Perioperative Flashcards
(35 cards)
what are the 6 indications for surgery?
1) diagnosis : to determine the presence or extent of abnormality
2) cure: to eliminate or repair. pathological condition (ex: removing a ruptured appendix)
3) palliation : to alleviate symptoms without cure (cutting a nerve root to relieve pain)
4) prevention: to reduce the risk of developing a condition (removal of a mole before it becomes malignant)
5) cosmetic improvement: to alter physical appearance ( breast reconstruction post mastectomy)
6) exploration : to determine the nature or extent of disease (laparotomy)
what does the suffix -ectomy mean?
excision/removal
what does the suffix -oscopy mean?
looking into
what does the suffix -ostomy mean?
creating of opening into
what does the suffix -otomy mean?
cutting into/incision
what does -plasty mean?
repair/reconstruction
when does the pre-operative admission assessment occur and what is done?
usually occurs AT LEAST 1 day prior to surgery
youre checking their weight, physical assessment, consent forms, labs, airways etc.
what are common day of surgery assessments that should be done?
psychosocial assessment: stress can negatively affect surgical outcomes and anxiety can impair cognition and decision making so best to help the pt through this
what other assessments are done on the day of surgery?
health history
medications including herbal
what is preopertive education and the 3 forms?
1) sensory - preoperative holding area may be noisy, drugs may be odorous, OR can be cold, light in the OR may be bright, monitoring machines may be heard (beeping)
2) procedural - what to bring and what type of clothing to wear, why turning, deep breathing and coughing after surgery is important (lowers risk of pneumonia and clears lungs), incentive spirometer, use pillow for splinting after surgery, mobilizing pain management
3) process information - a preoperative admission/holding area. family can stay here. when pt wakes up identify all monitors around them
what are 7 common medications for preoperative pts?
1) benzodiazepines - reduces anxiety and used for sedative
2) anticholinergics - reduce respiratory and oral secretions
3) opioids - decrease intraoperative anesthetic requirements and pain
4) antiemetic - decrease nausea and vomiting after surgery
5) antacids - increase gastric pH, decreases gastric volume
6) antibiotics - routinely given IV 30min before surgery
7) eye drops - indicated for cataract surgery
what is a circulating nurse?
not scrubbed, gloved or gowned
remains in the unsterile field
main responsibility is documentation and monitoring sterile field
pt safety as well
pt advocate and well being
what is a scrub nurse?
performs surgical asepsis and remains in sterile field
gowned, gloved in sterile attire
main responsibility is assisting surgical team by preparing and handling instruments
what is a registered nurse first assistant?
preoperative nurse with formal surgical education, skills and knowledge
main responsibility is to collaborate with surgeon on planning preoperative, intraoperative and postoperative patient care. they can also suture under the supervision of the surgeon
what is the surgeon & assist?
performs surgical procedure
basically the big guy who is making the plans for surgery and does the surgery
the assist just holds the retractors and assists with hemostasis and suturing
what is anesthesiologist?
responsible for administering anesthetic agents, monitoring vitals and adjusting meds as appropriate
how does anesthesia work?
by blocking sensory nerve impulses thus patient will not feel pain
what about positioning for surgery? 5 things
proper positioning involves:
1) ensure correct skeletal alignment
2) prevent pressure on nerves, skin, bony prominences
3) prevent occlusion of arteries and veins
4) provide modesty in exposure
5) recognize and respect individuals needs
what is general anesthesia?
loss of consciousness, skeletal muscle relaxation
used for long surgeries
what is local anesthesia?
loss of sensation without loss of consciousness
- injection of agent into the tissues through which the surgical incision will pass
what is regional anesthesia?
reversible loss of sensation to a region of the body by blocking the nerve fibres
ex: epidural or spinal blockers
- injection of local anesthetic into or around a specific nerves or group of nerves
what is procedural sedation?
midl depression of consciousness that result from administration of IV sedatives. this is so the patient can tolerate minor procedures but still maintain airway control
where does spinal and epidural get injected?
spinal : local anesthetic given below L2
- Autonomic, sensory and motor blockade. vasodilation: may become hypotensive and no sensation of pain, no ability to move
epidural : injection of a local anesthetic into the epidural space. dosage can be titrated to control sensory or motor block
which one is faster spinal or epidural?
spinal is faster but results are the same
