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  • Preoperative Checklist: Ilocos Sur Provincial Hospital-Gabriela Silang

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    Dienizs Labini
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    This preoperative checklist is for a male patient named P.K. undergoing a procedure at the Ilocos Sur Provincial Hospital. The checklist details the preoperative preparations and confirms that consent was obtained, medical clearance and materials are ready, hair and nails were prepared, valuables removed, vitals were taken, medications administered, and the operating room was notified.

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    6.Preoperative Checklist

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    This preoperative checklist is for a male patient named P.K. undergoing a procedure at the Ilocos Sur Provincial Hospital. The checklist details the preoperative preparations and confirms that consent was obtained, medical clearance and materials are ready, hair and nails were prepared, valuables removed, vitals were taken, medications administered, and the operating room was notified.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    51 views1 page

    Preoperative Checklist: Ilocos Sur Provincial Hospital-Gabriela Silang

    Uploaded by

    Dienizs Labini
    This preoperative checklist is for a male patient named P.K. undergoing a procedure at the Ilocos Sur Provincial Hospital. The checklist details the preoperative preparations and confirms that consent was obtained, medical clearance and materials are ready, hair and nails were prepared, valuables removed, vitals were taken, medications administered, and the operating room was notified.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    Republic of the Philippines

    Province of Ilocos Sur


    ILOCOS SUR PROVINCIAL HOSPITAL-GABRIELA SILANG
    Vigan City

    PREOPERATIVE CHECKLIST

    SURNAME: _______________________________ AGE: 18 HOSP. NO. 2000350

    GIVEN NAME: P. K M.I.: __________ SEX: Male WARD: 107

    AM PM NIGHT REMARKS
    1.Kind of operation/procedure
    2.Consent for the Operation signed
    3.Medical clearance updated
    4.Materials and medicines completed
    5.Available blood properly cross-matched
    6.Operative area prepared
    7.Bowel prep done
    8.With pre-op orders
    9.NPO post-midnight maintained
    10.hair prepared, combed if necessary
    11.Oral hygiene don
    12. Nail polish/make-up/contact lens removed
    13. Jewelries removed
    14. Dentures removed
    15. Dressed in gown/camisa
    16. Underwear removed
    17. With wrist identification tag
    18. Vital signs taken before and after pre-op medications
    BP 120/80 PR 81 RR 20 Temp. 38.6 Wt. 50 kg

    19. Pre-op medication administered


    20. OR notified

    Confirmed by:

    __ _DIENIZS LABINI, RN______


    Nurse Signature over Printed Name

    ______________________________
    OR Personnel

    NUR 013-0

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