To help prevent errors in the surgical procedure, the National Patient Safety Goal instituted a directive that prior to presurgical medication, each patient must:

A. Stage III and the patient has depressed reflexes. Stage III of anesthesia is the surgical stage, where the patient is under deep anesthesia, and reflexes are typically depressed. However, tensed muscles and irregular respirations may indicate that the patient is still in an earlier stage of anesthesia (stage II).

B. Stage IV and the patient will not depend on the anesthesia machine for oxygenation. Stage IV is the deepest level of anesthesia, where respiratory and cardiovascular functions are severely depressed. It does not match the description of tensed muscles and irregular respirations, which are more characteristic of an earlier stage (stage II).

C. Stage II and the surgical environment should be kept quiet. Stage II of anesthesia is the excitement stage, where patients may exhibit tensed muscles, irregular respirations, and uncoordinated movements. The surgical environment should be kept quiet to minimize stimuli that could cause agitation or further excitement in this stage.

D. Stage I and the patient's hearing is amplified. Stage I is the stage of anesthesia where the patient is still conscious and responsive to stimuli. The description of tensed muscles and irregular respirations does not match this stage. Additionally, the patient’s hearing would not be amplified in stage I, but rather in stage II or as they begin to emerge from anesthesia.

A. When still conscious, participate in marking the surgical site. The surgical site marking should be done with patient participation before anesthesia to confirm accuracy and prevent wrong-site surgery.

B. Have a photograph of the surgical site in the medical record. Photographs are not a standard requirement for surgical verification.

C. Have the unit nurse confirm their identity. Identity confirmation is necessary but not sufficient to prevent wrong-site surgery. Marking the site is the key step.

D. Verbally state the location of the surgical site and the expected procedure. Verbal confirmation is important but should be combined with physical marking of the site to ensure accuracy.