Pre-Op

Question 1

3 phases of perioperative nursing

Answer 1

1) preoperative
2) intraoperative
3) postoperative

Question 2

goal?

Answer 2

assisst pt, understand whats going to happen, what meds taking, when last time they took meds, sedation method

Question 3

preop begins when

Answer 3

when you decide to get surgery, ends the moment you are in OR

Question 4

postop first thing

Answer 4

return set of vitals

Question 5

classifications of surgery (6)

Answer 5

1) diagnostic (we want to confirm something is wrong)
ex/ biopsy, colonoscopy (usually outpatient)
2) explorative (same as 1)
3) reconstructive (repair physical deformity; medical or elective)
ex/ cleft palette, breast reconstruction
4) curative (diseased/damaged)
ex/ apendectomy, hysterectomy
5) palliative (alleviates pain or disease symptoms doesn’t fix)
ex/ tumor depunking (shave down tumor)

Question 6

types of urgency (4)

Answer 6

1) emergent (PRIORITY!)
ex/ AAA repair
2) urgent (require prompt attention w/ in 24-48 hours)
ex/ surgical wound infection
3) required (indicated for health, not immediately important)
4) elective (satisfies clients desire)
ex/ tummy tuck, chin reconstruction

Question 7

preop nursing:

assessment

Answer 7

• history and physical exam
• general assessment
• thorax & lungs
• heart & vascular system
• abdomen / neuro status
• allergies*
• learning & discharge needs
• preop pain assessment
• get informed consent from person doing the procedure (before anything)
• current weight & height accurate from administering meds

Question 8

preop nursing:

risk factors

Answer 8

• age; very young and very old
• nutrition; better nutrition the better
• obesity; increase surgical risk (larger surface)
• fluid & electrolyte imbalance
• pregnancy

Question 9

dehisance

Answer 9

surgical incision opening

Question 10

eviseration

Answer 10

organ popping out of incision

Question 11

preop assessment:

continued

Answer 11

-previous surgeries (preconceived conceptions)
ex/ fear, anxiety
-medication history (current meds including herbals)
-smoking habits
-alcohol & substance abuse (look @ liver function panels (takes 72 hours for withdrawal)
-family support (holistic)
-job concerns
ex/ full time dad w/ 3 kids & stay at home mom
-cultural & religious concerns

Question 12

preop assessment:

continued

Answer 12

• complete blood count (CBC)
• electrolytes
• coagulation studies
• BUN & Creatinine (kidney fx)
• glucose
• chest xray & EKG (make sure no existing pneumonia)
• scans & MRIs

Question 13

Complete Blood Count (CBC)

-make up of what 5 things

Answer 13

1) RBC
2) Hgb
3) Hct
4) WBC
5) Platelets

Question 14

range for RBC

Answer 14

• carry oxygen via hemoglobin
• produced by bone marrow
  men: 4.6-6.2
  women: 4.2-5.4

Question 15

range for Hgb

Answer 15

hemoglobin & oxygen carry

men: 13.5-18
women: 12-16

Question 16

range for Hct

Answer 16

% of total blood volume that consists of RBC

• men: 40-54%
• women: 12-16

Question 17

range for WBC

Answer 17

increase in WBC = infection

-5,000-10,000

Question 18

Platelets

Answer 18

-major fx in blood clotting

150-450

Question 19

range for sodium (Na)

Answer 19

-level of Na reflects fluid status of the body (volume deficiency)
135-145

Question 20

range for Potassium (K)

Answer 20

• normal cardiac fx, controls neuro & muscular
  3. 5-5.0
• hypokaltremia = decrease K muscle weakness/cramping
• hyperkaltremia - increase K causes weakness/paralysis

Question 21

range for Chloride (Cl)

Answer 21

95-105

-assoc with acid/base balance; muscle activity

Question 22

bicarbonate range

Answer 22

19-25

-Buffer ex/ Tums

Question 23

ALT*** & ranges

Answer 23

LIVER ENZYME

male: 10-40 u/mL
female: 8-35 u/mL

Question 24

AST*** & ranges

Answer 24

LIVER ENZYME

male: 10-40
female: 15-30

Question 25

when ____ and ____ are _____, something is wrong with liver | -usually in alcoholics

Answer 25

AST & ALT elevated

Question 26

magnesium ranges

Answer 26

- usually with K deficiency | 1. 4-7.5

Question 27

calcium ranges

Answer 27

- produced in bone | 8. 9-10.1

Question 28

sub Q bubble needed for what med

Answer 28

Lovanox

Question 29

PT (prothrombin time)

Answer 29

men: 9.6-11.8 seconds female: 9.5-11.3 secs

Question 30

INR (International normalized ratio)

Answer 30

in controls: .76-1.27 | for anticoagulation: 2.0-3.0

Question 31

APTT (Activated Partial Thromboplastin Time)

Answer 31

35-45 seconds

Question 32

Platelets

Answer 32

150-450 L | (lower than 150 = risk for bleeding)**

Question 33

which tests used for coumadin

Answer 33

PT & INR

Question 34

which test used for IV Heprin

Answer 34

APTT

Question 35

renal function labs: | -creatinine

Answer 35

shows how well kidneys are working male: 0.6-1.3 female: 0.5-1.0

Question 36

renal function labs: | -BUN (Blood Urea Nitrogen)

Answer 36

5-20mg

Question 37

fasting serum glucose

Answer 37

70-110 mg

Question 38

conditions that increase risks of surgery (7)

Answer 38

1) bleeding disorders 2) diabetes mellitus 3) heart disease 4) URI/Chronic Respiratory Disease 5) Liver disease 6) fever 7) kidney disease

Question 39

drugs that increase risks of surgery (first 5)

Answer 39

- certain antibiotics - antidysrhythmics - anticoagulants - anticonvulsants - antihypertensives

Question 40

drugs that increase risks of surgery (last 4)

Answer 40

- corticosteroids (used for respiratory issues) - insulin - diuretics - some OTC

Question 41

preop nursing diagnoses

Answer 41

- deficient knowledge - anxiety/FEAR - pain - risk for infection - impaired physical mobility - disturbed body image - disturbed sleep pattern

Question 42

preop goals

Answer 42

- client will verbalize the importance of early postop ambulation before surgery - client will demonstrate coughing & deep breathing exercises in preop period

Question 43

preop interventions

Answer 43

-client teaching: breathing & leg exercises

Question 44

informed consent whose responsibility?

Answer 44

- doctor/surgeon: explains procedure risks & complications | - takes 2 signatures for nurses