| Course | NSG 123 Medical-Surgical Nursing I |
|---|---|
| Unit | Unit 5 |
| Paper type | Perioperative record |
| Length | About 380 words, 4 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | BSN |
| Updated | October 2026 |
Free sample paper for NSG 123 Unit 5
Before and After a Laparoscopic Sigmoid Colectomy: A Verified Preoperative Checklist and a Timed Postoperative Record, Each With a Watch Column
Student Name
Department of Nursing, Herzing University
NSG 123: Medical-Surgical Nursing I
Instructor Name
February 13, 2026
Before and After a Laparoscopic Sigmoid Colectomy: A Verified Preoperative Checklist and a Timed Postoperative Record, Each With a Watch Column
Context
The composite 58-year-old dispatcher from the earlier units did not settle after her drain was cleared on day 4. After discussion with the surgical team, she consented to a laparoscopic sigmoid colectomy with primary anastomosis on hospital day 7. The team's pathway follows enhanced recovery principles, which aim for early drinking and eating, early walking, and pain control that limits opioids (Gustafsson et al., 2019).
Part One: Preoperative Record, Day 7
Each item is recorded as done, refused, or not applicable, with the watch column showing what would be looked for if the item were missed or abnormal.
| Item | Status | Watch column |
|---|---|---|
| Identity confirmed with two identifiers; wristband and allergy band checked (no known drug allergies) | Done 0610 | Any mismatch stops the process until resolved |
| Signed surgical consent in chart, matching the procedure on the schedule | Done 0612 | Wording of procedure must match the operating list |
| Surgical site marked by the surgeon | Not applicable (midline abdominal procedure; per the facility's policy, marking was not required) | Policy checked, not assumed |
| Nothing by mouth status: clear carbohydrate drink finished at 0500 per pathway; no solids since midnight | Done | Report any intake after the cutoff to the anesthesia team |
| Blood glucose before surgery | Done 0615: 108 mg/dL | Levels above the pathway's threshold are reported |
| Potassium and magnesium within range this morning | Done: 4.0 mmol/L and 2.0 mg/dL | Low values can affect heart rhythm under anesthesia |
| Antibiotic due within the hour before incision, sent with patient | Done | Timing confirmed at the operating room handover |
| Venous thromboembolism prophylaxis given as ordered; compression devices applied | Done 0600 | Devices must be on and working at transfer |
| Percutaneous drain secured, output recorded (10 mL overnight) | Done | Surgeon aware that the drain remains in place |
| Jewelry, dentures, glasses removed; valuables to daughter | Done; she refused to remove her wedding ring, which was taped per policy | Tape checked at handover |
| Voided before transfer | Done 0630 | Bladder distension after surgery is harder to judge if not voided |
Education Given, in Her Words
Told about walking on the evening of surgery, early drinking, the pain plan, and the incentive to breathe deeply and cough with a pillow over the incisions. Her teach-back: "I'll be walking tonight if I can, sipping water when I wake up, and I push the button for pain before it gets bad, not after." She asked, "Will I have a bag?" and was told that the plan was to join the bowel without a stoma, and that the surgeon would explain if that changed.
Handover From the Recovery Unit
The recovery nurse's report at 1135 gave the procedure as completed laparoscopically without conversion, estimated blood loss 50 mL, no complications noted by the surgeon, one dose of ondansetron given for nausea in recovery, and a patient-controlled analgesia pump programmed with the anesthesia team's settings. The drain from the original abscess had been removed during the operation. The first set of floor observations was compared with the last recovery set before the recovery nurse left, so that any change in transfer would be noticed at once.
Part Two: Postoperative Record, Day 7 and Night
Observations at their recorded times, with the watch column naming what would change the plan.
| Time | Observations and what she reported | Watch column |
|---|---|---|
| 1140 | Arrived on floor. Drowsy, rousable, oriented. T 36.8, HR 82, BP 128/76, RR 14, SpO2 96% on 2 L. Pain 4/10. Four small port dressings dry. Drain removed in the operating room per surgeon's note. Urinary catheter draining clear yellow urine. | Sedation and respiratory rate with opioids; dressing strike-through; urine under 30 mL/h |
| 1300 | Awake. Sipping water, tolerated 120 mL. Pain 3/10 with scheduled acetaminophen and PCA available. Abdomen soft, appropriately tender. | Nausea or vomiting; abdomen becoming distended or rigid |
| 1600 | Walked 15 m with nurse and walker; mild lightheadedness settled on sitting. T 37.1, HR 88, BP 120/74. Urine 45 mL/h. | Tachycardia above 100, falling BP, new fever: possible bleeding or leak |
| 2000 | Pain 5/10 on coughing, 2/10 at rest. Used PCA twice since 1600. Drank 450 mL total. Passed no flatus yet. | Pain out of proportion to findings; abdomen distending |
| 0000 | Sleeping, rousable. RR 14, SpO2 95% on room air (oxygen stopped at 2100). Urine 40 mL/h. | Oxygen saturation below 92% off oxygen |
| 0400 | T 37.4, HR 90, BP 118/70. Pain 3/10. Dressings dry. Legs: compression devices on, calves soft. | Calf pain or swelling; temperature trend |
Sources
The preoperative verification items follow the surgical safety checklist approach, which reduced complications and deaths in a multinational study (Haynes et al., 2009), and the course medical-surgical text (Hinkle et al., 2022). Early drinking and walking follow the enhanced recovery guideline (Gustafsson et al., 2019). The patient is a composite.
