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PREOPERATIVE TEACHING

Pre operative teaching must address highest


priority and include information that focus
on safety of the patient. It mainly concerns
three types of information. It include
sensory, procedural and process
information
Preoperative teaching decrease anxiety and
encourage client to participate actively in
their own care.
Sensory informations
• Holding area may be noisy
• Drugs and cleaning solution can be smelled
• Operation theatre can be cold , warm blankets are
available
• Talking may be distorted in OT due to mask. Questions
should be asked if something is not understood
• OT bed will be narrow. A safety belt will be applied over
the knees
• Light in the OT may be very bright
• Monitoring machines (tickling and pinging noises)may be
heard when awake. Their purpose is to monitor and
ensure safety
Procedural information
• What to bring and what type of clothing wear to the
ambulatory surgery centre
• Any changes at the time of surgery
• Fluids and food restrictions
• Physical preparation required
• Purpose of frequent vital sign assessment
• Pain control and other comfort measures
• Insertion of IV line
• Procedure for anaesthesia administration
• Expected surgical site and or side marked with ink or
marker
Process information
• Admission area
• Preoperative holding area, operating room
amd recovery room
• Families can usually stay in holding area
until surgery
• Families may be able to enter recovery
area as soon as patient is awake
• Identification of any technology that may
present on awakeningsuch as monitors
and central lines
• Other areas to be covered in preoperative
teaching
• Deep breathing excercises
• Coughing excercises
• Turning excercises
• Extrimity excercises
• Deep breathing exercise
Breathing and coughing exercise helps to
expand collapsed lungs and to prevent post
operative pneumonia and atelectasis.
STEPS
Sit on edge of bed or supine with knees
flexed to relax the abdominal musculature
Place the hands on abdomen
Inhale through nose until abdomen balloons
outward
Exhale through pursed lip
• Coughing exercise
STEPS
Client may be in sitting or lying position
Splint the incision with pillow or lacing the
fingers tightly across the wound
Have the client take a deep breath,
exhaling through mouth before coughing
from deep in lungs
Deep breathing exercise before coughing
will stimulate cough reflux.
• Turning exercise

Teach the patient to turn in bed from side to


side using side rails to assist movement.
Turning prevent venous stasis and
respiratory problem.
• Extremity exercises

Ask the client flex and axtent each joint


particularly the hip, knee and ankle joint
keeping the lower back flat. Have the
client move each foot in circular motion.
These exercise help to prevent circulatory
problem such as thrombophlebitis by
facilitating venous return to heart.
Encourage ambulation after surgery when
appropriate.
• Post operative equipments

Client may be instructed about the


equipment that may anticipated
postoperatively. Depending on the surgical
procedure various tubes, drains I.V lines
may be used. Discussion should be
focussed on the purpose of specific
equipments and how it is related to
surgical procedure.
a) Tubes –most common types of tubes
used are indwelling catheters for bladder
drainage and N.G tube for gastric
decompression.
b) Drains-drains are usually inserted during
surgery to promote evacuation of fluid
from operation site.
c) Intravenous infusion line and device-the
purpose infusion line and device is to
administer medication in peri operative
period.