Page 473 - Saunders Comprehensive Review For NCLEX-RN

themselves. The nurse must engage another nurse as
a witness to the consent given over the telephone.
B. Nutrition

1. Review the surgeon’s prescriptions regarding

the NPO (nothing by mouth) status before surgery.
2. Withhold solid foods and liquids as prescribed to
avoid aspiration, usually for 6 to 8 hours before
general anesthesia and for approximately 3 hours
before surgery with local anesthesia (as prescribed).
3. Insert an intravenous (IV) line and administer IV
fluids, if prescribed; per agency policy, the IV catheter
size should be large enough to administer blood
products if they are required.
C. Elimination
1. If the client is to have intestinal or abdominal surgery,
per surgeon’s preference, an enema, laxative, or both
may be prescribed for the day or night before surgery.

2. The client should void immediately before

surgery.
3. Insert an indwelling urinary catheter, if prescribed;
urinary catheter collection bags should be emptied
immediately before surgery, and the nurse should
document the amount and characteristics of the urine.
D. Surgical site
1. Clean the surgical site with a mild antiseptic or
antibacterial soap on the night before surgery, as
prescribed.
2. Shave the operative site, as prescribed; shaving may be
done in the operative area.

Hair on the head or face (including the eyebrows) should be

shaved only if prescribed.
E. Preoperative client teaching
1. Inform the client about what to expect postoperatively.
2. Inform the client to notify the nurse if the client
experiences any pain postoperatively and that pain
medication will be prescribed and given as the client
requests. The client should be informed that some
degree of pain should be expected and is normal.
3. Inform the client that requesting an opioid after
surgery will not make the client a drug addict.
4. Demonstrate the use of a patient-controlled analgesia
(PCA) pump if prescribed and explain that the client
is the sole person who should push the button to

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