Lecture 2.1 - Peri and Post-Op Care Flashcards
(40 cards)
What is inpatient surgery?
Same-day admission
What is ambulatory surgery?
Procedures that take less the 2 hrs and usually less than 3-4 hours in PACU/PARR
When is information about medications collected during the preoperative assessment?
Immediately in ER, weeks in advance for elective
When does a person begin NPO before elective surgery?
from midnight the night before
What is malignent hyperthermia?
An increase in temperature and muscle contractions - adverse effect of general anesthesia for some people. Must determine if there is a history during preoperative assessment
Why might information about previous surgeries be important before another?
Tells story of medical Hx, presence of scar tissue can cause problems.
What is delirium tremens? How is it treated?
Seizure, agitation, tremor associated with alcohol withdrawal.
Treated with valium (diazepam or other benzos)
Why is deep breathing and coughing so important post-operatively?
Prevent alveolar collapse (atelectasis)
What are the three types of information a patient might want preoperatively?
Sensory
Process (general flow of locations and what is to be expected)
Procedural (More details such as where IV will be started, what to expect at each location)
What is the nursing role on the day of surgery, during preparation?
Communication, final pre-op teaching, and readiness
verify signed consent
Why might anticholinergics be used in preop pts?
To reduce secretions
What is the role of the perioperative nurse?
To prepare the room with the team and act as a patient advocate throughout the surgical experience
What is the role of the circulating nurse during a surgery?
Not scrubbed, gowned, gloves
Remains in unsterile and documents
What is the role of the scrub nurse during surgery?
To follow designated scrub procedure, remain gowned and gloved in sterile attire, and to remain in the sterile field.
What is the role of the Registered Nurse First Assistant?
To handle tissue and instruments, provide exposure to the surgical site, and assist with homeostasis. Might perform suturing.
Required additional education.
What is the difference between local and regional anesthisia?
Local is smaller area, regional is loss of sensation of an entire nerve group.
What are the initial priorities during assessment right after surgery?
Vitals, neuro, GU/GI, assessment of surgical site and dressing, communication with pt
Why is early ambulation so important in post-op patients?
Prevents blood clots and stimulates peristalsis (can take up to 72 hours for normal resumption of ileus peristalsis)
What are the most common causes of airway compromise during the post-op period? Who is most at risk?
Obstruction, hypoxemia, hypoventilation d/t sedation or pain
Those who receive general anesthesia, are older, or smoke heavily are at higher risk
What are potential alteration of the respiratory system common in patients postoperatively?
Atelectasis
–> Most common (alongside aspiration pneumonia) after abd and thoracic surgery
Pulmonary edema
Aspiration of gastric contents –> Pneumonia
What causes atelectasis? What is is characterized by?
Obstruction of bronchi from retained secretions or decreased resp excursion.
No lung sounds will be present in the collapsed lung
What can cause Pulmonary Edema? What signs are indicative of it?
Can result from fluid overload, left-Vent failure, prolonged airway obstruction, sepsis, aspiration
Characterized by hypoxemia, crackles, decreased compliance, infiltrates on X-ray.
What are some signs of hypoxemia?
tachypnea, gasping, apprehension, restlessness, and a rapid, thready pulse.
What are the most common complications in CDV function postoperatively?
Hypo, HTN, Dysrhythmias
