post op Flashcards
(177 cards)
1
Q
goal of post op care
A
support healing and recovery
prevent complications
2
Q
what is the first priority of the RN when a pt arrives on the unit?
A
take vital signs and compare to baseline
3
Q
post op complications
A
pain exhaustion immobility loss of control exposure
4
Q
what is the most common cause of obstruction with a post op pt
A
tounge
5
Q
what is the first sign of a respiratory problem
A
restlessness
6
Q
alveolar collapse causes airless condition of the lungs
A
atelectasis
7
Q
what is the cause of atelectasis
A
hypoventation prolonges bedrest ineffective cough pain tachypena dyspnea fever tachycardia
8
Q
inflammation of lungs
A
pneumonia
9
Q
how are the most effected with repiratory complications
A
elderly
obese
malnourished
chronic respiratory disease
10
Q
inhalation of gastric contents
A
aspiration pneumonia
11
Q
when should deep breathing and coughing begin
A
as soon as pt is responsive
12
Q
what is the most important intervention to prevent post op complications
A
ambulation
13
Q
what does early ambulation do
A
increases vital capacity of lungs
increase muscle tone, and increase circulation
14
Q
what is the goal of interventions
A
maintence of adequate respiratory function to prevent complications
15
Q
what directly affects cardiac output
A
fluid status
16
Q
what can contribute to cardiovascular alteration
A
fluid and electolyte imblance
17
Q
inflammation with clot
A
thrombophlebitis
18
Q
clot dislodges and travels
A
embolus
19
Q
what helps to prevent DVT
A
early ambulation
EPCs
leg excercises
20
Q
clot lodged in pulmonary circulation
A
plumonary embolus
21
Q
what are signs and symptoms of pulmonary embolus
A
restlessness dyspnea tachypnea sudden sharp chest pain crackles change in mental status
22
Q
clot and inflammation in superfical veins
A
superficial thrombophelbitis
23
Q
brief lapse in consciousness caused by transient cerebral hypoxia
A
syncope
24
Q
signs and symptoms of sycope
A
postural hypotension
vascular pooling
25
if pt faints what should you do
assist to floor to prevent injury
26
how long does fluid retention lasts
2-5 days post op
27
what can cause fluid deficit
vomiting bleeding drainage
28
hypokalemia
low potassium
29
what are signs and symptoms of hypokalemia
muscle weakness, irritability, weakness, confusion, arrhythmias
30
the first void after surgery should be ?
200 mL
31
what is the biggest risk for UTIs
indwelling catheters
32
when do you want to remove a catheter
within 24 hours
33
rapid decline of kidney function
acute renal failure
34
what are some signs of acute renal failure
elevated BUD, elevated creatinin
35
how long must you listen for bowel sounds in order for them to be absent
5 minutes each quadrant
36
what is the first sign of bowel function
flatus
| gas
37
what increases peristalsis
early ambulation
38
temporary paralysis of the bowel
paralytic ileus
39
signs and symptoms of paralytic ileus
pain
abd destention
N&V
40
singultus
hiccups
| intermittent spasms of diaphragm
41
what are hiccups caused by
irritation of phrenic nerve
42
inflammation of soft palate
palatitis
43
what is the largest organ of the body and its the first line of defense
skin
| integumentray skin
44
injury in which there is a break in the continuity of body tissues
wound
45
wound in which each tissue layer is cut and sepreated smoothly by sharp bladed instruments
incision
46
irregular tear in tissue layers
laceration
47
scraping away of protion of skin or mucus membrane as resulr of injury or mechanical means
abrasion
48
injury to tissue where skin is not broken
contusion
49
wound made by sharp instrument
puncture or stab
50
puncturing or tearing of tissue from inside by broken bone
fracture
51
exudate
drainage
52
clear watery plasma drainage
serous
53
bloody drainage
sanguineous
54
combination of plasma and blood pinkish to light red
serosanguineous
55
thick, infected (yellow, green, brown) pus
purulent
56
what is the most common after 48 hours after surgery
hemmorrage
57
what are signs and symptoms of hemmorrage
restlessness, pale, cold, clammy, vital sign change decrease b/p, increase hr & rr
58
when assessing the dressing what should you do
place date and time and circle any drainage on the dressing, look under pt for any additional bleeding
59
what is the objective of wound care
promote hemostasis
prevent infection
prevent furtur wound injury
60
when wound edges are neatly approximated
primary intention
61
what pahse of wound healing lasts 3-5 days, the area fills with blood and clots form
