Question

Case Study, Chapter 17, Preoperative Nursing Management

2. The nurse in a gynecology clinic is completing preoperative teaching for a patient scheduled for an abdominal hysterectomy next week. The patient states that she is currently taking 325 mg of aspirin daily for chronic joint pain, along with a multivitamin. The patient has type 2 diabetes; she closely monitors her blood glucose levels. Currently, she is taking an oral hypoglycemic agent. The nurse advises her to ask the anesthesiologist whether she should take this medication the morning of surgery. (Learning Objectives 2 and 4)

The nurse instructs the patient to stop taking the aspirin. What is the rationale for this action?

Why is it important to assess the patient for use of herbal products prior to surgery?

c.The patient asks how surgery could affect her blood glucose; how should the nurse respond?

Answer 1

ABDOMINAL HYSTERECTOMY: is a surgical procedure whereby the uterus or womb is removed. ASPIRIN: is a drug used to treat pain, fever and inflammation. WHY IS IT IMPORTANT TO STOP TAKING ASPIRIN BEFORE SURGERY? In this case of pre-operative teaching plan for a patient scheduled for abdominal hysterectomy, the nurse instruct the patient to stop taking aspirin because of the risk for bleeding after surgery. The drug intake should be stopped 7 days prior to the surgery and can be re-started when the surgery has passed. WHY IS IT IMPORTANT TO ASSESS THE PATIENT FOR USE OF HERBAL PRODUCTS PRIOR TO THE SURGERY? The nurse assess the patient for the intake of herbal supplements due to surgical risks that are known and suspected to increase bleeding. Some herbal supplements associate with cardiovascular risks, prolonged anesthesia effects , some drugs interact with other drugs and some increases photosensitivity. In this case study, the nurse assess for herbal products due to high risk for bleeding. HOW THE BLOOOD GLUCOSE LEVEL AFFECT AFTER SURGERY AND HOW SHOULD THE NURSE RESPOND? It is necessary to control the blood sugar levels before, during and after surgery. In this case study, the patient has type 2 diabetes mellitus and he is taking an oral hypoglycemic agent to control his blood glucose level. The nurse help the patient by explaining what is the cause of elevated blood glucose level, its complications and how to control it after the surgery. CAUSE: The physical and emotional stress of the patient during the surgical procedure, followed by changes in lifestyle, diet and exercise before and after surgery is the cause for increased blood glucose levels. COMPLICATIONS: The nurse should explain the complications of blood glucose level to the patient. It delays the healing process and can increase the chances of getting a wound infection. HOW TO CONTROL BLOOD GLUCOSE LEVEL: The nurse should explain the patient on how to control blood glucose level to reduce the anxiety related stress on patient and also the nurse should give assurance on controlling the blood glucose level. The teaching plan should include a) checking blood glucose level regularly b) diet and exercise and c) diabetes medications to control sugar level.