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NURS 1345 > Perioperative Care POWERPOINT > Flashcards

Perioperative Care POWERPOINT Flashcards

1
Q

When do you wash with special soap (Chlorhexidine Gluconate- CHG) provided by the surgeon

A

2 - 3 days 72 hrs

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2
Q

When should you

Not eat for a surgery

Types of beverages you may have up to 5 hrs before surgery

When not to smoke, chew tobacco, or drink alcohol

A

Not eat for a surgery - 11PM

Types of beverages you may have up to 5 hrs before surgery - Black Coffee, Water, 7-Up

When not to smoke, chew tobacco, or drink alcohol

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3
Q

Day of surgery

Take medication with sip of water

Consult with surgeon if having same-day surgery

True or False

A

True

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4
Q

Elective

Urgent

Emergent

Give examples

A

Elective: Hernia, Cataracts, Joint replacement

Urgent
Intestinal / bladder blockage, Kidney Stones, Cholecystectomy

Emergent

Gun/ Stab wounds
Aortic aneurysm

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5
Q

Match

Simple, Minimally Invasive, Radical

Preformed through use of endoscope

Extensive, directed at finding the root cause

Only most overtly affected area involved in surgery

A

Minimally Invasive Surgery
Preformed through use of endoscope

Radical
Extensive, directed at finding the root cause

Simple
Only most overtly affected area involved in surgery

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6
Q

Halothane, Isoflurane, Sevoflurane, and Desflurane

Are which type of drugs

A

Anestesia

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7
Q

______ is a genetic disorder that causes a severe reaction to certain anesthesia drugs
, leading to a rapid rise in body temperature and muscle contractions. Other symptoms include:
Rapid heart rate
Abnormally fast breathing
Muscle rigidity
Breakdown of muscle fibers
Increased acid levels in the blood
Bleeding
Dark brown urine

A

Malignant hyperthermia (MH)

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8
Q

This type of surgery _____

Risk for paralytic ileus, venous Thrombosis

A

Abdominal

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9
Q

This type of surgery _____

Risk for: pulmonary complications

A

Chest or high abdominal

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10
Q

This type of surgery _____

Risk for: Airway complications

A

Neck, oral, facial

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11
Q

Physiological Stress Response

Adrenal glands release _____

Which stimulates _____ to cause gluconeogenesis

Hyperglycemia causes: ( low / high ) Wound healing & (low / high) infection rates

A

Cortisol

Liver

Low wound healing/ high infection rates

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12
Q

Preoperative care begins & ends when

A

Begins: Surgery is Scheduled

Ends: time of transfer to surgical site

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13
Q

General anestesia drugs including

Desflurane, enflurane, isoflurane, sevoflurane

Depolarizing neuromuscular junction blocker: Succinylcholine

Can all trigger this life threatening disease

A

Malignant hyperthermia

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14
Q

Dantrolene at 2.5 mg/kg is used for which disease

A

Malignant hyperthermia

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15
Q

Malignant hyperthermia S / S

( High / Low ) end-tidal carbon dioxide

(High / Low) oxygen sat.

Brady / Tachycardia

Treatment: Give Dantrolene sodium (skeletal muscle relaxer)

A

High end-tidal carbon dioxide

Low oxygen sat.

Brady / Tachycardia

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16
Q

S/S of Malignant hyperthermia

Muscle (flacid/rigidity) Jaw/ chest
( Hypotension / Hypertension)
(Bradypenea/ Tachypnea)
(Skin molting/ cyanosis)
This color urine

A

Muscle rigidity Jaw/ chest
Hypotension
Tachypnea
Skin molting & cyanosis Both
Brown Urine

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17
Q

In Preoperative Phase

Why ask about joint replacement history?

A

Electrocautery pads over prosthetics will cause burns

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18
Q

What is the most important thing to look at when evaluating Lab Values?

Exp. Do we always call a Dr. if a Na level is 130

A

Trends

No, if their Na level was 125 a few days ago and has risen to 130 is No need to call the Dr.

