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Fundatmentals > Perioperative Nursing > Flashcards

Perioperative Nursing Flashcards

0
Q

Surgery performed to resolve a health problem by repairing or removing the cause

A

Curative

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1
Q

Surgery performed to determine the origin and cause of a disorder or the cell type for cancer

A

Dagnositc

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2
Q

Surgery performed to improve a patient’s functional ability

A

Restoritive

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3
Q

Surgery performed to relieve the symptoms of a disease process, but not to cure the disease

A

Palliative

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4
Q

Surgery performed primarily to alter or enhance personal appearance

A

Cosmetic

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5
Q

Surgery planned for correction of a nonacute problem

A

Elective

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6
Q

Surgery that requires prompt intervention; may be life threatening if treatment is delayed more than 24-48 hours

A

Urgent

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7
Q

Surgery requiring immediate intervention because of life-threatening consequences

A

Emergent

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8
Q

Type of procedure where only the most overtly affected areas are involved in the surgery

A

Simple

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9
Q

Extensive surgery beyond the area obviously involved

A

Radical

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10
Q

What is the purpose of radical surgery?

A

Finding a rot cause of the problem

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11
Q

Surgery performed in a body cavity or body area through one or more endoscopes; can correct the problems, remove organs, take tissue for biopsy, reroute blood vessels and drainage systems

A

Minimally invasive surgery

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12
Q

What are the benefits for the patient of ambulatory surgery?

A

Less anesthesia, less healing time, smaller scars, less hospital stay, less opioid medications

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13
Q

Why are older patients at an increased risk for complications in surgery?

A

The normal aging process decreases immune system functioning and delays wound healing

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14
Q

When anesthetizing a patient, what do you specifically have to ask them about?

A

Cardiac disease and problems

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15
Q

What kinds of complications are more likely to occur in older patients?

A

Pulmonary

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16
Q

What should the preoperative nurse be assessing her patients for?

A

Current health problems, potential complications related to anesthesia, and potential complications that may occur after surgery

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17
Q

Which electrolyte imbalance is absolutely critical to correct before surgery?

A

Potassium

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18
Q

What does anesthesia do?

A

Blocks nerve impulses, suppresses reflexes, promotes muscle relaxation

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19
Q

When and where does the induction phase of anesthesia occur?

A

In the waiting room before the surgery

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20
Q

What is done during the induction stage of anesthesia?

A

Prep, put in the IV, consent must be done, pre-medications

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21
Q

What occurs during the maintenance phase of anesthesia?

A

Positioning of patient, prepping the skin, surgical procedure

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22
Q

What occurs during the emergence phase of anesthesia?

A

Reversal or decrease of drugs causes patient to awaken

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23
Q

Loss of sensation in an area of the body due to a nerve block of multiple peripheral nerves

A

Regional anesthesia

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24
Q

Loss of sensation at application site only

A

Local anesthesia

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25
Q

In a patient with spinal anesthesia, what do you have to watch especially for?

A

Respiratory paralysis, drop in blood pressure, and loss of sensation in fingers and toes

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26
Q

How can respiratory paralysis be prevented in patients with spinal anesthesia?

A

Elevation of the upper body

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27
Q

Why does spinal anesthesia cause a drop in blood pressure?

A

Vasodilation associated with the block

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28
Q

Anesthesia that depresses the level of consciousness while allowing maintenance of reflexes

A

Conscious Sedation

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29
Q

What is the nurse’s responsibilities for a patient in conscious sedation?

A

Monitor and check the airway, LOC, O2 saturation and ECG

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30
Q

What increases the risks of anesthesia?

A

Fluid and electrolyte imbalance, respiratory complications, cardiovascular disease, obesity, diabetes, renal disease, and sleep apnea

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31
Q

Why does sleep apnea increase the risk of anesthesia?

A

Can’t metabolize anesthesia well

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32
Q

Why does obesity increase the risk of anesthesia?

A

Patients are often malnourished and the meds are desponsited in the fatty tissue

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33
Q

What happens during surgery to mess up fluid and electrolyte balances?

A

Increase in ADH and aldosterone, stress hormones are released, and platelet aggregation increases

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34
Q

Why are malnourished patients at a higher risk of surgical complications?

A

Negative nitrogen balance can cause impaired healing

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35
Q

Why does diabetes increase surgical risk for complication?

A

Increased susceptibility to infection, impaired wound healing

36
Q

Why do respiratory problems increase the risk for surgical complications?

A

Difficulty clearing secretions, reduces means to compensate for acid/base alterations

37
Q

Why does liver disease increase the risk for surgical complications?

A

Alters drug metabolism, impairs wound healing, impaired clotting times

38
Q

What preoperative diagnostic tests should be run on patients?

A

CBC with diff, coagulation studies, BUN, creatinine, ECG, pulmonary function tests, and type and cross match

39
Q

What is the duty of the physician in obtaining informed consent?

A

Explain the nature and reason for the surgery, who will be performing it, all available options and risks

40
Q

What is the nurse’s responsibility in obtaining informed consent?

A

Witness the explanation and the signature

41
Q

Minimally, what must be verified by all members of the surgical team?

A

Patient’s identity, correct site and side, correct patient position, and agreement on the proposed procedure

42
Q

Why are patients made NPO before surgical procedures?

