pre-op pt.

Question 1

Pain

Answer 1

Common after surgery

Question 2

When should we do Patient Education?

Answer 2

We want to do patient education?

Question 3

What role does teamwork and collaboration have on care of the peri-operative pt.?

Answer 3

Must acknowledge that their is going to be more than one person working with the patient within the OR and outside of the OR

Question 4

How does fluid & electrolytes relate to the surgical pt.?

Answer 4

If the pt. hemorrhages out on the table it can cause a decrease in the pt.’s circulating BV. A decrease in the pt.’s circulating BV can cause a decrease in BP and an increase in HR. If pt has a decrease in BP then that decrease in BP will cause improper perfusion to the kidneys. Kidneys need proper perfusion to work properly. This will cause electrolyte retention due to low urine output.

Question 5

How does immunity & infectioon relate to the surgical pt.?

Answer 5

Infection of the surgical site in the number one post op. complication in patients.

Question 6

How does mobility relate to the surgical pt.?

Answer 6

Mobility can affect the way a pt. is positioned while in the OR. It can also affect the pt.’s recovery because they need to be able to ambulate after surgery to avoid post op. complications

Question 7

How does stress & coping relate to the surgical pt.?

Answer 7

Some pt.’s are nervous about undergoing surgery due to the unknown; it’s our jobs as nurses to help them cope with this stress and anxiety

Question 8

How does tissue intergrity relate to the the surgical pt.?

Answer 8

Post op. pt. will have a surgical site wound; different things can affect the way a pt.’s wound healing process

Question 9

How does tissue perfusion relate to the surgical pt.?

Answer 9

Impaired tissue perfusion can cause things like hypoxia, hypoxemia, or even a DVT

Question 10

Preoperative

Answer 10

Before the pt. goes into surgery; we’re preparing for them to go into surgery

Question 11

Intraoperative

Answer 11

The patient is in surgery

Question 12

Postoperative

Answer 12

After the patients surgery; pt. is in the PACU

Question 13

Diagnostic surgery

Answer 13

used to determine the cause and orgin of a disorder; have to take a tissue sample via biopsy with the intention of diagnosing…sometimes we have to stage it

Question 14

Curative surgery

Answer 14

removing a diseased area and repairing/eliminating the pathological condition; ex. removing a benign tumor, removing a diseased gallbladder (Cholestasis) or appendicitis

Question 15

Palliative surgery

Answer 15

Doing a surgery to improve the quality of ones life without a cure; surgery should not be extensive; ex. forming illeostomy for someone who has a tumor in the intestines or cutting a nerve so someone doesn’t feel pain in a certain area

Question 16

Preventive surgery

Answer 16

Having a surgery to prevent a illness/condition from occurring; ex. getting a double mastectomy if you were positive for the BRCA 1 or BRCA 2 gene or removing a pre-cancerous mole

Question 17

Reconstructive surgery

Answer 17

performed on an abnormal or damaged body structure to improve its functional ability; ex. total knee replacement or total hip replacement

Question 18

Cosmetic surgery

Answer 18

performed to reshape normal body structures to improve the pt. appearance or self-image

Question 19

Transplant surgery

Answer 19

performed to replace a malfunctioning structure

Question 20

Elective surgery

Answer 20

Is pre-planned, done to correct a condition that is non-life threatening; ex. total knee replacement, cataract surgery, ex.

Question 21

Urgent surgery

Answer 21

Surgery that needs to be done within 24-48 hrs. before it become life threatening; ex. kidney stones, urethral blockage, bowel obstruction, fracture, eye injury

Question 22

Emergency surgery

Answer 22

Surgery that needs to be done right away because it is life threatening; ex, GSW, stabbing, abdominal bleed, compound fracture, appendectomy

Question 23

How does age affect surgery?

Answer 23

pt.’s developmental status will affect the way they cope with surgery bot physically and psychologically; physiological and pshycological reactions to surgery along with anesthesia can affect/bring out the pt.’s stress response

Question 24

How does surgery affect our infants?

Answer 24

parents can help prepare our infants by adjusting care that will support the needs of the child; provide oral means for the infant for any pre-surgery prodecures; help parents get through grief, guilt, or anxiety; monitor their RS, F+E, and glucose

Question 25

How does surgery affect our children ?

Answer 25

Assess their developmental status so we an do use proper teaching techniques along with communication with them; assess stress and coping; assess safety and comfort post op.