References
Gustafsson, U. O., Scott, M. J., Hubner, M., Nygren, J., Demartines, N., Francis, N., Rockall, T. A., Young-Fadok, T. M., Hill, A. G., Soop, M., de Boer, H. D., Urman, R. D., Chang, G. J., Fichera, A., Kessler, H., Grass, F., Whang, E. E., Fawcett, W. J., Carli, F., ... Ljungqvist, O. (2019). Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations: 2018. World Journal of Surgery, 43(3), 659-695. https://doi.org/10.1007/s00268-018-4844-y
Haynes, A. B., Weiser, T. G., Berry, W. R., Lipsitz, S. R., Breizat, A.-H. S., Dellinger, E. P., Herbosa, T., Joseph, S., Kibatala, P. L., Lapitan, M. C. M., Merry, A. F., Moorthy, K., Reznick, R. K., Taylor, B., & Gawande, A. A. (2009). A surgical safety checklist to reduce morbidity and mortality in a global population. New England Journal of Medicine, 360(5), 491-499. https://doi.org/10.1056/NEJMsa0810119
Hinkle, J. L., Cheever, K. H., & Overbaugh, K. J. (2022). Brunner & Suddarth's textbook of medical-surgical nursing (15th ed.). Wolters Kluwer.
NSG 123 Unit 5 instructions, in plain terms
Unit 5 asks you to document preoperative preparation and postoperative care for a surgical patient. Expect to complete a verified preoperative checklist, record education given, summarize handover from recovery and document postoperative observations at set times with what each is watching for. Many versions ask how detailed the checklist should be and how often postoperative observations are taken. Check whether your section uses a facility form. Each checklist item should be recorded as done, refused or not applicable. Education should be recorded in the patient's words to show understanding. Postoperative observations follow a schedule, often every 15 minutes, then 30, then hourly. Name what each observation watches for, such as bleeding or urine output.
How the NSG 123 Unit 5 example is put together
The record opens with context explaining why surgery was needed. Part One lists checklist items with status and a watch column, covering consent, allergies, fasting, site marking and medications. The education section quotes the patient's understanding of walking and drinking early. The handover section records the recovery nurse's report. Part Two lists observations at each time with values and what they watch for. Where a value is borderline, such as low urine output, the record notes the action taken. The sources section cites the checklist and enhanced recovery evidence. The record is factual and timed, the kind of document a surgical team would rely on across shift changes.
NSG 123 Unit 5 rubric: what full points look like
Herzing's rubric for a perioperative record usually covers completeness of the checklist, accuracy of status, education, handover, timed postoperative observations and actions on abnormal values. Every checklist item and every observation time is read, so a missing entry is easy for a grader to spot. Status points reward done, refused or not applicable recorded for each item, never a bare tick. Education criteria look for the patient's own words, which show understanding rather than delivery. Handover points go to the key facts from recovery: procedure, blood loss, fluids, drains and pain plan. Action criteria reward a documented response to borderline values, such as low urine output. Enhanced recovery elements, such as walking on the evening of surgery, are often credited. Times written in the 24-hour format help. The surgical safety checklist study by Haynes and colleagues anchors the preoperative section.
Common NSG 123 Unit 5 mistakes, and how to avoid them
Perioperative records in Unit 5 often slip by checking items without stating status. Another frequent problem is postoperative observations without times. Students often omit what each observation watches for, such as bleeding or retention. Education is recorded as given rather than understood. The handover from recovery is missing or reduced to a line. Borderline values are recorded without action. Enhanced recovery steps, such as early walking and drinking, are absent. Pain scores are recorded without the intervention given or the score after it. Fluid balance is not tracked after surgery. Finally, time every observation and act on what it shows, because graders reward a record where a reader can see what the nurse noticed and did at each point.
Get a NSG 123 Unit 5 example written to your instructions
Send the Unit 5 instructions and the rubric from your NSG 123 classroom, and say which procedure the record is built around. We write a custom example that keeps the halves in their own shapes, records how each preoperative item was verified, times the recovery entries and runs a watch column beside both. First custom sample free, back in 24 to 48 hours.
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NSG 123 Unit 5 questions, answered
Does the record need a real operation?
It needs a named procedure, since the watch column depends on one, but the patient stays constructed. Choose something your course covers and keep the detail at the level the reading supports. A procedure you have only seen described in passing tends to produce a watch column of general items, which is where these documents usually thin.
How detailed should the preoperative half be?
Detailed enough that each line says what was confirmed and how. Whether your section wants a checklist, a narrative or the classroom's own form, the marks sit in the verification rather than in the format. Send the form with the instructions if you have one, since the wording of these lists differs between sections and settings.
Where does the watch column come from?
From the reading your course sets and any material the instructions name, cited. Complications listed for a procedure vary between texts, and a column with no attribution behind it falls apart the moment your instructor opens another text. Keep the entries tied to this operation and this patient rather than to the general list.
Where can I find a free NSG 123 Unit 5 sample paper?
You can read the whole NSG 123 Unit 5 perioperative record here for free, verified preoperative checklist and timed postoperative observations. A record for a different surgery can be written on request.
What goes on a preoperative checklist?
Identity, consent, allergies, fasting status, site marking, medications taken or held, removal of jewelry and devices, and education. This sample records each as done, refused or not applicable for a colectomy patient.