Perioperative Nursing Care for NCLEX: Preop, Intraop & Postop Management
Master perioperative nursing for the NCLEX. Review preoperative assessment, intraoperative safety, and postoperative complication management.
Perioperative Nursing Care for NCLEX Preparation
Perioperative nursing encompasses the three phases of surgical care: preoperative, intraoperative, and postoperative. NCLEX questions frequently test knowledge of nursing responsibilities during each phase.
Preoperative Phase
The preoperative phase begins when the decision for surgery is made and ends when the patient is transferred to the operating room. Key nursing responsibilities include verifying informed consent, completing preoperative assessment including vital signs, allergies, and medication history, and ensuring all preoperative testing is complete. Teach patients about deep breathing exercises, incentive spirometry, leg exercises, and splinting techniques. Verify NPO status (typically nothing by mouth after midnight or 6-8 hours before surgery). Complete the preoperative checklist including removing jewelry, dentures, and nail polish. Verify that the surgical site is properly marked.
Intraoperative Phase
The intraoperative phase begins when the patient enters the OR and ends with transfer to PACU. The circulating nurse verifies patient identity, surgical site, and procedure using the surgical safety checklist (time-out). The scrub nurse maintains the sterile field and passes instruments. Monitor for malignant hyperthermia: rapid temperature increase, muscle rigidity, tachycardia, and metabolic acidosis. Treatment includes dantrolene sodium. Count sponges, sharps, and instruments before and after the procedure.
Postoperative Phase
The postoperative phase begins in the PACU and continues until the patient fully recovers. In PACU, assess airway patency, breathing, circulation, level of consciousness, surgical site, and pain. Monitor for complications: hemorrhage (tachycardia, hypotension, restlessness, decreased output), atelectasis (fever within 24-48 hours, diminished breath sounds), wound infection (fever after 72 hours, redness, purulent drainage), DVT (calf pain, swelling, positive Homans sign), and paralytic ileus (absent bowel sounds, abdominal distension).
Discharge Teaching
Provide instructions on wound care, activity restrictions, medications, signs of complications requiring medical attention, and follow-up appointments. Ensure the patient has a responsible adult for transportation. For practice questions, try our clinical nursing mini-exams and review surgical complications cheat sheets.