Question 26

How does surgery affect out geriatric population?

Answer 26

assess any pre-existing conditions ex. HTN, diabetes, COPD, cardiac arrhythmias, CHF; assess ability to hear to ensure proper education and communication; more prone to hypothermia due to loss of subq fat; more prone to PNA, infection and other complications; more prone to respiratory and cardiac mortality+morbidities due to aged lungs and heart

Question 27

Can we do surgery on a patient with infection?

Answer 27

No; unless it was an emergency

Question 28

Can we do surgery on pt.'s with chronic illnesses or pre-existing conditions?

Answer 28

We would need a write off from their provider stating that the pt. is stable enough for surgery

Question 29

Pre-admission

Answer 29

Ensure we have: pre-op teaching done, pre-op meds in the pt., pre-op assessment done, pre-op admission testing done,

Question 30

What is an advance directive?

Answer 30

Written instructions of what the pt. wants done to them during end of life care if they're ever in terminal illness or mental incapacity; AD do not apply when the pt. goes into surgery

Question 31

Corticosteroids

Answer 31

reduce inflammation; delay wound healing, causes to thin out

Question 32

Anticoagulants

Answer 32

slow down blood clotting; increase the pt.'s risk of hemorrhaging in the OR or post op bleeding; ex. ibuprofen, aspirin, heparin, warfarin, enoxaparin, neproxin

Question 33

Diuretics

Answer 33

remove excess fluid from the body; where water goes sodium follows along with other electrolytes; this loss of electrolytes will cause them to be low and could cause cardiac problems in the OR or cause us not to be able to operate

Question 34

Sedative/Tranquilizers

Answer 34

If combined with post op. meds. pt. can have an adverse reaction

Question 35

Herbs & Supplements

Answer 35

Some herb and supplements can cause an increase in bleeding such as: vitamin E, garlic, fish oil, and ginko; all herbs & supplements must be stopped 2-3 wks prior to surgery

Question 36

Physical Assessment: Nutrition

Answer 36

must know H&W because this lets anesthesia know how much anesthesia to administer to pt.; nutrients needed for wound healing should be increased prior to surgery (protein); obese and malnourished pt.'s are at a higher risk for complications

Question 37

Physical Assessment: Respiratory

Answer 37

assessing history of chronic respiratory problems such as: COPD, asthma, CHF (left sisded symptoms are in the lungs and sound wet); assessing smoking...can affect the pt.'s recovery post op and intra op.; assessing current status...if pt. has a active upper respiratory infection we cannot operate on them

Question 38

Physical Assessment: Cardiovascular

Answer 38

history of CV disease puts pt. at risk for complications intra op. and/or post op.

Question 39

Physical Assessment: Hepatic & Renal

Answer 39

needed to effectively remove waste products; hepatic disorders affect metabolism of anesthesia & meds; renal disorders affect excretion of anesthesia, meds, & fluid

Question 40

Physical Assessment: Endocrine

Answer 40

pt. with diabetes are at increased risk for hypo/hyperglycemia, wound infection and metabolic acidosis; pt.'s receiving steroids (play on the adrenals) are at risk for adrenal insufficiency (improper creation of hormones); pt with hyper/hypothyroidism can affect metabolic rate; important that anesthesia knows about these chronic disorders

Question 41

Physical Assessment: Immunological

Answer 41

assess for allergies, sensitivities, or reactions; pt.'s with immunological disorders are at increased risk for infection; pt.'s who are immunosuppressed: chemo pts., HIV pts., pts. taking immunosuppressants after surgery, and pts on corticosteroids

Question 42

Physical Assessment: Neurological

Answer 42

assess ability to respond, follow commands, and keep train of thought; assess vision and hearing; assess cognitive functioning; establish pre-op baseline so that we can compare post op.

Question 43

Physical Assessment: Integumentary

Answer 43

assess current condition of skin especially for rashes, breakdown, or dermalogical conditions; select body parts free from body art for injections, IV sites, & labs

Question 44

Physical Assessment: Mobility

Answer 44

assess for mobility problems, may affect the way a pt. is positioned during surgery; mobility aids should be brought with pt. the same day of surgery

Question 45

Prior Medication Therapy: Corticosteroids

Answer 45

can cause CV collapse if discontinued suddenly; Dr. has to prescribe a tapering schedule

Question 46

Prior Medication Therapy: Thiazide diuretics

Answer 46

Can cause extreme respiratory depression due to an imbalance of