Preoperative and postoperative procedural work

Preoperative Period:
Before performing the surgery, the nursing team must follow these steps:

1. Prepare the Patient's File: Ensure the file contains:
• Treatment sheet
• The physician's opinion and all medical consultations
• Medical history sheet
• Physician’s signature on the surgery consent form
• The patient's medical and laboratory tests, including:
• Complete blood count
• Blood chemistry
• Urine analysis
• Imaging tests including:
• Chest X-ray
• X-ray of the surgery area
• Any other relevant imaging
• Electrocardiogram (ECG)
• Prepare blood units for the patient:
• Determine the type and quantity
• Blood type identification
• Cross-matching
• Prepare the required amount 12 hours before surgery
2. Preparing the Patient:
• Psychologically prepare the patient and explain all steps of the surgery.
• Teach the patient exercises to perform after surgery.
• Prepare the surgical area 12 hours before the operation, including:
• Hand hygiene
• Preparing necessary tools near the patient
• Gradually uncovering the area
• Placing a sterile drape
• Shaving in one direction
• Skin cleansing
• Ensure cleanliness and sterilization
• Re-sanitize tools and wash hands
3. Preoperative Preparation:
• Ensure the patient sleeps the night before surgery and administer any necessary medications.
• Empty the bladder before transferring to the operating room.
• Administer an enema if required.
• Verify the patient's personal details.
• Confirm the readiness of the patient's body and take vital signs.
• Ensure preoperative medication is administered.
• Change the patient's clothing to surgical attire.
• Place personal belongings in a safe area.
• Secure dentures if applicable.
• Ensure nails are clean, remove nail polish, and take out contact lenses.
• Accompany the patient to the operating room.

1. Improve respiratory function and the overall condition of the patient.
2. Reduce the likelihood of postoperative complications.

Nursing Care Upon Arrival in the Unit:

1. Ensure the patient's level of consciousness.
2. Confirm the dressing is in place and there is no bleeding or leakage.
3. Verify that any connections, such as drainage tubes, are secured and properly connected to the collection containers.
4. Ensure the drainage container is positioned lower than the patient’s body for proper fluid drainage.
5. Monitor vital signs (pulse, respiration, temperature, blood pressure) and central venous pressure if present.
6. Auscultate the chest to monitor the type of breathing and evaluate the patient's color.
7. Raise the head of the bed 30–40 degrees to allow the lungs to expand if the patient’s condition permits.
8. Monitor the ECG for any abnormalities.
9. Encourage the patient to perform deep breathing exercises.
10. Encourage the patient to perform coughing exercises to clear any mucus from the respiratory tract.
11. Maintain the airway and ensure it remains clear of mucus. If there are secretions, assess the quantity, viscosity, color, and odor of the mucus, and notify the physician if there are large amounts or if it appears to contain blood.
12. Attempt to alleviate or reduce the patient's pain by reassuring them and assessing the location, nature, and intensity of the pain.
13. Assist the patient in regaining normal movement, especially joint mobility, by helping them stand and move early if their condition allows, ideally on the evening of the surgery.
14. Monitor and record fluid intake and output every hour immediately after the surgery.
15. Administer blood transfusions if needed and provide necessary fluids as prescribed by the physician.
16. Early administration of oral fluids and food if the patient’s condition permits.
17. Monitor for any complications.