A

To ensure that the stomach contains a limited volume of gastric secretions to decrease the risk of aspiration

43
Q

Which types of drugs are commonly allowed on the day of a surgical procedure, despite NPO status?

A

Drugs for cardiac disease, respiratory disease, seizures, and hypertension

44
Q

What teachings should a nurse do for the preoperative patient?

A

Diaphragmatic breathing, splinting, leg exercises, turning and mobility, equipment, medications

45
Q

How can the nurse monitor fluid and electrolyte balance in a preoperative patient?

A

Weigh them

46
Q

What is the most important way to prevent surgical infection?

A

Antibiotics before surgery

47
Q

What must be in the patient’s chart before surgery?

A

Signed and witnessed consents for the procedure and for blood transfusions, history and physical completed, diagnostic test results, baseline vitals and nurse’s notes

48
Q

When do the 3 surgical time outs occur?

A

Before anesthesia, before surgery starts, and before the patient leaves the OR

49
Q

Registered nurses who coordinate, oversee, and are involved in the patient’s nursing care in the OR

A

Circulating nurses

50
Q

Prepares supplies and equipment on the sterile field, maintains safety, does a sharps count

A

Scrub nurse

51
Q

When are counts of the equipment performed?

A

Before the procedure, during the procedure as items are added, at the closure of the first layer of the surgical wound, and immediately before the complete skin closure

52
Q

Which members of the surgical team are not scrubbed in?

A

Anesthesia provider and the circulating nurse

53
Q

What adverse reactions to anesthesia may the patient display during emergence?

A

Retching, vomiting, and restlessness

54
Q

When a patient is experiencing malignant hypothermia, what electrolyte imbalances will he display?

A

Hypercalemia and hyperkalemia

55
Q

How often should the vital signs of a postoperative patient be taken?

A

Every 5 minutes

56
Q

What is the best way to minimize skin breakdown during surgery?

A

Pad bony prominences

57
Q

What is the most sensitive indication of malignant hypothermia?

A

An unexpected rise in the end-tidal carbon dioxide level, along with a decrease in the oxygen saturation

58
Q

Once discharged from the PACU, how often should vitals be taken?

A

q15 minutes x 4, q30 minutes x 4, q1 hour x four, q4 hours

59
Q

What are the postoperative risks for all patients?

A

Pneumonia, shock, cardiac arrest, respiratory arrest, venous thromboembolism, and GI bleeding

60
Q

What is the priority assessment of a postoperative patient upon admission to the PACU?

A

Patent airway and adequate gas exchange

61
Q

What are the “4 W’s” of postoperative complications?

A

Wind, wound, water, walk

62
Q

What is the treatment for malignant hypothermia?

A

Dantrolene

63
Q

What can cause a postoperative patient to have hypotension?

A

Supine positioning and hypometabolism

64
Q

What are the nurse’s priority focuses for a postoperative patient?

A

Maintain airway and body temperature

65
Q

If left untreated, what does atelectasis turn into?

A

Hypostatic pneumonia

66
Q

How often should the lungs of a postoperative patient be checked?

A

q4 hours x 6, then q8 hours

67
Q

How much of a difference in systolic or diastolic blood pressure is reportable to the surgeon?

A

15-20 point difference or 25%

68
Q

How often should the level of consciousness of a postoperative patient be assessed?

A

q4-8 hours

69
Q

What type of vein distention can indicate fluid overload?

A

Carotid

70
Q

What types of IV fluids are generally used for fluid replacement in the PACU?

A

Isotonic solutions

71
Q

What is the best indicator of intestinal activity?

A

Passage of flatus or stool

72
Q

What fluid and electrolyte imbalances can occur with NG tubes?

A

Fluid volume deficit, hypokalemia, hyponatremia, hypochloremia, and metabolic alkalosis

73
Q

What is the minimum expected urine output for postoperative patients?

A

30mL/hr

74
Q

At what point does serosanguineous drainage indicate dehiscence?

A

Beyond day 5

75
Q

In what patients is wound separtation more likely to occur?

A

Diabetic, immune deficient, malnourished, or steroid using patients

76
Q

How often should a postoperative patient’s dressings be checked?

A

q8 horus

77
Q

When does surgical pain usually reach its peak?

A

Post op day 2

78
Q

At what point should patients be voiding after surgery?

A

6-8 hours postoperative

79
Q

At what point can a patient eat after surgery?

A

When the gag reflex has returned

80
Q

In what types of surgeries is nausea and vomiting most seen?

A

Abdominal, eye, ear, intracranial, and testicular surgeries

81
Q

What are the effects of early ambulation?

A

Increases smooth muscle tone, improves GI/GU function, stimulates circulation/prevents venous stasis, and increases vital capacity to increase respiratory functions

82
Q

At what point would a wound infection start to become evident?

A

3-4 days postoperative

83
Q

What type of dressing should be used on a infected surgical wound?

A

Wet to dry

84
Q

How often should a wet to dry dressing be changed on an infected surgical wound?

A

1 to 3 times/day

85
Q

Why are wet to dry dressings used on infected surgical wounds?

A

They promote healing from within and debridement

86
Q

What should a postoperative patient’s diet be high in?

A

Protein, calories, and vitamin C

87
Q

What do snoring sounds when inhaling indicate in a postoperative patient?

A

Respiratory depression

88
Q

How should a postoperative patient with respiratory depression be positioned?

A

Side-lying with the head in a neutral position

Fundatmentals (6 decks)

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