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NURS 412 > Pre-op care > Flashcards

Pre-op care Flashcards

(45 cards)

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1
Q

Preoperative

A

period of time from when the decision for surgical intervention is made to when the pt is transferred to OR

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2
Q

Intraoperative

A

period of time from when the pt is transferred to the OR or when pt is admitted to PACU

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3
Q

PACU

A

Post-Anesthesia Care Unit

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4
Q

Post operative

A

period of time that begins with the admission of the pt to the PACU and ends after follow up evaluation in the clinical setting/home

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5
Q

Perioperative

A

Period of time that constitutes the surgical experience (all levels)

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6
Q

Types of surgery

A

Emergency (STAT)
Urgent (Within 24 hours)
Elective (planned)

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7
Q

Purposes of surgery

A

Diagnostic
Curative
Preventative
Exploratory
Cosmetic

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8
Q

Informed Consent

A
  • ACTIVE PROCESS
  • 3 elements (voluntary, mental capacity, properly informed)
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9
Q

What is the nurses role in informed consent?

A

Ensure all info is known by pt
Notify physician if pt has more questions or unclear

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10
Q

What is the surgeon’s role in informed conset?

A

tx/procedure
professionals involved
anesthesia risks
benefits
potential harm
options
right to refuse

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11
Q

What does the nurse have to do before the premedication is given?

A

Make sure informed consent has been signed

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12
Q

Assessment pre-op

A

hx
physical assessment
baseline VS
tests are completed

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13
Q

What are the goals of pre-op care?

A

Physical status changes
psychological status
baseline data
review meds
tests are completed
consent
pt support
discharge plan

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14
Q

Latex allergies often…

A

hx of contact dermatitis or atopic immunological rxns
allergies to fruits, nuts, avocados, figs, chestnuts, papayas
repeated exposure to latex

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15
Q

What is included in a health hx?

A

Diagnosed medical conditions
Current health issues
health hx (family, woman, malignant hyperthermia)
Does pt understand reason for surgery

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16
Q

What is involved in a psychological assessment?

A

Stress often influences body functioning –> address fears, anxiety, concerns about loss, previous hospital experiences
determine social network
be empathetic and provide info prn
notify anesthesiologist if fear is extreme

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17
Q

What are the most common fears?

A

Fear of death
Fear of pain and discomfort
Fear of mutilation or alteration in body image
Fear of anesthesia
Fear of disruption of life functioning and pain

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18
Q

How are fears expressed?

A

asking a lot of questions, withdrawing, reading, trivial talk

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19
Q

Previous med use

Study These Flashcards
A

document ALL meds (OTC, herbal)

20
Q

What does aspirin cause?

21
Q

What does garlic and ginger do?

Study These Flashcards
A

interfere with coagulation

22
Q

When does warfarin and aspirin need to be discontinued

Study These Flashcards
A

5-7 days before surgery

23
Q

What to remember with med use

Study These Flashcards
A

some meds are given and not depending on doctors orders the day of surgery, talk to doctor

24
Q

What to remember with drug and alcohol use

Study These Flashcards
A

Surgery is postponed if pt is acutely intoxicated
hx of alcoholism is often accompanied by malnutrition and delirium trenems
alcohol use affects liver function affecting metabolism making drugs last longer

25
What is delirium trenems
confusion, irregular HR and shaking
26
What does smoking do for the surgical pt?
complicates anesthesia (makes heart work harder, wounds take longer to heal)
27
Nervous system assessment
A + O x 3 (cognitive function) Hearing and vision
28
Cardiovascular assessment
Auscultate, BP, HR, pulse (if BP is uncontrolled, surgery may be held) ECG, coagulation/INR/meds
29
Respiratory assessment
RR, O2, sat, ABG DB and C exercises, incentive spirometry inquire about recent airway infections hx of dyspnea, cough, hemoptysis told to OR team smoker? COPD or asthma? - high risk of bronchospasm, laryngospasm, hypoxemia and atelectasis surgery is postponed if pt has resp infection
30
When do smokers have to stop smoking before surgery?
6 weeks before surgery or at least 24 hours
31
Hepatic/Renal function
optimal functioning ensures meds, anesthetics, body wastes and toxins are processed and removed from body LFT
32
Renal assessment
Function tests voiding b/c males inability to void can be due to enlarged prostate which can make catheterization difficult hx of urinary and renal diseases note problems voiding and inform OR
33
Integumentary assessment
all abnormalities noted hx of pressure ulcers = extra padding, affects postop healing
34
Musculoskeletal assessment
mobility bring mobility aids to surgery report problems affecting neck or lumbar spine (can effect airway management and anesthesia delivery spinal anesthesia may be difficult if pt can not flex lumbar spin (need to bend when administering)
35
Endocrine assessment
pt with diabetes are at risk for: - hypoglycemia - hyperglycemia (high stress) - ketosis - Cardiovascular issues - delayed wound healing - infection
36
Insulin and Surgery
blood sugar should be stabilized 12-16 hours before surgery clarify with surgeon insulin dose before surgery capillary blood glucose should be take throughout surgery
37
What does hyper and hypothyroidism affect the pt?
alter metabolitic rate lab tests need to be done and nurse should find out if thyroid meds are to be given
38
Immune function
allergies? has the pt reacted to blood transfusion before? Latex? is the pt immunocompromised? what is the pts temp? (if too high, surgery is postponed)
39
What causes surgery to be postponed?
High temp Uncontroled BP Smoking, alcohol and drug intoxication/use Uncontrolled BG Resp infection
40
Fluid and electrolyte status assessment
V + D or difficulty swallowing can cause imbalance most pts are NPO before surgery Diuretics!!! --> get rid of K --> look at lab tests good nutritional status = good wound healing
41
Lab and diagnostics
taken before surgery (CBC, INR, WBCs, platelets) make sure all are done and in chart
42
Pre-op meds
Benzos (reduce anxiety) Anticholinergics (reduce secretions) Opioids (pain) Antiemetics (nausea) Antacids (prophylactic) Eye drops (eye surgery) Usual meds
43
Preop teaching
teach as individual use multiple strategies should be started ASAP leave room for questions be aware of anxiety include sensations the pt will feel teaching = decreased stress
44
Older Adult considerations
Combination of chronic illnesses decreased ability for organ to return to normal after a disturbance most pt >65 have challenges altered affects of opiods and anesthesia increased risk of adverse rxns to meds comorbidities (chronic disease, polypharm)
45
Pre-op interventions for nurses
management of nutrition and fluids (NPO?, clear liquid diet - usually by midnight before surgery) Make sure pt: - hospital gown - braid hair, remove pins - remove jewelery - inspect mouth, remove dentures - void prior to surgery, cath? - nailpolish removed

NURS 412 (21 decks)

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