inital phase
62
what wound healing pahse lasts 5 days to 4 months the immature connective tissue cells migrate to healing site and the wound is pink and vascular
granulation phase
63
wound is pink and vascular
granulation tissue
64
what phase of wound healing has remodeling of collagen the scar is formed and fibroblasts disappear
maturatino phase
65
what wound healing phase are the edges not neatly approximated
secondary intention
66
what phase of the wound healing process is there delayed suturing of the wound, the wound is left open for infection to clear
tertiary intention
67
what sub phases are in primary phase of the wound healing process
inital
granulation
maturation
68
in surgical wounds infection is apparent in how many days
3-5 days
69
in traumatic wounds infections are apparent in how many days
2-3 days
70
who is at an increased risk for infection
malnourished or obeses pts
71
what are signs and symptoms of infection
```
fever
pain or tenderness at site
edges of wound inflamed
WBCs up
drainage (green, yellow, brownish)
```
72
dehiscence
edges of wound open up, partial or total separation of wound edges
73
signs and symptoms of dehiscence
sudden increase in serosanguineous drainage
| feels like something gave way
74
wound edges separte and abdominal contents protrude to outside
evisceration
75
excess production of collagen tissue
keloid or hypertrophic scars
76
flexible material placed thru tissues to hold edges together
sutures
77
what kind of sutures are used in abdominal wounds
retention sutures
78
large, wire encased in rubber to prevent skin trauma
retention staples
79
when are sutures removed
7-10 days
| facial are 3-5 days
80
what is used when non absorbable sutures would be used
staples (external only)
81
adhesive skin closure
steri-strips, butterfly
82
what is the purpose of wound dressings
```
protect from microorganisms
aides hemostasis
promotes haling
supports splinting]covers wound
cusion and protect
```
83
what wound dressing product permits drainage from wound and allowes air to get to the wound
gauze
84
what wound dressing product requires secondary dressing to secure in place
also impregnated with an agent
impregnated non adherent dressings
85
what wound dressing product allows visualization of wound, adhesive, plastic and non absorbant dressing
transparent adhesive film
86
when does dischage planning begin
on admission
87
what is the average length of stay
24 hours to 5 dyas
88
what does dischage planning include
```
care of wound site and dressings
medications
activities
dietary
symptoms to be reported
follow up care
```
89
somnology
study of sleep
90
state of decreased physical or mental work that leave the individual feeling mentally relaxed, phycially calm and free from anxiety
concept of rest
91
a state of consciousness/preception and reaction to the enviornment is decreased
concept of sleep
92
biological clock, 24 hour day
circadian rhythm
93
REM sleep
rapid eye movement, restores brain
94
what are the characteristics of REM sleep
active dreaming
difficult to arose
increased brain activity
95
NREM Sleep
restores body physically
96
what % is NREM sleep
75-80%
97
what are the characteristics of NREM sleep
brain waves slow
vital signs decerased
skeletal muscles relax
98
what are the stages of sleep
Stage 1: very light sleep, drowsy
Stage 2: light sleep, awakens easily
Stage 3: medium depth sleep, snoring may occur
Stage 4: deep sleep, difficult to arouse, rearely moves
99
inability to obtain adquate amount of quailtiy of sleep
insomina
100
sudden wave of overwheling sleepiness
narcolepsy
101
periodic cessation of brathing during sleep caused by obstructive airflow
sleep apnea
102
prolonges periods of inadequate sleep
sleep deprivation
103
abnormal event that occurs during sleep
parasomnia
104
somnambulism
sleep walking
105
involuntary urination during sleep
enuresis
106
grinding and clenching teeth during sleep
bruxism
107
what kind of impact of sleep dysfunction has on the surgical pt
less energy
| delayed healing and recovery
108
a universal experience, reason many people seek health care, vital physicological warning system
pain
109
what is McCafferys definition of pain
pain is whatever the pt says it is and exists whenever the pt says it does
110
chronic pain
recurrent or longer than 6 months
111
heightened response to painful stimuli
hyperalgesia
112
nonpainful stimuli produce pain
allodynia
113
unpleasent abnormal senstion
dysesthesia
114
does the pain threshold change with age
NO
115
