Patient Pre-op Checklist
First visit: Meet with Surgeon
Specific pre-op tests will be determined at this visit. These tests will need to be done before your
Pre-op Tests may include
ξ Echo date ________
ξ Cardiac catheterization date ________
ξ Carotid ultrasound date ________
ξ CT scan date ________
ξ Pulmonary function tests date ________
ξ Other: ________________________________
Considerations for Post discharge to discuss and arrange with family before
Plan to stay in the hospital for 4-5 days. When you leave the hospital, you will need to have
someone drive you home and stay with you for at least the first week. You will not be able to
drive for 4 weeks. You will have lifting restrictions for 12 weeks after surgery. If you do not
have enough help at home, you may want to consider a short stay at a rehab center.
Dental appointment and screening
See your dentist before your valve or aneurysm surgery. If you have a problem getting an
appointment, please contact your surgeon’s office for help.
If you smoke, try to stop smoking or at least cut back before surgery. Smoking impairs and
delays healing. Ask your doctor or nurse if you need help to quit.
Second visit: Pre-op Work-up
ξ Have blood drawn in the lab and a chest x-ray done.
ξ Meet with nurse practitioner or physician’s assistant.
ξ Meet with Learning Center nurse.
ξ Meet with Anesthesia Screening Clinic nurse.
ξ Do other tests before surgery, if needed.
Arrange for leave from work, if needed
Your surgeon’s office will help you fill out Family and Medical Leave Act (FMLA) papers or
other leave paperwork. Please contact their office if you need help.
May Complete a Power of Attorney for Health Care or Living Will
You may want to consider completing a Power of Attorney (POA) for Health Care or Living
Will before surgery. A POA allows you to name a health care agent who could speak for you if
were not able to understand your health care choices and make your wishes known. If you need
help with this, please contact your surgeon’s office.
Home or closer place to stay night before surgery
You may wish to stay in Madison the night before your surgery if you do not live nearby. A
Housing/Hotel Accommodations Coordinator, (608) 263-0315, can provide you with a list of
hotels in Madison. The coordinator can also arrange for your stay at a discount rate.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor.
This is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because
each person’s health needs are different, you should talk with your doctor or others on your health care team
when using this information. If you have an emergency, please call 911. Copyright © 5/2017 University of
Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7245