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Adult 1 Exam 1 > Perioperative > Flashcards

Flashcards in Perioperative Deck (73):
1

Informed consent for a surgical procedure is necessary when a procedure meets the following four conditions:

1. invasive procedures, such as surgical incision, a biopsy, a cystoscopy, or paracentesis
2. procedures requiring sedation and/or anesthesia
3. a nonsurgical procedure, such as an arteriography, that carries more than a slight risk to the patient
4. procedure involving radiation

2

Emergent:

pt requires immediate attention; disorder may be life threatening, without delay; severe bleeding, bladder or intestinal obstruction, fractured skull, extensive burns, gun shot, GI obstruction, stabbing

3

Urgent:

pt requires prompt attention, within 24-30 hours, acute gall bladder infection, kidney or ureteral stones

4

Required:

pt needs to have surgery, plan within a few weeks or months, prostatice hyperplasia without bladder obstruction, thyroid disorders, cataracts

5

Elective:

pt should have surgery, failure to have surgery not castrophic, repair of scars, simple hernia, vaginal repair

6

Optional:

decision rests with pt, personal preference, cosmetic surgery

7

Vitamin K

essential for normal blood clotting

8

Vitamin C

allow for collagen formation to strengthen the wound

9

protein

enhances wound healing

10

Restriction of nutrition/fluids

prevent aspiration

11

Intestinal preparation

allow satisfactory visualization of the surgical site and to prevent trauma to the intestine or contamination of the peritoneum by fecal matter colonoscopy allows visualization of the colon

12

Urinary catheterization

performed in the OR as necessary, monitor intake and output, usually remove post opp day one to decrease risk of infection

13

Administration of preoperative medications

use is minimal with ambulatory or outpatient surgery. If prescribed, it is usually administered in the preoperative holding area

14

Anticoagulants –

can increase the risk of bleeding during the introperative and postoperative periods; should be discontinued in anticipation of elective surgery. The surgeon will determine how long before the elective surgery the pt should stop taking it, depending on the type of planned procedure and the medical condition of pt

15

Anti-seizure agents –

IV administration of med may be needed to keep the pt seizure-free in the intraoperative periods

16

Corticosteroids –

cardiovascular collapse can occur if discontinued suddenly. A bolus of corticosteroids may be administered IV immediately before and after surgery.

17

Diuretics –

during anesthesia, may cause excessive respiratory depression resulting from an associated electrolyte imbalance

18

Insulin –

IV insulin may need to be administered to keep the blood glucose within normal range

19

Aspirin is withheld ____ days before surgery, if possible, because it acts by
___________________

7-10 days; Inhibiting platelet aggregation

20

Diabetics undergoing surgery are at risk for four major complications:

Hyperglycemia, hypoglycemia, acidosis

21

List three significant nutritional concerns for the elderly surgical patient:

pre-op - dehydration, hypovolemia, and electrolyte imbalances
post-op – wound healing, return of normal bowel function, and fluid and electrolyte imbalance

22

Name three primary goals necessary to promote postoperative mobility:

Improve circulation, prevent venous stasis, promote optimal respiratory function (insentive spirometry increase lung expansion)

23

After administration of a preoperative medication, what patient safety measures must be maintained:

Keep pt up in bed with side rails raised cause medicine can cause lightheadedness or drowsiness. Observe the t for untoward reaction. The immediate surroundings are kept quiet to promote relaxation

24

Who is responsible for initiating and what does the phrase “time out” mean during the intraoperative period

Circulating nurse; second verification of the surgical procedure, every member of the team verifies the pt, procedure, and surgical site using objective documentation and data before beginning surgery

25

Stage I of General Anesthesia

beginning anesthesia – as the pt breathes in the anesthetic mixture, warmth, dizziness, and a feeling of detachment may be experienced

26

Stage II of General Anesthesia

excitement – characterized by struggling, shouting, talking, singing, laughing, or crying, often avoided if the anesthetic agent is administered smoothly and quickly

27

Stage III of General Anesthesia

surgical anesthesia – reached by continued administration of the anesthetic vapor or gas

28

Stage IV General Anesthesia

medullary depression – reached if too much anesthesia has been administered

29

What nursing assessment indicates that a patient has recovered from the effects of spinal anesthesia?

Return of sensation

30

What contributes to post-spinal anesthesia headache?

Size of needle, leakage of fluid from the subarachnoid space through the puncture site, and the pts hydration status

31

List five potential intraoperative complications:

Nausea & vomiting, anaphylaxis, hypoxia & other respiratory complications, hypothermia, malignant hyperthermia,

32

Who is responsible for transferring the patient from the operating room to PACU?

