Overview
Introduction
Perioperative care has two linked jobs: reduce predictable risk before the procedure and detect physiologic change before it becomes a complication afterward.
Perioperative care has two linked jobs: reduce predictable risk before the procedure and detect physiologic change before it becomes a complication afterward. The LPN/LVN establishes baseline vital signs, pain, mental status, respiratory function, skin condition, allergies, medication use, glucose when indicated, and the patient's usual elimination pattern. Verify that the correct patient, procedure, site, allergies, required documentation, and ordered preparations are identified; the team uses the Surgical Safety Checklist during Sign In, Time Out, and Sign Out. Fasting is individualized rather than automatically defined as NPO after midnight. For a healthy patient having an elective procedure, clear liquids may be permitted until 2 hours before the procedure, including when procedural sedation is planned; age and pre-existing conditions can change the plan. Ask specifically about GLP-1 receptor agonists, dose escalation, gastrointestinal symptoms, and other conditions that slow gastric emptying. Risk factors may lead anesthesia to prescribe a liquid diet, use gastric ultrasound, or choose an airway-protective induction. SGLT2 inhibitors create a separate hazard: perioperative ketoacidosis can occur with a near-normal glucose, so nausea, vomiting, abdominal pain, or dyspnea warrants urgent ketone...
