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Flashcards in Perioperative Nursing Deck (65)
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1

What are the earliest recorded surgical procedures?

Circumcision and trepanation

2

Preoperative Phase

begins w/ the decision to proceed w/ surgical intervention and ends with the transfer of the patient onto the operating room table

3

What are the 4 categories of surgical procedures?

1. Diagnostic
2.Exploratory
3.Curative
4.Palliative

4

Diagnostic Surgery

used to confirm a diagnosis (biopsy)

5

Exploratory Surgery

to determine the extent of the disease

6

Curative Surgery

to remove or repair damaged or diseased tissue (ectomy)

7

Palliative Surgery

relieves symptoms to make patient comfortable, but does NOT cure

8

Emergent Surgery

patient requires IMMEDIATE surgery
-performed to maintain life, organ/limb function, remove a damaged organ, stop hemorrhage

9

Urgent Surgery

Surgery is imperative
-patient requires prompt attention
-performed within 24-30 hours
ex: acute gallbladder infection, kidney or urethral stones

10

What would prompt a legal case?

Physician delayed decision to perform surgery and the patient died

11

Required/Planned Surgery

Patient needs to have surgery, but timing is not immediate
-scheduled several weeks/months in advance
ex: prostatic hyperplasia, thyroid disorders, cataracts

12

Elective Surgery

Patient should have surgery, but failure to have surgery is not catastrophic
ex: repair of scars, simple hernia, vaginal repair (cosmetics)

13

What does a nurse look at for a preoperative nursing assessment?

Nutritional and Fluid Status
Drug/Alcohol use
Psychosocial Factors
Spiritual/Cultural Beliefs

14

Alcohol Withdrawal Syndrome or Delirium Tremens

-anticipated b/t 48-72 hours after alcohol withdrawal
-increased mortality rate postop
-contributed to cardiac dysrhythmias and bleeding tendencies

15

What are the 5 fears associated with Psychosocial Factors?

Fear of unknown
Fear of death/pain
Fear of anesthesia
Fear of cancer
Fear of loss of job

16

Informed Consent

the patient's autonomous decision about whether to undergo a surgical procedure
-consent is a legal mandate

17

What are 3 rules for informed consent?

1. Consent must be given voluntarily
2. Refusing to undergo a surgical procedure is a person's legal right and privilege
3. Required for invasive procedures, any procedure requiring sedation, and nonsurgical procedures such as a heart cath

18

Who is responsible for explaining the procedure, the risks, and the benefits?

the physician

19

What is the nurses job with informed consent?

to make sure the consent form is signed, in a prominent place on the patients chart, and accompanies the patient to the OR

20

What is part of the preoperative checklist?

Bloodwork
Vital signs
Hospital gown
Dentures removed
Voided
Consent Sign

21

How recently should vital signs have been checked for preop checklist?

within 15 minutes of departure

22

What blood work should be completed for preop checklist?

CBC-total hematocrit, WBC, platelets
MBP-electrolytes
Chest X-ray

23

What body systems are important to assess preop?

respiratory, cardiovascular, renal, and endocrine systems

24

What should the nurse include in patient teaching preop?

-Deep breathing, coughing, incentive spirometry
-Mobility
-Pain management
-Nutrition and fluids

25

What is the progression of the patients diet postop?

NPO--Clear liquids-- Full liquids-- soft-- diet prior to surgery

26

What should the nurse discuss with the patient's family?

-inform about the "waiting area"
-Never judge the seriousness of an operation by the length of time a patient is in the OR
-Discuss Post Anesthesia Care Unit (PACU)

27

Postoperative Period

begins after surgery and continues until the patient is discharged

28

Post anesthesia care is divided into 2 segments

Phase I PACU and Phase II PACU

29

Phase I PACU

includes the immediate recovery phase

30

Phase II PACU

Patient is prepared for self-care or care in the hospital, an extended care setting or discharge