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NUTRITIONAL CARE OF A SURGERY PATIENT

Updated on August 29, 2016

PREOPERATIVE NUTRITIONAL CARE

Surgery places great physiologic and psychological stress on the body. Nutritional demands are greatly increased; Deficiencies can easily develop and sooner or later lead to serious clinical problems. Thus careful atten­tion to preoperative preparation of the patient and to his postoperative therapeutic needs reduces complications and provides resources for better wound healing and a more rapid recovery.

PREOPERATIVE NUTRITIONAL CARE

NUTRIENT STORES

When time permits, in cases of elective surgery rather than emergency situations, nutritional preparation of the patient for sur­gery should correct any nutrient deficiencies that exist, The diet should also provide op­timum reserves for the period of surgery itself and for the time immediately afterward, when no oral feedings can be taken, These nutrient stores particularly demand protein, calories, vitamins, and minerals.

Protein

The most common nutritional deficiency in surgical patients is that of protein. Tissue and plasma reserves are imperative to fortify the patient for blood losses during surgery and for tissue breakdown in the immediate postoperative period.

Calories

If protein is to be used for its building purposes, sufficient non-protein calories must always be provided for energy demands. If underweight is present to any degree, sufficient extra calories have to be provided to build the weight up to maintenance level. Glycogen stores in the liver are necessary to spare protein for tissue synthesis. If the patient is overweight, some weight reduction is indicated to reduce surgical risk.

Vitamins and minerals

Tissue stores of vitamins are needed for the added metabolism of carbohydrates and proteins. Any deficiency state such as anemia should be corrected. Electrolytes and fluids should be in balance and correction made of any dehydration acidosis or alkalosis.

Immediate preoperative period

In the usual preparation for surgery, nothing is given by mouth for at least 8 hours prior to surgery; this assures that the stomach has no retained food at the time of the operation. Food in the stomach may be vomited and aspirated during anesthesia or recovery from it. Also any food present may increase the possibility of postoperative gastric retention or expansion or interfere with the surgical procedure itself.

If the surgery is of an emergency nature, no time is available for building up nutritional reserves. This is all the more reason for maintaining an optimum nutrient reserve supply constantly through an optimum daily diet.

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