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Managing the Surgical Experience Flashcards

Exam 1 (60 cards)

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1
Q

What is the role of the preoperative nurse?

A

Educator
Advocate

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2
Q

What is included in the preoperative checklist?

A

Documentation
Assessment
Physical preparation
Educational needs

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3
Q

Informed Consent components include: name of who?

A

Name of surgeon to perform surgery

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4
Q

Informed Consent components include: consent for?

A

Consent for procedure itself
Consent for anesthesia
Consent to administer blood products

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5
Q

Informed Consent includes reason for what?

A

Reason intervention will benefit the patient

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6
Q

Informed Consent also include alternatives to what?

A

Alternative options to surgery

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7
Q

What is included in Time Out/Pause for a Cause?

A

Correct patient

Correct procedure

Correct surgical site

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8
Q

Patient Assessment includes (include 6 things)

A

Patient History
Age
Allergies and sensitivities to latex
Current medications, including over-the-counter medications, vitamins, and herbal supplements
Medical history and treatment plans
Surgical history

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9
Q

Patient Assessment includes (include 5 things)

A

Previous anesthesia and responses to anesthesia
Last oral intake
Any medical implants or devices
Any piercings
Dental implants

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10
Q

Patient Assessment: What is included in Patient History?

A

Nutrition deficiencies
Family history
Social history, including smoking and drug and alcohol habits
History of mental illness or abuse
Support system and living conditions
Advance directives

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11
Q

What systems are assessed?

A

Cardiovascular
Respiratory
Neurological
Liver/renal
Integumentary
Gastrointestinal
Genitourinary

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12
Q

Patient Preparation for the Surgical Experience includes:

A

Laboratory assessment

Radiological assessment

Patient teaching
Anticipatory guidance
Recovery
D V T prophylaxis
Mobility
Preventing pneumonia

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13
Q

Patient Preparation for the Surgical Experience: What is included in patient teaching

A

Patient teaching
Anticipatory guidance
Recovery
D V T prophylaxis
Mobility
Preventing pneumonia

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14
Q

Physical Preparations

A

Intravenous line
Bowel and bladder preparation
Skin preparation
Medications

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15
Q

Physical Preparations: What should you ensure prior to transfer?

A

Consents completed
History and assessment complete
Learning needs met
Skin and bowel prep complete
Preoperative medication administered

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16
Q

Intraoperative Management includes

A

Roles and responsibilities of O R team members
Priority assessments
Anesthesia
Airway management
Risks and complications
Support strategies

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17
Q

Surgical Settings

A

Inpatient surgical settings
Ambulatory or outpatient surgical settings

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18
Q

Surgical Categories

A

Elective surgery
Urgent surgery

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19
Q

Surgical Team Members: Sterile team members include:

A

Surgeon
Surgical assistants
Scrub nurse or surgical technologist

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20
Q

Priority Assessments and Procedures (continued): What is included in the surgical pause?

A

Surgical pause
Correct patient
Correct procedure
Correct surgeon
Correct position
Correct equipment
Correct imaging studies

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21
Q

Surgical scrub- What do you use?

A

Long-acting antimicrobial soap

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22
Q

What occurs during a surgical scrub?

A

Long-acting antimicrobial soap

3-5 minutes
Jewelry removed
Nails clean and short

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23
Q

Priority Assessments and Procedures (continued): What is done with attire?

