Pre and Post-Op Procedures

Pre-Op Assessment/Procedure:
1. Take weight of patient
2. Once in room:
a. Review and sign paperwork
i. What surgery is being completed
1. Sign to consent surgery
ii. If the patient has traveled outside the country
iii. When the patient drank/ate last
b. Ask about general information
i. Past medical history
ii. Daily medication taken and at what times
iii. Allergies
c. Take vitals of patient
i. Blood pressure
ii. Oxygen level
iii. Pulse
iv. Listen to heart tones, rhythms
d. Put ivy into patient
e. Before surgery, doctor comes in and makes sure everything is understood
f. Antibiotic is given before surgery as a preventative

Post-Op Procedure:
1. If patient is not awake right when they get back from surgery, give them time for the
anesthesia to wear off
2. Take vitals of patient(every half an hour until discharged)
a. Blood pressure
b. Temperature
3. Always assessing patients pain on a scale from 1-10
4. Patient has to meet PADSS before being able to be discharged
a. PADSS Measurements(patient must be a 9 or 10 when all categories are
added up to be discharged)
i. Vital Signs:
1. 2 = Within 20% of preoperative value
2. 1 = 20% to 40% of preoperative value
3. 0 = 40% of preoperative value
ii. Surgical Bleeding:
1. 2 = Minimal
2. 1 = Moderate
3. 0 = Severe
iii. Ambulation and Mental Status:
1. 2 = Oriented x 3 and has steady gait
2. 1 = Oriented x 3 or has steady gait
3. 0 = Neither
iv. Intake and Output:
1. 2 = Has had p.o. fluids and has voided
 2. 1 = Has had p.o. or has voided
3. 0 = Neither
v. Pain or Nausea and Vomiting:
1. 2 = Minimal
2. 1 = Moderate
3. 0 = Severe
5. Doctor talks to patient about how the surgery went and what they want the patient to
do to recover
6. Review and sign discharge papers