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NURS 1345 > Perioperative Care POWERPOINT > Flashcards

Perioperative Care POWERPOINT Flashcards

(72 cards)

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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
What is chlorhexidine gluconate used for
Skin prep for surgery
26
Two most important areas to Exercise after surgery
Legs & Lungs
27
DVT deep vein Thrombosis can turn into a PE Pulmonary Emblosim What are signs and symptoms of DTV _____ Swelling & pain that increases____
Unilateral swelling & pain that increases with walking
28
When coughing or sneezing, hold a pillow firmly against your incision with both hands. This is called ____
splinting
29
Intraoperative phase Begins Ends
Begins: client arrives in preoperative holding area Ends: at time of transfer to Post-Anesthesia Care Unit (PACU)
30
Why don't we massage legs with DVT
Embolism can break off and travel to lungs
31
When are Prophylaxis antibiotics given during the perioperative care
1 hr before surgery
32
Sedatives/hyponotics/Anxiolytics Diazepam, lorazepam, midazolam Are this type of drug
Benzodiazepine
33
Atropine & glycopyrrolate are this type of drug
Anticholinergic
34
Promethazine & diphenhydramine are this type of medication
Antihistamines
35
Chlorpromazine Prochlorperazine Metoclopramide Odansetron Are these types of drugs
Antimetics
36
Does the circulating nurse enter the sterile field?
No
37
lidocaine, mepivacaine, prilocaine, bupivacaine, etidocaine, and ropivacaine and levobupivacaine. All do what
Temp stop pain in a particular part of body
38
Regional anestesia Numbs only part of the body that will undergo surgery Give examples
Spinal / Epidural
39
Spinal or Epidural Location Outside Cerebralspinal Fluid Inside Cerebralspinal Fluid Onset: Immediate 10 - 20 minutes
Spinal Inside Cerebralspinal Fluid Immediate Epidural Outside Cerebralspinal Fluid 10 - 20 minutes
40
Post Dural Postural Headache PDPH is a postural headache (ie, worse when upright, improved when supine) How does this happen
that usually occurs within 72 hours of dural puncture Spinal / Epidural
41
Type of Sedation used for Minor surgical procedures Endoscope Cardiac Catheterization Cardioversion Airway maintained Rapid return to normal
Moderate Sedation Conscious Sedation
42
General anesthesia Methohexital (Brevital) Is this type of drug
Barbiturates
43
Droperidol Etomidate Ketamine Midazolam Proposal Are all this type of drug
Nonbarbiturate general anestesics
44
Anesthesia adjuncts Causes paralysis Work on blocking Acetylcholine 2 forms Non- depolarizing Pancuronium Atracurium Cisatracurium Rocuronium Vecuronium Depolarizing Succinylcholine
Neuromuscular junction blocking agents
45
Neostigmine (anticholinesterase) + glycopyrrolate or atropine Sugammadex Are which type of drug with what affects
Neuromuscular reversal agents Reverse the affects of paralysis
46
Nalbuphine Pentazocine Meperidine Fentanyl Are all this type of Anesthesia Adjunct
Narcotics
47
Reversal agent for Narcotics
Naloxone Narcan
48
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
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
3 phases of anesthesia
Induction Maintenance Recovery
50
During the maintenance phase of anesthesia Stage 3 is maintained via which type of medication
Gas
51
Immediate Postoperative Period Is referred to as...
PACU
52
Aldrete Scale is used for...
Discharge from the PACU
53
In disseminated intravascular coagulation. Possible problems with this
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
Post op Neurological education Headache Vision changes Increasing back pain while coughing Chart or Report Immediate
Report Immediate
55
Wound Dehiscence is 
a partial or total separation of previously approximated wound edges, due to a failure of proper wound healing
56
Wound Evisceration is ...
the uncontrolled exteriorization of intraabdominal contents through the dehisced surgical wound outside of the abdominal cavity
57
Wound dehiscence / evisceration Which is a Surgical emergency Which is a report immediately
Which is a Surgical emergency: evisceration Which is a report immediately: dehiscence
58
Serous vs Purulent drainage
Serous = Clear / White Normal Purulent = Yellow, Foul smelling, Infection
59
Give an example of a gravity drain (2)
Penrose / T-tube
60
Two types of surgical drains
Jackson Pratt Hemovac
61
Report which urine output
<30 mL/hr
62
Monitor this with NSAID use
GI tolerance
63
For most Opiods monitor this first. However Oxycodone w/ aspirin measure this Oxycodone w/ Acetaminophen
normal measure RR Oxy w/ aspirin = GI Oxy w/ acetaminophen = BP
64
First 3 things to do in OD of Opiods
1. Maintain airway open 2. Call rapid response 3. Administer Naloxone
65
Incase of Opiods OD 1. Maintain airway open 2. Call rapid response 3. Administer Naloxone Admin Ox if ...
Hypoxia present /RR <10
66
Why would you obtain suction equipment in case of an OD
Naloxone can make you vomit
67
Suffix - flurane
General anesthesia
68
Suffix - ium
Neuromuscular blockers Also, Succinylcholine
69
Suffix Pam / lam
Benzodiazepine
70
Suffix Zine/ mide
Antimetics Also, ondansetron
71
physostigmine salicylate is used for...
Antidote for anticholinergic
72
Flumazenil (Romazicon) is used for
Antidote for Benzodiazepine

NURS 1345 (12 decks)

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