Preoperative Nursing Management
Psychological Nursing Assessment during the Preoperative Period
- Fear of the unknown
- Fear of death
- Fear of anesthesia
- Concerns about loss of work, time, job and support from the family
- Concerns on threat of permanent incapacity
- Spiritual beliefs
- Cultural values and beliefs
- Fear of pain
Psychological Nursing Interventions:
- Explore the client’s fears, worries and concerns.
- Encourage patient verbalization of feelings.
- Provide information that helps to allay fears and concerns of the patient.
- Give empathetic support.
An informed consent is necessary to be signed by the patient before the surgery. The following are the purposes of an informed consent:
- Protects the patient against unsanctioned surgery.
- Protects the surgeon and hospital against legal action by a client who claims that an unauthorized procedure was performed.
- To ensure that the client understands the nature of his or her treatment including the possible complications and disfigurement.
- To indicate that the client’s decision was made without force or pressure.
Criteria for a Valid Informed Consent
- Consent voluntarily given. Valid consent must be freely given without coercion.
- For incompetent subjects, those who are NOT autonomous and cannot give or withhold consent, permission is required from a responsible family member who could either be apparent or a legal guardian. Minors (below 18 years of age), unconscious, mentally retarded, psychologically incapacitated fall under the incompetent subjects.
- The consent should be in writing and should contain the following:
- Procedure explanation and the risks involved
- Description of benefits and alternatives
- An offer to answer questions about the procedure
- Statement that emphasizes that the client may withdraw the consent
- The information in the consent must be written and be delivered in language that a client can comprehend.
- Should be obtained before sedation.
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