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medsurg > perioperative > Flashcards

perioperative Flashcards

(48 cards)

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1
Q

what is surgery?

A

treatment through operation and instrumentation

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2
Q

purposes of surgery

A

diagnose
explore
cure
transplant
palliative
reconstructing
preventative
cosmetic

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3
Q

-ectomy

A

incision or removal

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4
Q

-lysis

A

the destruction of

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5
Q

-orrhaphy

A

the repair or suture of

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6
Q

-oscopy

A

looking into

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7
Q

-ostsomy

A

creation of an opening

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8
Q

-otomy

A

the cutting into or incision of

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9
Q

-plasty

A

the repair or reconstruction of

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10
Q

MIS

A

minimally invasive surgery
- laparoscopy

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11
Q

robotic-assisted surgery

A

Da Vinci robot

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12
Q

emergent vs elective surgery

A

emergency surgery and planned surgery

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13
Q

inpatient vs outpatient

A

inpatient is admitted after surgery
outpatient go home same day

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14
Q

three phases of surgery

A

peri-op
intra-op
post-op

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15
Q

readiness for surgery (6 main things to monitor)

A

VS
especially BP
hemostasis and coagulation
fluid and electrolytes
infection- resolved before hand preferable
nutrition - to promote healing

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16
Q

purpose of pre-op assessment

A

to prepare pt for surgery and protect from complications

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17
Q

pre-op health history

A

medical
surgical
family
- esp with anesth.
- malignant hyperthermia

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18
Q

malignant hyperthermia

A

life-threatening response to coming off anesthesia

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19
Q

psychosocial pre-op assessment

A
  • fear and anxiety
  • stressors
  • knowledge and reason for surgery
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20
Q

which substances are in the pre-op medication assessment

Study These Flashcards
A
  • anticoagulants
  • antiplatelets
  • opioids
  • antihypertensives
  • herbs and supplements (Ginko, fish oil, cava, ginger and valerian
21
Q

drug intolerance vs allergy

Study These Flashcards
A

drug intol. is unpleasant reactions of medicine
allergy is anaphylaxis, hives

22
Q

pre-op allergy assessment

Study These Flashcards
A
  • sulfa drugs
  • latex
    -* history of latex exposure, hay fever, asthma, or allergy to eggs, avocadoes, bananas, chestnuts, and peaches
23
Q

cardiovascular pre-op ROS

Study These Flashcards
A
  • CV hx?
  • 12 leads ECG, coagulation labs
24
Q

endocrine pre-op ROS

Study These Flashcards
A
  • diabetes
  • thyroid disorders (altered metabolism of drugs)
  • addisons disease (may need corticoid steroids)
24
hepatic pre-op ROS
- if liver is affected, clotting factors may be low causing bleeding - drug metabolism
25
respiratory pre-op ROS
- dx/ conditions? - tobacco use? - ABGs, PFTs
25
GU/renal pre-op ROS
- drug metabolism/ excretion - BUN/CR (very important) - if voiding issues-> may need cath.
26
neurological pre-op ROS
- need to know baseline for nl - emergence delirium: difficulty coming in and out of anesth. (elderly are more prone)
27
musculoskeletal pre-op ROS
- be aware of surgical positioning - spinal anesthesia, slow to wear off - know if mobility aids are used
28
pre-op labs
- VS - BMI/ BSA - type and cross - CBC (for anemia/ infection) - BMP (for electrol./ kidney funct) - coagulation (PT, INR, PTT) - serum albumin - BG
29
physical pre-op ROS
?
29
nutritional pre-op ROS
- caffeine may be needed after waking up - anesthesia hangs on to overweight ppl longer
30
RNs role in consent
witness for the MD
30
pre-op diagnostic tests
- ECG - HCG (preg.) - urinalysis (UTI) - CXR (enlarged heart or lung issues)
30
* the sooner they go home....
the more instructions they will need
30
three requirements for informed consent
1. adequate disclosure 2. clear understanding 3. voluntary consent
31
who is responsible for consent
MD
32
post op coughing
have pt take deep breaths and cough splint any incisions
33
one of the best ways to have good surgical outcomes ...
early ambulation
34
traditional NPO
NPO after midnight the day before surgery
35
American Society of anesthesiologist recommendations for fasting
clear liquids- 2 hrs breast milk- 2 hrs other milk/formula- 4 hrs light meal- 8 hrs regular meal- 8 hrs
36
pre-op, remove...
cosmetics nail polish jewelry dentures glasses or contacts
37
getting dressed pre-op...
put on gown remove undergarments cover hair
38
when to empty bladder pre op
before pre-op meds
39
typical pre-op meds
cefazolin- infection atropine glycopyrrolate- ↓ oral secre. scopolamine- ↓N/V insulin- stabalize BG metoclopramide- ↑ gastric emptying ondansetron- ↓N/V diazepam- ↑anx., induce sedation labetalol- manage htn famotidine- ↓ HCl secre. ↑pH, ↓gastric volume opioids- relieve pain
40
make sure pt has IV access when?
before surgery
41
what to mark on the patient before surgery
site of operation
42
TJC goals for surgery 2025
- correct surgery on correct pt in correct body part - mark correct place where surgery is to be done - pause before the surgery to make sure a mistake isnt being made

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