Therefore, it is the responsibility of the nurse to carefully assess the magnitude of the patients' fears and duly inform the physician of the situation. It is also natural for a patient to feel fear of pain and discomfort. The nurse may alleviate the fear by assuring the patient of the availability of analgesic and anesthetic drugs during the surgery and the option of having a self-induced pain medication post-surgery. In cases where there is possibility of body mutilation/alteration and inability to perform activities of daily living (ADL) as a result of the operation or the prevailing disease, it is best for the nurse to give the emotional support the patient needs in an "open, nonjudgmental attitude" (Bucher et al., 2007, p.345). Furthermore, the nurse might seek the support of the patient's family to help the patient during this difficult time and inform both the patient and the patient's family of the availability of support groups and other medical teams that could help the patient adjust to the new situation.
Careful, competent, and considerate care throughout the surgical experience will help reduce any anxiety felt by the patient and his family, will help assist in the recovery of the patient, as well as help prevent future complications.
In the preoperative period, it is essential that the nurse perform a thorough assessment of the patient's physiologic and psychologic status to ascertain the mental and physical fitness of the patient in going through with the procedure and, to determine the appropriate nursing intervention to be carried out in order to further prepare the patient for his surgical experience.
Health and Medication History Taking. Relative information about the patients' past health and medication history including inherited familial traits might uncover facts that could very well hinder the possibility of having a safe and favorable surgical outcome and/or increase the risk factors of having the surgery. For this reason, information on previous hospitalizations, surgeries, allergies, genetic predispositions, past and present medications and, other health practices such as drinking or smoking habits should be collected and documented appropriately.
Review of the Systems. Specific aspects of the body systems should also be assessed carefully and competently. It is very important that the preoperative nurse is knowledgeable of what to look for in each body system as this might, again, affect the overall outcome of the operation. Charting of the patients' intake and output in determining the fluid and electrolyte balance is critical for this purpose.
Patient Teaching. Patient teaching should include learning needs, discussion of diagnostic tests, establishing diet regiments and family visits, review of OR procedures, effect of medications to be administered, purpose and administration procedure of IV therapy, pain and pain management, recovery process and, post-operative exercises to be learned. This would also be a good opportunity for the nurse to assess the knowledge of the patient regarding the why's and for's of the surgery and ascertain the need for further teaching from the physician.
Surgical Preparation. Surgical preparation would depend on the type of surgery to be