A

Donning of surgical attire
Scrubs
Surgical attire

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24
Q

Two types of anesthesia

A
  1. General anesthesia
  2. Regional anesthesia
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25
General anesthesia
Being put to sleep Reversible unconscious state Variety of methodologies
26
Anesthesia: Variety of methodologies
Volatile agents IV agents Muscle relaxants Complications
27
Regional anesthesia includes:
Spinal Epidural Caudal Nerve block
28
What does airway management mean in surgery?
Protecting and ensuring proper oxygenation and ventilation
29
What are complications associated with airway management?
1. Laryngo-spasm 2. Bronchial intubation 3. Tracheal and esophageal perforation 4. Aspiration
30
Common Intraoperative Positions include:
1. Supine 2. Trendelenburg 3. Reverse Trendelenburg 4. Fowler's
31
Positioning Devices
O R bed Headrest Arm boards Arm restraints Padding Blankets Pillows Safety straps Sandbags Bean bags Towels Foam pads Gel devices
32
Nursing Management: Nursing Diagnoses
Risk for impaired tissue and skin integrity Risk for infection Risk for injury Risk for knowledge deficit Risk for potential unplanned hypothermia Risk for potential thrombus
33
Nursing Management: Assessments- What are RNs ensuring?
Ensure OR consent is signed Ensure correct patient positioning Ensure supplies are available
34
Nursing Management: Assessments- What are RNs monitoring?
Monitor donning of OR attire Check fluid and instruments for temperature Confirm flashed instruments are cool
35
Nursing Management: Actions of the nurse include:
Keep patient warm Maintain sterile field Accurately record number of sponges and sharps Accurately measure irrigation fluid Keep OR doors closed Keep hallways clear of equipment
36
Postoperative management occurs when:
1. Begins immediately after surgery 2. Continues until first follow up appointment
37
What occurs in Post-Anesthesia Care Unit (PACU)?
1. Close observation after anesthesia 2. Control pain 3. Prevent complications
38
What are the three levels of PACU care?
1. Phase I 2. Phase II 3. Phase III
39
What does Phase I of PACU care involve?
Phase I involves the nursing care provided in the immediate postanesthesia period.
40
What occurs during Phase I?
There is intense, close monitoring, including blood pressure, respiratory rate, oxygen levels, cardiac monitoring, level of sedation, and end-tidal CO2 monitoring, or capnography.
41
What is the goal of Phase I?
The goals of care in this phase are to stabilize the patient’s vital signs, allow the patient to wake up from anesthesia, and achieve adequate pain control.
42
When would a patient transfer from Phase I to Phase II?
● An awake patient with a stable airway ● Adequate oxygen saturation ● Stable vital signs and hemodynamic status
43
What is the focus of phase II?
In phase II, the focus of nursing care is on preparing the patient to be discharged to an extended-care environment or home.
44
What occurs during Phase II?
While in phase II, nursing staff and the multidisciplinary team will work with the patient and their care team to bring the patient to an optimal level of functioning, including mobility and taking food by mouth, if appropriate.
45
What does Phase III focus on?
Phase III, or extended observation of postanesthesia care, focuses on providing ongoing care for patients remaining in the postoperative care area after discharge criteria have been met.
46
What occurs during phase III?
The nurse continues to monitor and provide care to this patient.
47
What is the goal of Phase III?
The goal is to prepare the patient for transfer to an inpatient unit when a transfer bed is made ready or for self-care and discharge home.
48
Patient Care in the Post-Anesthesia Care Unit includes:
Assessment and monitoring Timely interventions Evaluation of interventions Reassessment of patient condition Evaluation
49
Patient Care in the Post-Anesthesia Care Unit - What are the priority assessment?- list 5
Airway patency Respiratory status Viral signs Neurologic function Temperature and skin color
50
Patient Care in the Post-Anesthesia Care Unit - What are the priority assessment?- list 5 more.
Pain Condition of dressings Condition of visible incisions Patency of I V catheters and drains Hydration status
51
Patient Care in the Post-Anesthesia Care Unit: Diagnostic tests
Labs Chest radiograph Electrocardiogram
52
Patient Care in the Post-Anesthesia Care Unit: Pain Management includes:
Pain management Analgesics Non-pharmacologic interventions Patient-controlled analgesia
53
Patient Care in the Post-Anesthesia Care Unit: Managing postoperative nausea and vomiting
Complications Risk factors Treatment
54
Patient Care in the Post-Anesthesia Care Unit: Potential complications
Respiratory depression Pain Bleeding
55
Nursing Management: Assessments in the PACU?
Neurological Vital signs Peripheral pulses, temperature, color Urine output Pain Skin/surgical incision/wounds
56
Nursing Management: ACTIONS in the PACU?
Connect to cardiac monitor Start admission assessment immediately Document vital signs Handoff from O R Continuous monitoring Medicate as ordered Handoff to inpatient unit
57
Patient Care on the Inpatient Unit: Review orders of :
Vital sign parameters Activity Diet Pain, nausea, vomiting control
58
Patient Care on the Inpatient Unit: Potential Post-operative complications- respiratory
Atelectasis Pneumonia Pulmonary embolism
59
Patient Care on the Inpatient Unit : Potential Postoperative Complications – Cardiovascular
Fluid and electrolyte imbalance Tachycardia Vasoconstriction Dehydration Surgical fluid/blood loss Clot formation
60
Patient Care on the Inpatient Unit: Nursing Management – Assessment
Respiratory Vital signs Peripheral perfusion Neurological Gastrointestinal Genitourinary Skin/drains Pain Fluid and electrolyte balance

Medsurg (21 decks)

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