Preoperative Goals?

4

Identify Risk Factors

Plan care for patient safety

Determine psych status

Reinforce coping Strategies

Past Experience

Age

Current Health

Socioeconomic Status

Anesthesia

Death or Disability

Disruption of Life

Mutilation

Pain

Health History

6

Diagnosed Medical Conditions

Last Menstral Period

Previous Surgeries or Problems

Family Disease

Reaction to Anesthesia

Medications

7 days = Plavix, Herbs, Asprin

5 days = Coumadin

3 days = NSAIDs

1 day = Lovenox/Heprin

Day of = Diuretics, MOIs, hypoglycemics, metaformin

Antihypertensives

Beta Blockers

Calcium Channel Blockers

Anticonvulsants

Diagnostic - Determination of the presence and/or extent of pathology

Cure - elimination or repair of pathology

Palliation - alleviation of symptoms without cure

Prevention - before something happens

Exploration - determine nature or extent of disease

Cosmetic - breast redution ex. 

Prescription/OTC

Herbs

Vitamins

Recreational

Baseline vitals

Bleeding/Clotting times (INR, PT, PTT)

Possible prophylactic Antibiotics

Any recent airway infections

Hx: Dyspnea, cough, hemoptysis *Must tell OR*

COPD/Asthma high risk for atelactasis and hypoxemia

Smokers to quit 6 wees before

Hx: Renal or urinary disease

why?

F&E imbalanes

High risk for infection

Impaired wound healing

Altered response to drugs

*All woman assessed for pregnancy* LMP

Test performed 5 or more days after LMP

Bring any mobility aids to surgery

Report any neck or lumber spine injuries as they may affect airway and anesthesia delivery

wound dehiscence and infection

Slower recovery/wound healing

A/R for sleep Apnea

More cardiac and pulmonary stress

5x more likely for

MI, UTI, DVT, Weight bias