nursing interventions classification, a nursing intervention defined as management of a patient with urinary drainage equipment.
tube care: ventriculostomy/lumbar drain in the nursing interventions classification, a nursing intervention defined as management of a patient with an external cerebrospinal fluid drainage system. See also ventriculostomy and drain.
urinary incontinence care in the nursing interventions classification, a nursing intervention defined as assistance in promoting continence and maintaining perineal skin integrity. See also urinary incontinence.
urinary incontinence care: enuresis in the nursing interventions classification, a nursing intervention defined as promotion of urinary continence in children.
urinary retention care in the nursing interventions classification, a nursing intervention defined as assistance in relieving bladder distention. See also retention of urine.
wound care in the nursing interventions classification, a nursing intervention defined as prevention of wound complications and promotion of wound healing.
wound care: closed drainage in the nursing interventions classification, a nursing intervention defined as maintenance of a pressure drainage system at the wound site.

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.

preoperative care

the preparation and management of a patient before surgery. The patient's nothing-by-mouth (NPO) status, nutritional state, medical and surgical history, allergies, current medication, physical handicaps, signs of infection, and elimination habits are recorded. The patient's understanding of the operative, preoperative, and postoperative procedures; the patient's ability to verbalize anxieties; and the family's knowledge of the planned surgery are ascertained and education provided. The accuracy of patient's signed informed consent is verified, requests in the physician's preoperative orders are fulfilled, and the patient's identification bands and blood type are checked. Vital signs are recorded, and any abnormalities of the electrocardiogram, chest x-ray, or laboratory tests are reported to the surgeon and anesthesiologist. If needed, the number of matched blood units required to be held for a possible blood transfusion is determined. When ordered, an enema is given, a bowel preparation is completed, a nasogastric tube or indwelling catheter is inserted, and parenteral fluids are administered. If preoperative sedation is administered, the side rails of the bed are raised. Before transfer to the operating room with the completed chart, the patient voids, and any dentures, contact lenses, jewelry, and valuables are removed for safekeeping.
interventions The nurse performs and explains the preoperative procedures; reinforces the physician's explanation of the operation; provides instruction and emotional support; answers the patient's questions as honestly as possible, avoiding standard cliches in responding to any anxiety; and reassures the patient that medication will be available to relieve postoperative pain. Depending on the surgical procedure, the nurse shows the patient how to turn, cough, deep breathe, and support the incision during coughing. Instructions on leg exercises are also given. The nurse informs the patient and the patient's family about the postoperative period in the postanesthesia care unit or the intensive care unit, if indicated.
outcome criteria The patient who is carefully prepared for an operation, psychologically and physically, experiences less anxiety and is more likely to make an uneventful recovery.

preoperative

preceding an operation.

preoperative care
the preparation of a patient before operation. The preoperative period may be extremely short, as with an emergency operation, or it may encompass several days during which diagnostic tests, specific medications and treatments, and measures to improve the patient's general well-being are employed in preparation for surgery.
preoperative cleansing
preparation of the patient and surgical personnel to minimize contamination of the wound. See also scrub (2).
preoperative scrub-up
see surgical scrub.
References in periodicals archive ?
Surveyors also recognized the department's Center for Preoperative Care for its outstanding surgery booking process, and they suggested the Perioperative SafetyNet be adopted hospital-wide.
An existing customer, Sutter Health has been using Picis solutions across its network to provide a seamless continuum of patient information and reporting between preoperative care, surgery, anesthesia and post-operative care.
4) These findings suggest that optimal preoperative care for cardiac surgery patients should include screening for HPF4 antibody status.
The addition of Solumed positions 3M for growth in the fast-growing segment of intravenous (IV) site care and in preoperative care and hand hygiene, where CHG-based products are gaining momentum," said Chuck Kummeth, vice president and general manager, 3M Medical Division.
Total Perioperative Automation--Picis' Total Perioperative Automation([TM]) (TPA) system was selected by hospitals to provide a seamless continuum of patient information and reporting between preoperative care, surgery, anesthesia and post-operative care.