Mr. Baltazar will be undergoing surgery with general anesthesia. The client should be given which of the following instructions preoperatively?
A. Eat a big breakfast
B. Expect to be incontinent of urine postoperatively
C. Double your medication doses
D. Expect nausea, vomiting, shivering, and pain postoperatively
Correct Answer: D. Expect nausea, vomiting, shivering, and pain postoperatively
These responses should be expected, and the client should be prepared for them. The most common complication after general anesthesia is nausea and vomiting. Postoperative nausea and vomiting (PONV) are easier to prevent than treat, and multiple medications are available for patients who experience this issue. Shivering or chills is a common reaction to the medication given during surgery and typically resolves when the medication wears off. It can also be caused by a small drop in body temperature during surgery, an issue that is easily resolved by covering up with a few extra blankets until the cold chills pass.
Option A: Food is contraindicated before surgery. Always follow the doctor’s instructions about avoiding food and drink before the surgery. Fasting is usually necessary starting about six hours before the surgery. The client may be able to drink clear fluids until a few hours prior.
Option B: Urinary retention, not incontinence is likely. General anesthesia paralyzes the muscles of the body, and the bladder is a muscle. Not only can the medication affect the bladder, but many surgeries require the placement of a urinary catheter. While a urinary tract infection is more likely after having a foley placed for surgery, most patients do not experience any ill effects from the catheter. In rare cases, a patient cannot urinate after having surgery, and this requires immediate medical attention.
Option C: Medication is more likely to be held on the day of surgery. The client may need to avoid some medications, such as aspirin and some other over-the-counter blood thinners, for at least a week before the procedure. These medications may cause complications during surgery. Some vitamins and herbal remedies, such as ginseng, garlic, Ginkgo biloba, St. John’s wort, kava, and others, may cause complications during surgery. Discuss the types of dietary supplements taken with the doctor before the surgery.