What is the best method for the nurse to obtain information about the patients possible use of substances?
Patients who smoke are urged to stop 4 to 8 weeks before surgery to significantly reduce pulmonary and wound healing complications. Preoperative smoking cessation interventions can be effective in changing smoking behavior and reducing the incidence of postoperative complications. Patients who smoke are more likely to experience poor wound healing, a higher incidence of surgical site infection, and complications that include venous thromboembolism and pneumonia.
The nurse who is obtaining the patient's health history needs to ask frank questions with patience, care, and a nonjudgmental attitude. If alcohol abuse is suspected, additional information may be obtained by using common alcohol screening questionnaires such as the CAGE (Cutting down, Annoyance by criticism, Guilty feelings, and Eye-openers) (Ewing, 1984), AUDIT (Alcohol Use Disorders Identification Test), TWEAK (Tolerance, Worry, Eye-opener, Amnesia, Kutdown) (Chan, Pristach, Welte, et al. 1993), or SMAST (Short Michigan Alcohol Screening Test). The MAST (Michigan Alcohol Screening Test) has been updated to include drug use and has a geriatric version (The New York State Office of Alcoholism and Substance Abuse Services [OASAS], 2007).
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