Flashcards in Perioperative Nursing Deck (65)
What are the earliest recorded surgical procedures?
Circumcision and trepanation
begins w/ the decision to proceed w/ surgical intervention and ends with the transfer of the patient onto the operating room table
What are the 4 categories of surgical procedures?
used to confirm a diagnosis (biopsy)
to determine the extent of the disease
to remove or repair damaged or diseased tissue (ectomy)
relieves symptoms to make patient comfortable, but does NOT cure
patient requires IMMEDIATE surgery
-performed to maintain life, organ/limb function, remove a damaged organ, stop hemorrhage
Surgery is imperative
-patient requires prompt attention
-performed within 24-30 hours
ex: acute gallbladder infection, kidney or urethral stones
What would prompt a legal case?
Physician delayed decision to perform surgery and the patient died
Patient needs to have surgery, but timing is not immediate
-scheduled several weeks/months in advance
ex: prostatic hyperplasia, thyroid disorders, cataracts
Patient should have surgery, but failure to have surgery is not catastrophic
ex: repair of scars, simple hernia, vaginal repair (cosmetics)
What does a nurse look at for a preoperative nursing assessment?
Nutritional and Fluid Status
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
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
the patient's autonomous decision about whether to undergo a surgical procedure
-consent is a legal mandate
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
Who is responsible for explaining the procedure, the risks, and the benefits?
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
What is part of the preoperative checklist?
How recently should vital signs have been checked for preop checklist?
within 15 minutes of departure
What blood work should be completed for preop checklist?
CBC-total hematocrit, WBC, platelets
What body systems are important to assess preop?
respiratory, cardiovascular, renal, and endocrine systems
What should the nurse include in patient teaching preop?
-Deep breathing, coughing, incentive spirometry
-Nutrition and fluids
What is the progression of the patients diet postop?
NPO--Clear liquids-- Full liquids-- soft-- diet prior to surgery
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)
begins after surgery and continues until the patient is discharged
Post anesthesia care is divided into 2 segments
Phase I PACU and Phase II PACU
Phase I PACU
includes the immediate recovery phase