Page 474 - Saunders Comprehensive Review For NCLEX-RN

administer medication.
5. Instruct the client how to use noninvasive pain relief
techniques such as relaxation, distraction techniques,
and guided imagery before the pain occurs and as
soon as the pain is noticed.
6. The nurse should instruct the client not to smoke (for
at least 24 hours before surgery); discuss smoking
cessation treatments and programs.

7. Instruct the client in deep-breathing and

coughing techniques, use of incentive spirometry, and
the importance of performing the techniques
postoperatively to prevent the development of
pneumonia and atelectasis (Box 15-1).
8. Instruct the client in leg and foot exercises and the
purpose of sequential compression devices to prevent
venous stasis of blood and to facilitate venous blood
return (Fig. 15-1; see Box 15-1; see Fig. 15-3).
9. Instruct the client in how to splint an incision, turn,
and reposition (Fig. 15-2; see Box 15-1).
10. Inform the client of any invasive devices that may be
needed after surgery, such as a nasogastric tube,
drain, urinary catheter, epidural catheter, or IV or
subclavian lines.
11. Instruct the client not to pull on any of the invasive
devices; they will be removed as soon as possible.

F. Psychosocial preparation

1. Be alert to the client’s level of anxiety.
2. Answer any questions or concerns that the client may
have regarding surgery.
3. Allow time for privacy for the client to prepare
psychologically for surgery.
4. Provide support and assistance as needed.
5. Take cultural and spiritual aspects into consideration
when providing care (Box 15-2).
G. Preoperative checklist

1. Ensure that the client is wearing an

identification bracelet.

2. Assess for allergies, including an allergy to

latex (see Chapter 62 for information on latex allergy).
3. Review the preoperative checklist to be sure that each
item is addressed before the client is transported to
surgery.
4. Follow agency policies regarding preoperative

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