Question

The nurse in a gynecology clinic is completing ptroperative 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 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.

Q1. The nurse instructs the patient to stop taking the aspirin. What is the rationale for this action.

Q2. Why is it important to assess the patient of use of herbal products prior to surgery.

Q3. The patient asks how surgery could affect her blood glucose; how should the nurse respond?

Answer 1

1. Aspirin is an antiplatelet . Antiplatelet agents reduce the risk of ischaemic events but increase the risk of bleeding. When patients on antiplatelet therapy require surgery or invasive diagnostic procedures, it is advised to stop such therapy for a period of time which reduce the increased chance of bleeding during the surgery. The patient’s inherent risk for bleeding, concomitant treatments that may increase this risk, the potential of the procedure to cause bleeding. Hysterectomy is a major surgical procedure so the nurse instructed the patient to stop taking aspirin prior.

2. Use of herbal medicine is common among people. It should be assessed and stopped prior to the surgery.

A detailed drug history including herbal remedy use should be taken before operation.Side-effects and herb–drug interactions can be significant or fatal and should be reported.The lack of regulation means that herbal remedies can be of variable chemical content and contain toxins such as heavy metals. It will affect the anesthesia during surgery. So it is important to assess the patient about the use of herbal products prior to surgery.

3. Blood sugar level and surgery have a close relation. Surgical procedure leads to depletion of insulin and chance of increasing blood glucose.   Blood sugar that's even slightly elevated can lead to delayed healing and can increase your chances of getting a wound infection from less than 2 percent to over 10 percent. In general, the higher the blood sugar, the higher these risks.