Procedure Preparation, Imaging Safety and 12-Lead ECGs

Preoperative Data Collection, Consent, and Client Safety

Preparing a client for surgery requires strict attention to safety protocols, baseline data collection, and clear communication within the healthcare team. The provider performing the surgery or otherwise responsible for obtaining informed consent explains the procedure, its risks and benefits, and reasonable alternatives; the LPN/VN does not provide this initial explanation. The practical nurse (LPN/VN) functions as a witness to the client's signature on the surgical consent form, which serves only to confirm the client's identity and verify that the signature was given voluntarily. If the client expresses confusion or asks unresolved questions regarding the scheduled procedure, the LPN/VN must not attempt to explain the surgical details. Instead, the nurse must immediately notify the registered nurse (RN) or the primary healthcare provider so the provider can re-explain the operation and answer questions before the procedure advances.

During preoperative data collection, the LPN/VN gathers baseline vital signs and immediately reports abnormal values, such as an elevated temperature, to the RN. The nurse also checks baseline laboratory results, including serum potassium, hemoglobin, and coagulation studies, notifying the RN of any abnormalities. Physical verification includes confirming that the identification band, allergy band, and blood band (if applicable) are securely attached to the client. The LPN/VN participates in the preoperative safety verification by confirming that the surgical site marking is clearly present on the client and reporting any discrepancy directly to the RN. Within the LPN/VN scope of practice, the practical nurse never marks the surgical site.

Physical preparation focuses on reducing preventable perioperative complications. The LPN/VN checks for allergies to medications, latex, povidone-iodine, and surgical tape. The nurse verifies that the client has adhered to the prescribed preoperative NPO (nothing by mouth) status, which is vital to reduce the risk of pulmonary aspiration during anesthesia. If hair removal at the operative site is ordered, the nurse uses electric clippers rather than a razor, as clippers reduce skin injury and the resulting risk of surgical site infection. The LPN/VN removes and safely stores jewelry, dentures, contact lenses, eyeglasses, and prostheses according to facility instructions, though items required for communication may remain with the client until removal is required.

Client comfort and fall prevention are prioritized before medication administration. When possible, the LPN/VN assists the client to void before preoperative sedatives are administered to prevent bladder distention and eliminate the hazard of the client attempting to ambulate while sedated. Once preoperative sedatives or opioids are given, the nurse maintains prescribed bed rest, places side rails up according to facility policy, and ensures the call light is within direct reach. Finally, the LPN/VN reinforces the RN's initial teaching on postoperative recovery skills, reviewing deep breathing, coughing, incentive spirometry, and leg exercises. The nurse reinforces the technique of splinting abdominal or thoracic incisions with a pillow or folded blanket during coughing to protect the incision and manage discomfort.