Vascular Surgery 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 Vascular ultrasound date ________
ξ CT scan and/or MR scan date ________
ξ Pulmonary function tests date ________
ξ Other: ________________________________
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
ξ Meet with nurse practitioner or physician’s assistant
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 complete a Power of Attorney (POA) for Health Care or Living. Will before
surgery. A POA allows you to name someone who could speak for you if are 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.
Before and after surgery
You may wish to stay in Madison the night before your surgery if you do not live nearby. Guest
Service, (608) 263-0315, can provide you with a list of hotel’s in Madison. They can arrange for
your stay at a discount rate. When you leave the hospital you will need someone to drive you
home and stay with you.
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 © 3/2016. University of
Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7886.