Anesthesia person

33

two essential nursing priorities during immediate postoperative assessment of the patient are evaluation of:

Maintaining a pt airway, maintaining cardiovascular stability

34

Informed consent for a surgical procedure is necessary when a procedure meets the following four conditions:

1. invasive procedures, such as surgical incision, a biopsy, a cystoscopy, or paracentesis
2. procedures requiring sedation and/or anesthesia
3. a nonsurgical procedure, such as an arteriography, that carries more than a slight risk to the patient
4. procedure involving radiation

35

Emergent:

pt requires immediate attention; disorder may be life threatening, without delay; severe bleeding, bladder or intestinal obstruction, fractured skull, extensive burns, gun shot, GI obstruction, stabbing

36

Urgent:

pt requires prompt attention, within 24-30 hours, acute gall bladder infection, kidney or ureteral stones

37

Required:

pt needs to have surgery, plan within a few weeks or months, prostatice hyperplasia without bladder obstruction, thyroid disorders, cataracts

38

Elective:

pt should have surgery, failure to have surgery not castrophic, repair of scars, simple hernia, vaginal repair

39

Optional:

decision rests with pt, personal preference, cosmetic surgery

40

Vitamin K

essential for normal blood clotting

41

Vitamin C

allow for collagen formation to strengthen the wound

42

protein

enhances wound healing

43

Restriction of nutrition/fluids

prevent aspiration

44

Intestinal preparation

allow satisfactory visualization of the surgical site and to prevent trauma to the intestine or contamination of the peritoneum by fecal matter colonoscopy allows visualization of the colon

45

Urinary catheterization

performed in the OR as necessary, monitor intake and output, usually remove post opp day one to decrease risk of infection

46

Administration of preoperative medications

use is minimal with ambulatory or outpatient surgery. If prescribed, it is usually administered in the preoperative holding area

47

Anticoagulants –

can increase the risk of bleeding during the introperative and postoperative periods; should be discontinued in anticipation of elective surgery. The surgeon will determine how long before the elective surgery the pt should stop taking it, depending on the type of planned procedure and the medical condition of pt

48

Anti-seizure agents –

IV administration of med may be needed to keep the pt seizure-free in the intraoperative periods

49

Corticosteroids –

cardiovascular collapse can occur if discontinued suddenly. A bolus of corticosteroids may be administered IV immediately before and after surgery.

50

Diuretics –

during anesthesia, may cause excessive respiratory depression resulting from an associated electrolyte imbalance

51

Insulin –

IV insulin may need to be administered to keep the blood glucose within normal range

52

Aspirin is withheld ____ days before surgery, if possible, because it acts by
___________________

7-10 days; Inhibiting platelet aggregation

53

Diabetics undergoing surgery are at risk for four major complications:

Hyperglycemia, hypoglycemia, acidosis

54

List three significant nutritional concerns for the elderly surgical patient:

pre-op - dehydration, hypovolemia, and electrolyte imbalances
post-op – wound healing, return of normal bowel function, and fluid and electrolyte imbalance

55

Name three primary goals necessary to promote postoperative mobility:

Improve circulation, prevent venous stasis, promote optimal respiratory function (insentive spirometry increase lung expansion)

56

After administration of a preoperative medication, what patient safety measures must be maintained:

Keep pt up in bed with side rails raised cause medicine can cause lightheadedness or drowsiness. Observe the t for untoward reaction. The immediate surroundings are kept quiet to promote relaxation

57

Who is responsible for initiating and what does the phrase “time out” mean during the intraoperative period

Circulating nurse; second verification of the surgical procedure, every member of the team verifies the pt, procedure, and surgical site using objective documentation and data before beginning surgery

58

Stage I of General Anesthesia

beginning anesthesia – as the pt breathes in the anesthetic mixture, warmth, dizziness, and a feeling of detachment may be experienced

59

Stage II of General Anesthesia

excitement – characterized by struggling, shouting, talking, singing, laughing, or crying, often avoided if the anesthetic agent is administered smoothly and quickly

60

Stage III of General Anesthesia

surgical anesthesia – reached by continued administration of the anesthetic vapor or gas

61

Stage IV General Anesthesia

medullary depression – reached if too much anesthesia has been administered

62

What nursing assessment indicates that a patient has recovered from the effects of spinal anesthesia?

Return of sensation

63

What contributes to post-spinal anesthesia headache?

Size of needle, leakage of fluid from the subarachnoid space through the puncture site, and the pts hydration status

64

List five potential intraoperative complications:

Nausea & vomiting, anaphylaxis, hypoxia & other respiratory complications, hypothermia, malignant hyperthermia,

65

Who is responsible for transferring the patient from the operating room to PACU?

Anesthesia person

66

two essential nursing priorities during immediate postoperative assessment of the patient are evaluation of:

Maintaining a pt airway, maintaining cardiovascular stability

67

List potential postoperative complications:

Phenomonia, DVT, constipation, paralytic ileus , hematoma, infection (wound sepsis), wound dehiscence and evisceration

68

Explain patient-controlled analgesic (PCA):

Patient controlled, nurse give pt button

69

Describe in general terms what nursing care is needed during the first 24 hrs after surgery

Continuing to help the pt recover from the effects of anesthesia, frequently assessing the pts physiologic status, monitoring for complications, managing pain and implementing measures designed to achieve the long range goals of independence with selfcare, successful management of the therapeutic regimen, discharge to home, and full recovery

70

Dehiscence –

disruption of surgical incision or wound

71

Evisceration-

protrusion of wound contents, organs pop out (moisten saline gauze and notify MD)

72

Describe three postoperative conditions that put a patient at risk for common respiratory complications:

Respiratory depressive effects of opioid medications, decreased lung expansion secondary to pain, and decreased mobility

73

Inadequate fluid replacement is reflected in a postoperative patient by a urine output of less than ___ ml/per hour

30