Pt teaching decreases anxiety and is shown to improve Pt outcomes.

Checklist for Perioperative Teaching Needs

• Reason for surgery; nature of surgery.
• Members of surgical team.
• Components and use of pain scale (see Pain Scale in Tools).
• Anesthesia and post-op pain management plan.
• Length and location of surgery.
• Surgical site preparation.
• Location of incisions and post-op drains and dressings.
• Ambulation guidelines after surgery.
• Coughing and deep breathing (C&DB) and leg exercises.
• Splinting incisional area when coughing to decrease pain.
• Caregiver instructions—Pt should not be alone for first 24 to 48 hr.
• Incentive Spirometry (IS): IS may no longer be part of routine post-op care—follow facility guidelines. IS provides Pt visual feedback for deep breathing and lung expansion. American Association of Respiratory Therapists no longer recommends routine, prophylactic use in post-op Pts. Current guidelines recommend early ambulation to expand lungs and promote airway clearance.

Source: Armstrong, C O. (2017). Post-op incentive spirometry: why, when, & how. Nursing, 47(6):54–57. doi:10.1097/01.NURSE.0000516223.16649.02

Anxiety of Having Surgery

• Anxiety increases post-op pain medication requirement, affecting recovery by decreasing activity and mobility, which puts Pt at risk for complications such as constipation, DVT, and pneumonia.
• Anxiety increases risk of infection by decreasing immune response.

Caregiver Involvement

Caregiver should be included in all perioperative teaching.

Discussion of expectations with Pt and caregiver include:

• Length of surgery and how long Pt will be in PACU.
• When caregiver will get updates and be able to visit Pt after surgery.
• Discharge care may be covered at this time as Pt may be drowsy after surgery. Nurse can address caregiver concerns as well.
• Lastly, nurse should ensure caregiver is guided to appropriate waiting area where staff will be able to locate them for updates.