I- Pre- operative care :
1 - psychological preparation
It starts with the quality of care within the service. Surgeon operated inform the purpose and progress of the operation
The nurse reassured by creating an atmosphere of calm and confidence
2 - Pre -operative assessment and correction of disorders
Take samples for laboratory tests
 rhesus Group
 Urea, glucose
 NFS , VS , hematocrit
 protidemia
Ionogram  blood and urine
Locate and note : proteinuria , glycosuria, ketonuria
Monitor and record constants ( pulse , blood pressure, weight, urine output )
Make appointments for lung radio and ECG
Achieve the requirements of intensivist physician ( transfusion , electrolyte balances hydro , antibiotics , etc ... ).

3 - preparing the future made ​​: depending on the type of intervention, outside the scope of the emergency

3-1 preparation bowel
Three to four days before the date of the intervention
To give enemas or purgatives as prescribed , raise intestinal disinfectants
Monitoring regime to be without residue, rich in calories, do call by the dietician
The respiratory physiotherapy : learn future made ​​to cough and spit effectively required to aerosol
3-2 local preparedness
The day before surgery , help the person to make a full careful toilet
To the surgical field : soaping , shaving pubic chest , brushing with antiseptic and cover with a sterile field (depending on service )
Leave fasting the day before surgery

4 - the morning of surgery

Reassure future surgery
Ensure it is Fasting
To urinate or ask a urinary catheter ( aseptically )
Check drape
Put boots, shirt , hat
Remove jewelry, dentures
Take constants , do the analyzes ( note on the sheet temperature )
Premedication three quarters of an hour before the procedure , note premedication on anesthesia record
Allow the patient lying flat calm
Check the folder ( biological assessment , radiological assessment , ECG)
To provide transportation to the operating room of the future accompanied by his record

5 - during the stay in the operating room
Make room cleaning , the air
Remaking the bed without a pillow or bolster , warm with an electric blanket to remove the back of the patient
Gather in the room all the equipment necessary for the care and supervision
II- post- operative care
1 - return to the operating room

 To inform the type and outcome of surgery
 Install operated flat on the side hypertension
 Connect :
- The digestive suction probe on the jar and adjust the pressure (40 to 70 cm of water)
- The bladder catheter to a collector
 To monitor the recovery of every quarter of an hour consciousness :
- The pulse , blood pressure , heat and the color of the integument
- The degree of awareness
- Ventilation ( rate, frequency , amplitude, color)
- Diuresis
- Nature and volume losses externalized by drainage
- The state of the dressing
Note all these parameters on the monitoring sheet and report any discrepancies immediately
2 - care and monitoring after waking
 upon regaining consciousness , put operated in a semi-sitting position
 strive to create an atmosphere of calm physical and moral
 digestive continuous suction
 inform the patient , family, staff of the ban on oral intake ( beverages, food) the duration of the digestive aspiration
 ensure the permeability of the probe , the probe needed to irrigate the syringe with 20ml of saline
 monitor the effectiveness of the vacuum system, change jars each day and fittings ( must be sterile )
 daily note on the balance sheet of the suction volume
 mobilize the probe and attach it to the cheekbone to prevent ulceration of the nose wing
 make oral care and frequent nose
 when tested clamping before removal , monitoring and reporting nausea, vomiting, bloating

Intravenous resuscitation :
 have constant concern to save the venous capital and maintain a permanent vascular access
 prepare , ask infusion bottles with a maximum aseptic
 respect infusion volumes , flow monitoring
 Monitor 2 times daily input and venous path item . The smallest inflammatory signs order to remove the infusion and possible cultivation of the catheter.
The balance of inputs and outputs: The set scrupulously at least once a day.
Hygiene and comfort:
To support the early days of personal hygiene care , rehabilitation bed
To preventive care bedsores , put a mattress alernating if necessary .
3 - Prevention of complications :
 Raise the operated as soon as possible, to help keeping the wound with a bandage body.
 Make mobilize frequently the lower limbs, monitoring calves.
 If the power is prescribed anti- coagulate , to inject the fixed hours.

4 - Local care. Asepsis + + +
 Make the dressing median to the 2nd or 3rd day, suture removal du10éme the 12th day on the advice of the surgeon.
 Dressing, exchange , removal of abdominal drainage

5 - monitoring :
The nurse must ensure a careful and prolonged ; note the parameters on the monitoring sheet and report any discrepancies .
* Clinical Supervision:
State of consciousness and alertness
ventilation State
Pulse, blood pressure , venous pressure
temperature
State of the abdomen and appearance of losses externalized peritonitis ,
surgical wound
Laxation + + +
Biomonitoring case basis on medical advice. :
Draw blood for urea , electrolytes , hematocrit, protein
A sample of 24-h urine for electrolytes , check pH of urine

6 - recharge :
Remove from gastric aspiration laxation (gas ) to 3rd, 4th
Make contact with the dietician who established. It will very gradually after the resumption of transit in conjunction with parenteral nutrition to ensure proper nutritional balance Monitor transit + + + +, frequency, appearance of stool
Supplies liquid , semi liquid , with progressive reintroduction of cooked cereal ; meat, raw butter, toast ...... etc. .