154 Chapter 35 65. A pre-operative checklist is completed before a person is sent to surgery. Mark the steps that a nursing assistant can do and report to the nurse.

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154 Chapter 35 65. A pre-operative checklist is completed before a person is sent to surgery. Mark the steps that a nursing assistant can do and report to the nurse. OSF ST JOSEPH MEDICAL CENTER a200 EWashingon Screet, Blooningon, ili Phone (309) 62-3311 PRE-OPERATIVE CHECKLIST DATE OF SURGERY CHART PREPARATION NOT ADEQUATE INTIAL HERE AND EXPLAIN ADEQUATE INITIAL HERE 1. HISTORY AND PHYSICAL ON CHART WT. HT. 2. SURGICAL CONSENT ON CHART, SIGNED 3. CONSENT FOR ADM BLOOD BLOOD PROD 4. PREGNANGY TEST OBTAINED WHEN INDICATED 5. URINALYSIS REPORT ON CHART 6. BLOOD WORK TYPE 7. TYPE AND CROSSMATCH А CHEST X-ВAY REPORT ON CHART Я. ЕКО ВЕРОRТ ОN CHАRT READ 10. KNOWN ALLERGIES AND SENSITIVITIES NOTED ON CHART 11, KNOWN EXPOSURE ANDIOR ALLERGY TO LATEX NOTED ON CHART NOT ADEQUATE INTIAL HERE AND EXPLAIN ADEQUATE INITIAL HERE PATIENT PREPARATION 12. FAMILY NOTIFIED OF SURGERY NAME DATE/TIME 13. PATIENT IDENTIFICATION ON WRIST 14. ALL PROSTHESIS REMOVED (INCLUDING DENTURES, WIGS, HAIRPINS, CONTACT LENSES, COSMETICS, NAIL POLISH, ARTIFICIAL EYES, LIMBS, ETC.) 15. ALL JEWELRY REMOVED 16. CLOTHING REMOVED EXCEPT HOSPITAL GOWN WITH TIES 17. SURGICAL PREP DONE 18. TIME OF LAST MEAL OR FLUIDS 19. PRE-OP TPR AND BP T P E BP 20. VOIDED TIME 21. PRE-OP IV ANDIOR ANTIBIOTIC OR FOLEY TIME: DRUG COSAGE ПOUTE PREOPERATIVE MEDICATION GIVEN, TIME GIVEN BY SIDE RAILS UP READY FOR O.R DATE TIME SIGNATURE PATIENT IDENTIFIED BY TRANSPORTER AND STAFF NURSE TIME FLOCANBSr siGNATURE OR TRANPORTER OR NURME SGHATURE IDENTIFICATION OF INITIALS NITIALE SIGNATURE NITIAL Copyright C 2017, Ebevier Inc. Al

 
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