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Adult 1 Exam 1 > Perioperative > Flashcards

Perioperative Flashcards

(73 cards)

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1
Q

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

A
  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
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2
Q

Emergent:

A

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

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3
Q

Urgent:

A

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

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4
Q

Required:

A

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

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5
Q

Elective:

A

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

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6
Q

Optional:

A

decision rests with pt, personal preference, cosmetic surgery

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7
Q

Vitamin K

A

essential for normal blood clotting

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8
Q

Vitamin C

A

allow for collagen formation to strengthen the wound

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9
Q

protein

A

enhances wound healing

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10
Q

Restriction of nutrition/fluids

A

prevent aspiration

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11
Q

Intestinal preparation

A

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

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12
Q

Urinary catheterization

A

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

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13
Q

Administration of preoperative medications

A

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

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14
Q

Anticoagulants –

A

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

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15
Q

Anti-seizure agents –

A

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

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16
Q

Corticosteroids –

A

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

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17
Q

Diuretics –

A

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

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18
Q

Insulin –

A

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

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19
Q

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

A

7-10 days; Inhibiting platelet aggregation

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20
Q

Diabetics undergoing surgery are at risk for four major complications:

A

Hyperglycemia, hypoglycemia, acidosis

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21
Q

List three significant nutritional concerns for the elderly surgical patient:

A

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

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22
Q

Name three primary goals necessary to promote postoperative mobility:

A

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

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23
Q

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

A

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

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24
Q

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

A

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

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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

Adult 1 Exam 1 (15 decks)

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