Surgical Assessment- EXAM 2

Question 1

3 stages of preoperative care

Answer 1

Preoperative
Intraoperative
Postoperative

Question 2

Post anesthesia care unit

Answer 2

Receives general anesthesia patients after surgery

Question 3

Intensive care unit

Answer 3

Receives patients who are critical after surgery
airway patency is the priority!!!
EKG monitor, vitals, pulse ox and pain meds are done

Question 4

Postop assessment

Answer 4

Patient airway, airway hygiene, O2, SAT, ventalation
Seeing ability to move limbs and regain sensation from anesthesia
Watch cardio status
Ensure safety, bed rails, bed alarm
Fluid status

Question 5

What do you assess and report immediately, Post-op

Answer 5

Decreased level of consciousness or unresponsivness
Respiratory rate less than 10 breaths per minute
O2 stat below 92%
Tachycardia or bradycardia
Hyper or Hypo tension
Weak/absent pulse
Urine output < 30 ml per hour
Excessive bleeding at incision site

Question 6

Post-Op Medication types

Answer 6

Antimetic and pain meds

Question 7

Antimetic meds

Answer 7

Used in post-op to decrease nausea and vomitting
Zafron
Reglan
Decadron

Question 8

Pain meds

Answer 8

To relieve pain, lower b/p and pulse
Dilaudid
Morphine
Fentanyl

Question 9

What to do in an unstable patient, airway

Answer 9

Remain intubated, transferred to ICU and placed on ventilator

Question 10

What to do to a stable patient, airway

Answer 10

Extubated before transferred to post op care
Placed in sitting positioning sternum rub may be required

Question 11

What do you use to reverse respiratory depression caused by narcotics

Answer 11

Narcan

Question 12

JP and Hemovac drain

Answer 12

Work by suction
Placed during surgical prod=cedure to collect fluids from inside the surgical area

Question 13

Penrose drain

Answer 13

Placed inside the suture

Question 14

Suture types and when used

Answer 14

Staples: faster, skin heals better but is more expensive
Sutures: absorbable/non, using depends on tissue being sutured
Steri strips: used on not so deep indications

Question 15

How do you prevent postoperative complications

Answer 15

Incentive spirometer
TED stockings
Coughing and deep breathing
Wound care
Managing constipation
Managing pain
Infection prevention

Question 16

Compression socks

Answer 16

Prevent DVT with ambition
Need to be properly fitted

Question 17

Incentive spirometer

Answer 17

Used to prevent complications of pneumonia or atelectasis
Induces long slow deep breathing
Promotes lung expansion

Question 18

Safety considerations done before surgery is conducted

Answer 18

Check right person, right site and right procedure
Make sure patient is awake and aware
Patient has to be able to acknowledge and sign documents
Doctor will initial area needing surgery

Question 19

Malignant hyperthermia

Answer 19

Temperature goes above 100F
Rare and life threatening, caused by inherited gene
Can occur during anesthesia, during recovery shortly after surgery
S&S: muscle rigidity, JAW TIGHTENING will be first symptom, increasing calcium in the blood, high fever, fast heart rate, shallow breathing problems with low oxygen

Question 20

Immediate treatment to malignant hyperthermia

Answer 20

Dantrolene, stops the release of calcium in the muscle

Question 21

Malignant hypothermia

Answer 21

Temperature goes below 95F, results from defect in the storage of calcium
Occurs during surgery
More common in patients at extreme ages, undergoing abdominal surgery or procedures of a long duration

Question 22

Treatment of malignant hypothermia

Answer 22

With forced air warming device
Heating blankets too can restore body temp

Question 23

Patient teachings during discharge

Answer 23

Take medication as ordered
Avoid alcohol while taking meds
Change dressing as ordered to prevent infection
Report any increase in redness, swelling, pain or discharge from the incision or draining site
Increase activity as ordered
Get adequate sleep, nutrition and hydration
Follow up with post-op doctor appointment

Question 24

Preop teachings done to avoid post op complications

Answer 24

Cough and deep breathing: splinting
Caring for surgical incision
Pain managment
Managment of constipation
Advance diet as directed
Increase activity according to orders
FOLLOW UP with post op appt.

Question 25

What do you establish in care of infants

Answer 25

Full or pre term
Pre-terms are more prone to respiratory complications
Special care to reparatory status, glucose regulation, fluid and electrolytes balance