MedSurg Start: Module 7: Nursing Care of the Post Operative Patient Flashcards Preview

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Flashcards in MedSurg Start: Module 7: Nursing Care of the Post Operative Patient Deck (123)
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1

Difference between Medical v Surgical Patients?

Both have a system pathology BUT...

Surgery is the critical TREATMENT of a surgical patient's pathology (medical is a diagnosis).

2

Different Surgical Purpose Types?

Diagnostic
Curative
Reparative
Reconstructive
Palliative

3

Different Surgical Degrees of Urgency?

Emergent
Urgent
Required
Elective

4

Diagnostics Procedure

Gathering information/Going into the body and trying to find out what is occurring - maybe obtain tissue in order to diagnose

Ex: Diagnostic Biopsy of the Breast; HCT or Hgb Drops lead to Exploratory Surgery

5

Curative Procedure

Procedure in order to cure a problem

Ex: Appendectomy

6

Reparative Procedure

Repairs something that is wrong that is already there - not adding just fixing

Ex: Dislocated Shoulder needs to be put back in place

Ex: Ligament repair

7

Reconstructive Procedure

Recreating something normally in the body but generally using "Aftermarket Parts" or other materials

ex: Using titanium or ceramic or plastic to replace a hip

Ex: Reconstructive breast surgery post mastectomy

Ex: Grafts

8

Palliative Procedure

Not looking for a cure, but a procedure to provide better comfort

ex: If a chest tumor is pressing on the diaphragm they have trouble breathing, so a surgery could reduce the size and help with comfort.

9

Degree of Urgency: Emergent

A procedure that needs to be done IMMEDIATELY or else there will be serious consequences

10

Degree of Urgency: Urgent

A procedure that has a little more time than emergent, but still needs to be done within 24 hours

ex: most appendix surgeries

11

Degree of Urgency: Required

A procedure that must occur within the next few days/weeks

ex: Myocardial ischemia surgery must be done within 2 weeks

12

Degree of Urgency: Elective

A procedure that SHOULD/COULD be done, but you choose whether to do it or not

ex: A total hip replacement could be elective where you determine time and day

No serious consequences for not getting this

2020 Made this type of urgency more difficult and caused financial strains for hospitals

13

Possible Surgical Settings

Outpatient

Ambulatory or Same Day Surgery

Inpatient Surgery

14

Outpatient Surgical Setting

Done in the office, and you can often go home/drive home after - not done in the ER

ex: Blemish removal in the MD office

15

Ambulatory or Same Day Surgery Setting

Often a same day surgery that is invasive but is small and allows for ambulation in for the procedure and being brought to the car in a wheelchair allowing them to not have a need to spend the night

ex: Laparoscopic cholecystectomy

16

Laparoscopic cholecystectomy

A special device that goes down a tube to remove the gall bladder in pieces - small openings from it can be covered with bandaids and the person can leave same day

17

Inpatient Surgery Setting

A surgery involving overnight stay potentially even for a few days

ex: Open cholecystectomy (gallbladder removal)

ex: total joint replacement (sometimes Ambulatory, but often inpatient)

18

Peri-Operative Phases

Pre Operative

Intra Operative

Post Operative

19

Pre-Operative

Time between decision to proceed with surgery and arrival in the operating room

This period can take months if it is an elective history

This period allows for teaching, preparation, etc

20

Intra-Operative

Time actually in the OR

Not just while surgery is occurring, but when they are physically in the OR as well

21

Post-Operative

Starts with admission to PACU and ends with the last post-op follow up visit!

22

PACU

Post Anesthesia Care Unit

23

How might the peri operative phases change in length?

Based on the urgency of the surgery

24

What two important things does Informed Consent do?

1. protects the medical team

2. Protects the patient

25

What things must informed consent be?

1. Signed voluntarily

2. Signed by a person of legal age or emancipated minor

3. The person must be mentally Competent and able to understand information

26

Informed consent is a legal mandate required for what kinds of procedures?

Invasive Procedures (biopsy, PICC line insertion)

Procedures requiring sedation

Procedures involving radiation

Non-emergent surgery

27

PICC

Peripherally inserted central catheter

It is put in the periphery (arm) and travels up and sits in the central vessel (subclavian vein right before the right atrium to the heart)

28

What is one situation that does not need informed consent?

A life saving emergency procedure

29

Informed consent requires patient education from ____

The physician!! (or advanced practitioner like PA or NP)

30

What things must be discussed with the patient in order to get consent?

Benefit to procedure

Possible alternatives to procedures

Risk of procedure

Complications that could occur

Post Op Period Expectations like Diet, Pain, Etc