Pre-Op Total Joint Class

Report
Pre-Op Shoulder Surgery
Information
Welcome!
Goals
Inform the patient about what to expect…
 Before, during, after surgery
 Reduce anxiety
 Answer questions
 Help you become better-prepared
Information From The Nurse
We Care About You!!!
In an effort to personalize your care while in the
hospital, please let us know of any needs ahead of
time
If you have any specific requests, please contact the
Patient Navigator at 866-552-9357
What To Bring
 List of medications and allergies
 Glasses, hearing aids, dentures
 Flat, supportive, non-slip walking shoes
 Incontinence products -you may prefer a specific
product not provided by hospital (If staying
overnight)
What To Bring
 Comfortable and loose clothing to wear after
surgery


Oversized T-shirt or button-down shirt
Wear 2-piece outfits (i.e. top and bottom)
On the Day of Surgery…
 CHG (Chlorohexadene Gluconate) wipes will be
used to cleanse and disinfect the surgical site
before surgery begins
 CHG reduces bacterial growth on the body
 CHG will help reduce the chance of infection
following surgery
Equipment After Surgery
Oxygen
 Used a short time
 Let us know if you
have sleep apnea and
if you use oxygen or
CPAP/BiPAP at home
(if so, bring mask and
machine with you to
hospital)
IV or Intravenous Therapy
 May have one or two lines
 Fluids (blood, antibiotics, pain medication)
 Will leave it in until not needed.
Dressings and Drains
You may have a drain
in place.
Leave the dressing on
until the Doctor
says to take it off.
Foley Catheter To Drain Urine
 Rotator Cuff patients typically do not have
catheter placed
 Total Shoulder patients usually do have
catheter placed
 Helps to keep track of fluid balance
 Put in after you are asleep
Interscalene Nerve
Block/Catheter
***Some surgeons prefer not to use this***
 Numbs the shoulder region
 Patients will also receive
IV sedation to go to sleep
 Stays in from one to two
days
 Some patients may be sent
home with catheter in
place
Shoulder Sling/Immobilizer
 Purpose: to immobilize arm after surgery
 Length of time: dependent on Physician
 Keep shoulder still! Do not remove sling
unless instructed by your Physician or
Fall Precautions
After surgery, it is common to be off
balance and unsteady
For your safety, you may not get up on your
own and must call for assistance
Cryotherapy - “Polar Care” Device
 Your Physician may choose to use cryotherapy (cold therapy)
 Sends a cold signal to the brain to help with pain management
 Helps with pain and
swelling
 You take this home
with you
 “Ambulatory” or “Day-Surgery/Outpatient” patients may or may not
have Polar Care ordered
Rating Pain
 0 to 10 pain scale
 Pain patterns


Mechanical Pain
Surgical Pain
Know the Zone!
Our staff will make every effort to
help control your pain
We will automatically give you pain
medication around the clock
We ask that you partner with us and ask
for additional pain medicine if needed
Alternative pain options may be used
such as cold therapy and distraction
Our goal is to keep you in the 3-4 Pain
Zone (or less)
Compression Devices
(While in the hospital)
 Helps prevent blood clots
 Worn on the calf of each leg
 Help to push the blood back into circulation
 Wear them when you are in bed or in the
chair
Walking and Exercising
 Helps to prevent blood
clots from forming
 Exercise in and out of bed
 Ankle circles, foot pumps,
tightening leg and buttocks
muscles
Diet
 Initial diet is typically clear liquid unless
otherwise designated by your physician
 Diet will advance as tolerated
 Constipation due to pain medications



High fiber
Increase activity
Fluids
 Nausea-will have medication available
Call for Help
 Never get out of bed or chair unless you call for
assistance
 Call as soon as possible.
 Try to ask for help when a staff
member is already in the room.
Discharge
 Discharge from the hospital will occur 1 to 3
hours after surgery ends
Discharge Plan
Transportation (depends on what is medically necessary)
Most patients will go home in a car with family or
friends.
Prescriptions
 Your Surgeon will typically write
prescriptions for…




Pain medications
Anti-inflammatories
Antibiotics (if needed)
Nausea (if needed)
Follow-Up
Follow-up appointments are usually within 510 days after discharge from the hospital
During your Pre-Op visit to your Surgeon’s
office, your Post-Op follow-up date and time
will be scheduled
Precautions
In most cases, your shoulder will be immobilized in
a sling following surgery
You will not be permitted to move your arm until
your Physician/Therapist say so

