Flashcards in Perioperative Care Deck (112)
What are the purposes for surgery?
What are the four distinct phases of surgery?
What should be assess in pre- op?
Medication review (prescribed med, OTC, illegal, herbal, vitamins)
Pre- op labs and diagnostic tests
What are some meds that would cause concern in pre- op assessment?
- lovenox, heparin, warfarin, aspirin
Why is height and weight important?
To make sure they get the required anesthesia
Why is ROM limitations important?
Positioning during surgery
What is involved in health history for coping/adaption?
Stress and coping mechanisms
Age and gender
Coping/adaption: Socio- cultural
Plans for convalescence
Consider influence of religious/philosophical beliefs on surgical risk
Pastoral care referral
What are some surgical risks?
Chronic steroid use
Why is age a surgical risk for the very young?
Poorly developed lungs: increases risk of pulmonary problems
Looses water quickly being dehydrated
Why is being obese a surgical risk?
Excess adipose tissue and poor blood supply
- Prolonged surgery
- Prolonged excretion of anesthetic agent
- Reduced ventilatory function
- Slower healing process
Why is being underweight a surgical risk?
May lack needed vitamins and proteins
- Risk for poor wound healing and infection
- May be at risk for skin impairment with significance of bony prominences
Why is smoking a surgical risk?
Decreases ciliary action
Nicotine constricts blood vessels
Decreased amount of functional hemoglobin
Why is excessive alcohol consumption a surgical risk?
Affects liver function
- Metabolism and detoxification of drugs may be delayed
- May have poor nutrition: delayed wound healing
At risk of alcohol withdrawal (DT)
What are some pre- existing conditions?
Upper resp. infection
Chronic resp. disease
Chronic steroid use
If steroids are being used chronically and abruptly stopped what can happen to the patient?
What does BUN assess?
What does creatinine assess?
Guidelines and safe practice recommendations are published by who?
AORN (American operating room nurse association)
ASPAN (American society of perianesthesia nurses)
WHO (World health organization)
Joint Commission (SCIP)
According to the WHO, what are the ten essential objectives to for safe surgery?
- Operate on correct Pt on correct site
- Use methods known to prevent harm from
administration of anesthetics while protecting
Pt from pain
- Recognize & effectively prepare for life threatening
loss of airway or resp function
- Recognize & effectively prepare for risk of
high blood loss
- Avoid inducing an allergic or adverse drug
- Use methods known to minimize risk for
surgical site infections
- Prevent inadvertent retention of instruments
- Secure & identify all surgical specimens
- Effectively communicate & exchange critical
- Establish routine surveillance of surgical
When should the pre- op antibiotic be given?
Within 1 hr before incision
When should antibiotics be discontinued?
With what exception?
Within 24hrs of anesthesia end time
48hrs for cardiac surgery
What antibiotics should they be given 2hrs before incision?
What should be remembered about blood glucose and cardiac surgery patients?
Controlled 6am post-op serum glucose (less than 200 mg/dl post-op day 1 and 2)
Why is maintaining a normal blood glucose important post-op?
Risk of infections higher if blood glucose levels are elevated
What should be used for hair removal?