Routine Preoperative Teaching (Adults)
- Objective:
- Patient/family will verbalize understanding of routine preoperative instructions.
- Content:
- Refer to clinic policy Routine Preoperative Teaching for the Adult Patient.
Diet
- Nausea and/or vomiting may be present for the first 24 hours after surgery as a side effect of general anesthetic agents.
- Antiemetics may be ordered on a PRN basis IV/PO/PR.
- Diet will begin with clear liquids and advanced as tolerated when nausea/vomiting resolves.
Pain Management
- Introduce and explain pain assessment scales (Simple Descriptive, 0-10 Numeric). Identify patient's preference.
- Establish acceptable pain level and document.
- Reassure that patient will be assessed frequently for pain.
- Pain medication will be administered intravenously on PRN basis while IV access is available.
- Oral pain medications will be available when patient is taking PO.
Activity
- HOB is elevated 30°.
- Activity will be UAL.
Intravenous (IV) Solutions/Medications
- Necessary to administer fluids until oral intake adequate.
- IV necessary to administer analgesics/antiemetics and steroids (Decadron) for swelling.
Humidity
- Discuss methods of providing supplemental humidity to reduce mouth and throat dryness.
Voice Rest
- Patient may or may not be placed on voice restrictions:
- Strict voice rest for 48 hours after surgery is rarely used in our practice, but may be useful for selective cases.
- Conservative voice use for 2 weeks is more common, but not always recommended;
- The 'Arm's Length Rule": patient not to talk unnecessarily or vocalize any louder than to speak to someone an arm's length away.
- Paper and pen or picture board may be provided to assist in communication.
Wound Management
- Neck dressing will be in place and possibly an abdominal dressing if fat is harvested.
- Rubber-band drain in the neck incision line.
- Suture line care 2 to 4 times daily after dressing is removed, continued until sutures removed postoperative day 5 to 7.
Discharge Instructions
- Discharge instructions per B-19b1--Vocal Cord Procedure
- Discharge instructions per B-19b1--Suture Line Care