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19
Q

Would you always report a lab K value of 3.2 to the perioperative team?

A

Yes, always report hypo/Hyperkalemia to perioperative team

Forget trending

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20
Q

X rays are used for (back pain prior to spinal surgery/ respitory issues)

CT scans are used for (back pain prior to spinal surgery/ respitory issues)

A

X rays are used for respitory issues

CT scans are used for back pain prior to spinal surgery

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21
Q

After surgeon explains procedure the nurse may clarify facts and dispel rumors about the surgery

True or False

A

True

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22
Q

The nurse may not serve as a witness to the singing of an informed consent form

True or False

A

False

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23
Q

Informed consent

Life threatening scenario (patient unable to give consent)

Requires written consultation of a doctor

True or False

A

False

2 doctors are required

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24
Q

This type of presurgery prep has the following risk:

Electrolyte imbalance, fluid volume imbalance, vagal stimulation, hypotension

What can happen with vagal stimulation

A

Intestine prep

What can happen with vagal stimulation: PassOut

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25
Q

What is chlorhexidine gluconate used for

A

Skin prep for surgery

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26
Q

Two most important areas to Exercise after surgery

A

Legs & Lungs

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27
Q

DVT deep vein Thrombosis can turn into a PE Pulmonary Emblosim

What are signs and symptoms of DTV

_____ Swelling & pain that increases____

A

Unilateral swelling & pain that increases with walking

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28
Q

When coughing or sneezing, hold a pillow firmly against your incision with both hands. This is called ____

A

splinting

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29
Q

Intraoperative phase

Begins

Ends

A

Begins: client arrives in preoperative holding area

Ends: at time of transfer to Post-Anesthesia Care Unit (PACU)

30
Q

Why don’t we massage legs with DVT

A

Embolism can break off and travel to lungs

31
Q

When are Prophylaxis antibiotics given during the perioperative care

A

1 hr before surgery

32
Q

Sedatives/hyponotics/Anxiolytics

Diazepam, lorazepam, midazolam

Are this type of drug

A

Benzodiazepine

33
Q

Atropine & glycopyrrolate are this type of drug

A

Anticholinergic

34
Q

Promethazine & diphenhydramine are this type of medication

A

Antihistamines

35
Q

Chlorpromazine
Prochlorperazine
Metoclopramide
Odansetron

Are these types of drugs

A

Antimetics

36
Q

Does the circulating nurse enter the sterile field?

A

No

37
Q

lidocaine, mepivacaine, prilocaine, bupivacaine, etidocaine, and ropivacaine and levobupivacaine.

All do what

A

Temp stop pain in a particular part of body

38
Q

Regional anestesia

Numbs only part of the body that will undergo surgery

Give examples

A

Spinal / Epidural

39
Q

Spinal or Epidural

Location
Outside Cerebralspinal Fluid
Inside Cerebralspinal Fluid

Onset:
Immediate
10 - 20 minutes

A

Spinal
Inside Cerebralspinal Fluid
Immediate

Epidural
Outside Cerebralspinal Fluid
10 - 20 minutes

40
Q

Post Dural Postural Headache

PDPH is a postural headache (ie, worse when upright, improved when supine)

How does this happen

A

that usually occurs within 72 hours of dural puncture

Spinal / Epidural

41
Q

Type of Sedation used for

Minor surgical procedures
Endoscope
Cardiac Catheterization
Cardioversion

Airway maintained
Rapid return to normal

A

Moderate Sedation
Conscious Sedation

42
Q

General anesthesia

Methohexital (Brevital)