what is the 1st step in experience of pain
transduction
116
takes place after electrical implise enters the CNS
transmission
117
beomce conscious of pain (occurs in brain)
perception
118
"descending system" increase or decrease in pain signal intensity
modulation
119
peripheral nerve fibers carrying pain to SC have input modified before transmission to brain
gate control theory
120
what physiologic indicators of pain are caused by sympathetic nervous system
increased B/P, HR, RR
pallor
diaphoresis
pupil dialtion
121
TENS
transcutaneous electrial nerve stimulation
122
what is used to reverse the effects of narcotics
NARCAN
123
opiods (narcotics) cause what
RR depression
124
PCA
patient controlled analgesia
| pt uses IV pump to does own analgesia
125
infusion of opiets directly into epidural or intrathecal space around the spinal cord
epidural analgesics
126
HAI
healthcare associated infections
127
what are the most common tpes of HAI's
catheter associated urinary tarct infections
surgical site infection
bacteremia
pneumonia
128
microorganisms that cause disease
pathogen
129
microorganisms normal in one region of the body
resident or normal flora
130
source of microorganisms
reservoir
131
ability to cause disease
pathogenicity
132
strength or power of the pathogen
virulence
133
condition marked by subjective complaints, clinical signs and symptoms
disease
134
tracking infections
surveillance
135
risk of host to infection
susceptibility
136
resistance to infection
immunity
137
practices to confine specific microorganism to a specific area, limiting the number , growth, and transmission
medical asepsis
138
absence of most organisms
clean
139
presence of microorganisms, capable of causeing infection
dirty
140
practices to keep area or object free of all microorganisms as much as possible
surgical asepsis
141
way microorganism leaves reservior
portal of exit
142
from source to host
mode of transmission
143
person to person
direct
144
vehicle or vector borne
indirect
145
from self
autogenous
146
entry of mircroorganism into host
portal of entry
147
person at risk for infection
susceptible host
148
what is the chain of infection
```
infections agent
reservoir
portal of exit
mode of transmission
portal of entry
susceptible host
```
149
what are some defenses against infection
normal flora
body systems: dkin, respiratory tract, GI tract urinary tract
inflammaroty response4
150
4 signs of inflammation
erythema
edema
warmth
pain
151
antigens
foreign proteins
152
bodys defense is a
antibody mediated defense
153
what does healthcare associated infection occur
through poor aseptic practice
154
what is the #1 way to prevent infection
hand washing
155
what are unerviseral/standards precaustions
wear appropriate protective gear to prevent exposure to blood or body secretions
156
what actively kills bacteria
bacteriocidal
157
what prohibits growth so bacteria dies off
bacteriostatic
158
process that destroys all microorganisms
sterilization
159
wound involving a break in skin or mucous membranes
open wound
160
wound involving no break in skin integrity
closed wound
161
wound resulting from therapy
intentional wound
162
wound that occurs unexpectedly
unintentional wound
163
wound that involves only epidermal layer of skin
superficial wound
164
wound involving break in epidermal dkin layer, as well as dermis and deeper tissues or organs
penetrating
165
penetrating wound in which foreign object enters and exits an internal organ
perforating wound
166
closed surgical wound that did not enter GI, respiratory or GU tract
clean wound
167
wound entering GI, respiratory, or GU tract
clean/contaimintated wound
168
open, traumatic wound, surgical wound with break in asepsis.
contaminated wound
169
wound site with pathogens present, signs of infection
infected wound
170
who is eligible for PCA
mentally alert
| no allergy to anagelsia
171
types of PCA drug delivery
* Patient demand dose
* Loading dose or bolus
* Rescue dose
* Basal dose (continuous infusion)
172
when pt has PCA what should you assess for
* Vital signs
* SpO2 (pulse ox)
* pain score
* sedation score
* side effects of medication
173
how often do vitals have to be taken with PCEA
every 4 hours
174
medication in PCEA bag causes nerve block / No feeling in feet and legs
Bupivicaine
175
PCEA
patient controlled epidural anagelsia
176
drug administered via catheter into epidural space around the spinal cord / Binds to nerve roots to block sensory impulses
PCEA
177
drug administered via intravenous route into blood
PCA
