Surgery scheduling

The nurse tailors the preoperative explanations to fit die type of surgery scheduled. Not all of diese teaching points may be included in every explanation. 

When a patient is scheduled for eye surgery, it is most important that the eye drops ordered by the primary health care provider are instilled at the correct time. This is especially important when the purpose of the drug is to change the size of the pupil. 

A 57-year-old woman is scheduled for an abdominal hysterectomy due to uterine fibroids. She is very anxious about her surgery. 

Menorrhagia also may be treated with the levonorgestrel-releasing intrauterine device (IUD). This is a very effective treatment that consistently reduces menstrual flow by 90% or greater.29,30 Its use has resulted in the postponement or cancellation of scheduled endometrial resection surgery or hysterectomy. Specifically, 60% of treated patients have been able to avoid hysterectomy.30,34,35... 

Male infertility may result from cancer surgery, radiotherapy, hormonal imbalances, or damage of germinal stem cells. Testicular damage from radiotherapy depends on the treatment field, total dose, and fractionation schedule. Depending on the radiation, sperm counts may return to pretreatment levels in 10 to 24 months after therapy or maybe permanent in 80% of men after total-body irradiation for transplant. 

As a result of these findings, a scheduled standard pelvic exploration is now an obligatory procedure in clinical trials with new SERMs. It is important to note that this adverse effect has not been associated with tamoxifen or toremifene therapy (Maenpaa et al. 1997 Fisher et al. 1998), and in the case of raloxifene, a post hoc metaanalysis of 6926 nonhysterectomized postmenopausal women participating in clinical trials for 3 years or more showed a significant 50% reduction in the incidence of surgery for repairing pelvic floor relaxation, reported as an adverse event, compared with placebo (Goldstein et al. 2001). 

An alternate dose schedule is 600 units/kg subcutaneously in once-weekly doses (21, 14, and 7 days before surgery) plus a fourth dose on the day of... 

Initiation of therapy - App y one system to the postauricular skin (ie, behind the ear) at least 4 hours before the antiemetic effect is required. To prevent postoperative nausea and vomiting, apply the patch the evening before scheduled surgery. To minimize exposure of the newborn baby to the drug, apply the patch 1 hour prior to cesarean section. Scopolamine approximately 1 mg will be delivered over 3 days. Wear only one disc at a time. Do not cut the patch. 

There have been many valid criticisms of these preoperative radiation studies. These criticisms include the varied dose and fractionation schedules. No two trials have used the same radiation regimen. None of these trials have allowed an adequate interval between completion of radiation and surgery. In general, at least 4-6 wk are required for... 

Notify the dentist and other physicians of clopidogrel therapy before surgery is scheduled or new drugs are prescribed... 

Fentanyl is a semi-synthetic opioid, ft is a much more powerful version of morphine. Fentanyl is used during surgery as an anesthetic and is extremely dangerous when taken in a nonmedical context. First created in Belgium in the 1950s, fentanyl is 80 times more powerful than morphine. Due to its strength, fentanyl is listed as a Schedule I narcotic in the United States. 

Patients scheduled to undergo elective, noncardiac, nonvascular surgery... 

Meperidine (Schedule II) is a synthetic analgesic with opiate activity. It has 10-20% of the potency of morphine with all of the addictive side effects. It has a rapid onset of action and duration which makes its useful for relieving the pain associated with labor or as a preanesthetic before surgery. Its biotransformation produces normeperidine which has been associated with seizures. It was a botched clandestine attempt to synthesize a meperidine modification which produced the toxic drug that induced parkinson-type destruction of DA neurons in its users. 

Sawyer RG, Tribble CG, Newberg DS, Pruett TL, Minasi JS. Intern call schedules and their relationship to sleep, operating room participation, stress, and satisfaction. Surgery 1999 126 337-342. 

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