Perioperative Flashcards
(32 cards)
Intraoperative
In OR
Preoperative
Scheduled then transferred OR
Postoperative
PACU, ACU, ICU through follow up provider visit
Categories for surgical procedures
Diagnostic/exploratory Curative Ablative Reconstructive Palliative (reduce pain or symptoms)
General classifications
Major
Minor
Preoperative care
Client history Medical history Medications Allergies Tobacco/ETOH/other use Psychosocial/economic factors
Physical assessment
General Head and neck Integument Chest and lungs Cardiovascular GI GU Neuro and mobility
Diagnostic tests
UA Chest x-Ray CBC Blood type and cross match Electrolyte Fasting blood glucose BUN and creatine ALT, AST, LDH, bilirubin Serum albumin and total protein
Informed consent
Nature and purpose Expected outcomes Risks and benefits Alternatives to procedure Effect of not having procedure
Developmental considerations
Infancy Toddler Preschoolers School age Adolescent- body issues, privacy Adults-anxiety
Physical preparation
Anesthesia assessment
Skin prep
GI prep
Day of surgery
Consent Baseline VS Teeth Dress Void Nail polish Jewelry Hearing aids Glasses/contacts Medications
Intraoperative care
Surgical asepsis
Surgical scrub
Sterile field
Anesthesia
Moderate sedation (conscious sedation) IV narcotics and anti-anxiety agents
Regional anesthesia
Local, nerve blocker, epidural, spinal anesthesia
General anesthesia
Anesthetic agents
Inhalation
IV
Stages of anesthesia
Stage 1- introduction
Stage 2- excitement
Stage 3- appropriate for procedure
Stage 4- don’t want to go here
Environmental hazards
Equipment
Latex allergy
Exposure to blood and body fluids
Nursing roles
Scrub nurse Circulating nurse Admin IV infusion and medication Positioning Grounding Monitor
The universal protocol joint commission
- Conduct pre-procedure verification process
- Mark the procedure site
- “Time out”
Potential complications
N/V Respiratory Hypothermia Malignant hyperthermia Paresthesia and impaired skin integrity Excessive fluid and blood loss
Immediate post-op care
Receive report
Assess effects of anesthetic agents and surgical procedures
Monitor vital functions
Provide comfort and pain relief
Assessment in PACU
Maintain patent airway (priority) Maintain cardiovascular stability Assess for hypotension or shock Assess for hemorrhage Assess for hypotension and dysthymias Relieve pain and anxiety Assess neuro status Body temp Integument
Discharge criteria from PACU
VS
Gag reflex
Arousable
Discharge criteria from ambulatory surgical unit
A&O No respiratory distress Cough, swallow, walk No vomiting Voided Pain Bleeding Driver