This includes no lifting, pushing, pulling, sports, etc.
Therapy Progression
Passive Range of Motion (PROM)
Active Assisted Range of Motion (AAROM)
Active Range of Motion (AROM)
Resistive Exercises
***In order to prevent injury, Passive Range of Motion should be
maintained until your Physician and Therapist advance your
therapy
Activity
 Your Surgeon and/or Therapist may instruct
you to squeeze a ball or towel to decrease
hand or arm swelling
Prior to Surgery…
You may want to practice performing basic
activities (bathing, dressing, eating, etc.)
before your surgery using only the nonoperated arm…especially if your operated
arm is your dominant arm
Positioning
Use pillows or rolled towels to position/support arm
while lying in bed or sitting in chair
It’s not uncommon for patients to sleep in a recliner
because it can be a comfortable position
Positioning
Seated
(reclined)
Supine
(on back)
Side-Lying
(on non-operated side)
Infection Prevention
 To prevent infection, do not get incision wet
until your Physician says it is alright
Helpful Tips
 Pick up loose rugs and move furniture to the edges of the
room, make sure pets are out of the way
 While at home prior to surgery, move low- and high-lying
items to waist level
(i.e. in kitchen/bathroom cupboards, refrigerator)
 Arrange to be transported home in a car that is easy to get
in/out of
If You Are Staying
Overnight…
 Please bring toiletry items


Toothbrush
Toothpaste
 Incontinence products-you may prefer a
specific brand not provided by the hospital
 Books, magazines, hobby items
If You Are Staying
Overnight…
You will be oriented to your room
 Call bell
 TV Controls/Volume
 Thermostat
If You Are Staying
Overnight…
 Medications you receive in the hospital may come
in different colors and/or shapes than the same
medication you take at home
 Always ask nurse what meds are for
If You Are Staying
Overnight…
Your Surgeon may choose to use a PCA machine
PCA - Patient Controlled Analgesia
 “Pain Button”
 Administer to self
 Close monitoring
 NO ONE IS TO PUSH THE BUTTON EXCEPT
THE PATIENT!!!
If You Are Staying
Overnight…
Preventing Fever and Pneumonia
Incentive Spirometer


Breathe in 10-12 times an hour
while awake
Helps to expand air sacs in lungs
If You Are Staying
Overnight…
Condition H (Help)
 Dial 3111 and give room number
 Gives family and friends a way to call a Medical
Emergency team to the bedside
 Call if…


You notice a change in your loved one’s condition
You still have serious concerns about your loved one’s
condition after speaking to the healthcare team
If You Are Staying
Overnight…
 Dial L.O.U.D. (5683) on phone if sleep disturbed

Anonymous call
 TIGR TV Channels

Relaxation/Meditation channels
 Comfort Cart
If You Are Staying
Overnight…
Before going home…
You may fill your prescriptions at our Plaza Pharmacy
(Located on the First Floor of the hospital)
 Hours of Operation:

Mon-Fri (9:00AM-4:30PM)
 (919) 954-3921
Discharge
Please remember that once the Physician has written orders to discharge you
home, there are still many things that have to be completed before you
will be leaving the hospital. We want to make sure you have everything
you need-prescriptions, home health or rehab arrangements, and
information about your home care.
Sometimes this process can take up to 4 or 5 hours. We know you’ll be
eager to leave the hospital, and we want to be sure everything’s in place
to ensure a smooth and safe transition.
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If You Are Staying
Overnight…
Physical Therapy
If You Are Staying
Overnight…
Physical Therapy Treatment Sessions
 Available seven days/week
 One or two sessions per day with the Therapist
 A Physical Therapy/Occupational Therapy
evaluation will be performed (if you are staying
overnight in the hospital)
If You Are Staying
Overnight…
Occupational Therapy
If You Are Staying
Overnight…
 Your Occupational Therapist will evaluate your
adaptive equipment needs

Reacher

Sock aid

Bathing sponge
Pre-Surgical Checklist
Please discuss the following with your Surgeon before surgery takes
place…
 Date and time of follow-up appointment(s)
 Date and Time of Therapy appointments
 When you can shower
 When you can drive
 Exercises to perform at home
 Activities allowed/not allowed following surgery
Thank You!!!

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