Is this type of drug

A

Barbiturates

43
Q

Droperidol
Etomidate
Ketamine
Midazolam
Proposal

Are all this type of drug

A

Nonbarbiturate general anestesics

44
Q

Anesthesia adjuncts

Causes paralysis
Work on blocking Acetylcholine

2 forms

Non- depolarizing
Pancuronium
Atracurium
Cisatracurium
Rocuronium
Vecuronium

Depolarizing
Succinylcholine

A

Neuromuscular junction blocking agents

45
Q

Neostigmine (anticholinesterase) + glycopyrrolate or atropine

Sugammadex

Are which type of drug with what affects

A

Neuromuscular reversal agents

Reverse the affects of paralysis

46
Q

Nalbuphine
Pentazocine
Meperidine
Fentanyl

Are all this type of Anesthesia Adjunct

A

Narcotics

47
Q

Reversal agent for Narcotics

A

Naloxone
Narcan

48
Q

Stage 1 - 4

Medullary paralysis, very deep CNS depression, loss respiton, death can occur rapidly

Excitement stage: sympathetic stimulation (may be combative)

Surgical anesthesia, skeletal muscle relaxation, surgery can be safely done

Analgesia stage: losss of pain, patient conscious

A
  1. Analgesia stage: losss of pain, patient conscious
  2. Excitement stage: sympathetic stimulation (may be combative)
  3. Surgical anesthesia, skeletal muscle relaxation, surgery can be safely done
  4. Medullary paralysis, very deep CNS depression, loss respiton, death can occur rapidly
49
Q

3 phases of anesthesia

A

Induction
Maintenance
Recovery

50
Q

During the maintenance phase of anesthesia

Stage 3 is maintained via which type of medication

A

Gas

51
Q

Immediate Postoperative Period

Is referred to as…

A

PACU

52
Q

Aldrete Scale is used for…

A

Discharge from the PACU

53
Q

In disseminated intravascular coagulation.

Possible problems with this

A

abnormal clumps of thickened blood (clots) form inside blood vessels. These abnormal clots use up the blood’s clotting factors, which can lead to massive bleeding in other places

54
Q

Post op Neurological education

Headache
Vision changes
Increasing back pain while coughing

Chart or Report Immediate

A

Report Immediate

55
Q

Wound Dehiscence is

A

a partial or total separation of previously approximated wound edges, due to a failure of proper wound healing

56
Q

Wound Evisceration is …

A

the uncontrolled exteriorization of intraabdominal contents through the dehisced surgical wound outside of the abdominal cavity

57
Q

Wound dehiscence / evisceration

Which is a Surgical emergency
Which is a report immediately

A

Which is a Surgical emergency: evisceration
Which is a report immediately: dehiscence

58
Q

Serous vs Purulent drainage

A

Serous = Clear / White Normal

Purulent = Yellow, Foul smelling, Infection

59
Q

Give an example of a gravity drain (2)

A

Penrose / T-tube

60
Q

Two types of surgical drains

A

Jackson Pratt

Hemovac

61
Q

Report which urine output

A

<30 mL/hr

62
Q

Monitor this with NSAID use

A

GI tolerance

63
Q

For most Opiods monitor this first.

However

Oxycodone w/ aspirin measure this

Oxycodone w/ Acetaminophen

A

normal measure RR

Oxy w/ aspirin = GI

Oxy w/ acetaminophen = BP

64
Q

First 3 things to do in OD of Opiods

A
  1. Maintain airway open
  2. Call rapid response
  3. Administer Naloxone
65
Q

Incase of Opiods OD

  1. Maintain airway open
  2. Call rapid response
  3. Administer Naloxone

Admin Ox if …

A

Hypoxia present /RR <10

66
Q

Why would you obtain suction equipment in case of an OD

A

Naloxone can make you vomit

67
Q

Suffix

  • flurane
A

General anesthesia

68
Q

Suffix

  • ium
A

Neuromuscular blockers

Also, Succinylcholine

69
Q

Suffix

Pam / lam

A

Benzodiazepine

70
Q

Suffix

Zine/ mide

A

Antimetics

Also, ondansetron

71
Q

physostigmine salicylate is used for…

A

Antidote for anticholinergic

72
Q

Flumazenil (Romazicon) is used for

A

Antidote for Benzodiazepine

NURS 1345 (12 decks)

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