What specific preoperative nursing measures should the nurse review with the patient to help decrease the risk for postoperative complications? Explain the role of the nurse when implementing the immediate preoperative preparation the day before surgery and the morning of the surgery?

1. The preoperative nursing measures that the nurse should review with the patient to help decrease the risk for postoperative complications include the following:

• Providing education on coughing and deep breathing exercises to prevent respiratory complications such as atelectasis and pneumonia.
• Instructing the patient on how to use an incentive spirometer to improve lung function and prevent respiratory complications.
• Advising the patient to avoid smoking and secondhand smoke exposure for at least 24 hours before surgery to prevent respiratory complications.
• Encouraging the patient to ambulate and perform leg exercises to prevent venous thromboembolism (VTE) and deep vein thrombosis (DVT).
• Instructing the patient to use compression stockings or intermittent pneumatic compression devices to prevent VTE and DVT.
• Advising the patient to avoid food and drink after midnight on the night before surgery to prevent aspiration during anesthesia.
• Instructing the patient to shower or bathe with an antimicrobial soap before surgery to reduce the risk of surgical site infections.
• Advising the patient to remove nail polish, jewelry, and contact lenses before surgery to reduce the risk of complications during anesthesia.

The role of the nurse when implementing the immediate preoperative preparation the day before surgery and the morning of the surgery is to ensure that the patient follows the instructions given, such as abstaining from food and drink, showering with an antimicrobial soap, and removing nail polish and jewelry. The nurse also assesses the patient’s understanding of the instructions and provides additional education or clarification if needed. The nurse prepares the patient for the surgical procedure by administering medications and performing other interventions as ordered by the healthcare provider. The nurse also prepares the patient emotionally and psychologically for the procedure, providing support and reassurance as needed.

2. The rationale for instructing the patient to stop taking aspirin before surgery is to prevent excessive bleeding during and after surgery. Aspirin is an antiplatelet medication that inhibits platelet aggregation and can prolong bleeding time. This can increase the risk of bleeding during surgery and make it more difficult for the surgeon to control bleeding. Aspirin should be stopped at least seven days before surgery to allow for the body to restore normal platelet function.

Assessing the patient for use of herbal products prior to surgery is important because some herbal products can interact with anesthesia medications and increase the risk of complications during and after surgery. For example, St. John’s Wort can increase the metabolism of anesthesia medications and decrease their effectiveness. Garlic, ginkgo biloba, and ginseng can increase the risk of bleeding during surgery. The nurse should ask the patient about their use of herbal products and report any findings to the healthcare provider.

Surgery can affect blood glucose levels in patients with diabetes. The stress of surgery can cause the body to release hormones that increase blood glucose levels. This can be exacerbated by the use of anesthesia medications, which can also affect glucose metabolism. The nurse should inform the patient that their blood glucose levels will be closely monitored before, during, and after surgery, and that adjustments to their diabetes medication may be necessary. The patient should follow the instructions of their healthcare provider regarding the use of their diabetes medication on the day of surgery.