Page 36 - University of Martland Nursing Forum - Winter 2017

HEALTHY DIALOGUE
Surgery with Anesthesia:
Prepping Yourself or a Loved One
Q&A with Michelle Gonzalez, MSN, MSOM, RN, CRNA, clinical instructor
MBy Todd Karpovich
ichelle Gonzalez has
more than 18 years of experience practicing as a certified registered nurse
anesthetist (CRNA) in both civilian and military facilities. She is a commander in the U.S. Navy Reserve and has cared for service members at duty stations around the world—including those in Spain, Italy, South Korea, and Japan— and throughout the United States. At the University of Maryland School of Nursing, she teaches core content in and facilitates all simulation components
of the Nurse Anesthesia specialty in UMSON’s Doctor of Nursing Practice program, and she was the recipient of a 2015 Nursing Educator Doctoral Grant for Practice and Dissertation Research from the Maryland Higher Education Commission.
Q: What should you do before a surgical procedure to ensure that it goes as well as possible?
GONZALEZ: As a CRNA, I am asked this question frequently. Many people will talk to their provider or visit a pre-op clinic prior to a procedure. If this is the case, you will be provided information
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on when you can have your last oral intake, on medication guidance, and
on preoperative testing, if needed. Occasionally, labs are drawn the morning of surgery. Following the instructions of your providers in regard to preoperative do’s and don’ts is important for your health and safety during surgery. This
is especially important if you have conditions that require you to take medications on a regular basis.
Q: Should I take my normal medication before and after surgery?
GONZALEZ: There is no blanket answer for this question. Many prescribed medications interact with anesthetic agents, but there are times when patients are on medications that we want to continue throughout their surgery.
On some occasions, we recommend reduced doses of certain medications.
Also, the current recommendation
is to discontinue all over-the-counter supplements 10-14 days before surgery. This will minimize interference with anesthetic agents, including pain medications. An additional concern is that some supplements can interfere
with the body’s ability to form clots, which can diminish your body’s ability to stop bleeding during surgery or even after surgery is complete. If you are
not certain about which medications to take or not take or if you are taking any supplements, contact the pre-op clinic, prescribing provider, and/or surgeon doing your procedure for guidance.
Q: What can I eat before and after a surgical procedure?
GONZALEZ: Traditionally, the accepted NPO (nil per os or “nothing by mouth”) is six to eight hours of no liquids or solids before surgery; this is often referred
to as “nothing after midnight.” Eating instructions also depend on the time of day you are scheduled to have surgery,
on the procedure being done, and if it’s an adult or a child or infant undergoing anesthesia. If your procedure is scheduled as the second or third case of the day,
you may be able to eat and/or drink the morning of surgery. For example, if your procedure is scheduled at 2 p.m., you may be instructed to have a “light breakfast” or liquids until 6-8 a.m. This is something to discuss with your provider or with the pre-op clinic staff. Also, if you are taking medications, it is acceptable to take your morning medication (if instructed to do so) with a sip of water.
Q: Is there anything else I can do physically to prepare for the surgery, as far as exercise or extra rest?
GONZALEZ: Plan ahead to get things out of the way so that you can focus on recovery once surgery is over. Often,
ALL PHOTOS: KEVIN NASH