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NS 313- Med Surg Exam 1 > Pre-Operative > Flashcards

Pre-Operative Flashcards

1
Q
  1. AppendECTOMY
  2. ElectroLYSIS
  3. HerniORRHAPHY
  4. EndOSCOPY
  5. ColOSTOMY
  6. TracheOTOMY
  7. MammoPLASTY
A
  1. excision/removal
  2. destruction of
  3. repair/suture of
  4. looking into
  5. creation of opening
  6. cut/incision of
  7. repair/reconstruction of
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2
Q

What is a nurse’s role in a med surg unit?
Preoperative?
Intraoperative?
Postoperative?

A

Assessment/Teaching/Surveillance and Intervention

  • Teaching & Assessment
  • Surveillance- Vision opened to everything but using own knowledge to look for something specific
  • Postoperative- Surveillance & Teaching aimed at preventing complications and facilitating recovery and discharge
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3
Q

What are the most common psychological factors?

A

anxiety
fear
hope

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4
Q

What should be looked at during a PSYCHOSOCIAL assessment of a preoperative patient?

A 
Situational Changes
Concerns with the Unknown
Concerns with Body Image
Past Experience
Knowledge Deficit
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5
Q

What is the key priority in Preoperative Nursing?

How do you achieve this?

A
  • Patient Safety

- Always use the nursing process and gather data (Subjective and Objective)

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6
Q

What are some preoperative subjects you need to know in a nursing interview?

A
  • History
  • Allergies
  • Meds
  • Nutrition
    • Herbs
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7
Q

What should you do if a patient is on herbs?

A

D/C (discontinue) all herbs 2-3 weeks before surgery, Consult HCP for specific instructions

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8
Q

Herbs and Their Effects w/ Anesthesia

  1. Echinacea
  2. Ephedra
  3. Garlic
  4. Ginkgo
  5. Ginseng
  6. Kava
  7. St. John’s wort
  8. Valerian
A
  1. Echinacea- liver damage if you have liver disease
  2. Ephedra - hypertension and tachycardia
  3. Garlic - Prolonged bleeding during or after surger
  4. Ginkgo- Prolonged bleeding during or after surgery
  5. Ginseng- Hypertension and Tachycardia
  6. Kava- Liver damage and interactions with other medicine
  7. St. John’s wort- Excess Sedation
  8. Valerian- Excess sedation and Irregular Heart Rhythms
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9
Q

What complications can occur with a patient who takes a diuretic and a beta blocker to control blood pressure and with a low potassium level?

A

Dysrhythmias

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10
Q

What do you do if you determine that the patient has an URI (upper respiratory infection) and why?

What are the risks of someone going into surgery with a URI?

A
  • Inform the doctor and Reschedule surgery and Reassess
  • Lungs are at risk if you are in surgery due to General Anesthesia
  • Increased risk of laryngospasm or bronchospasm
  • Decreased SaO2
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11
Q

What risks are increased with someone with COPD going into surgery?

What should the nurse do?

A
  • Atelectasis and Hypoxemia

- Teach breathing techniques and lung exercises

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12
Q

What should the nurse do about smokers about to go into surgery?

A

Try to get them to quit 6 weeks prior

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13
Q

What risks does a patient with a history of urinary or renal diseases about to go into surgery have?

What should the nurse do?

A

Increased potential for

  • Fluid & Electrolyte Imbalances
  • Coagulopathies
  • Increased risk for infection- kidneys
  • Increased wound healing- kidneys
  • Watch voiding carefully
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14
Q

If a patient is on a diuretic such as Lasix, what occurs in their body?

What medication should they watch out for then and why?

A
  • Pees out K+ resulting in hypokalemia

- Digoxin because digoxin toxicity will more likely occur if the person has hypokalemia

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15
Q

What is more likely to happen with a patient with valve replacement?

A

More likely to have blood clots

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16
Q

What does a patient with a history with valve replacement need before surgery and why?
What else do you need to do?

A
  • Antibiotic Prophylaxis
    because they are at risk for endocarditis
  • Let the surgeon know
17
Q

If a patient has a certain food allergy such as eggs, avocados, bananas, chestnuts, potatoes, and peaches, what else an that indicate?

What do you need to do for these patients?

A
  • Patients with certain food allergies are likely to have latex allergies
  • Use special non-latex materials during surgical procedures
18
Q

What are some important things that the patient needs to do when recovering from surgery?

A
  • Spirometry
  • Coughing
  • Ambulation
19
Q

What does the nurse need to do in terms of paperwork before the surgery?

A

Get the patient’s informed consent in very legal, plain language while witnessing the patient’s signature.
- Make sure the patient is informed

20
Q

What are the exceptions where you don’t have to get the patient’s signature?

A
  • Minor (Get Parent’s Signature)
  • Incompetent (Get Guardian’s Signature)
  • Emergency (Document Surgery)
21
Q

If the patient is not informed or does not consent voluntarily, what should you do in terms of getting their signature?

A

Don’t have them sign and notify the surgeon and do this before pre-op drugs are given

22
Q

What are the elements of Valid Informed Consent that can be considered as adequate disclosure?

A
  • Diagnosis
  • Nature and Purpose of Proposed Treatment
  • Risks and Consequences
  • Probability of Successful Outcome
  • Availability, benefits, and risks of alternative treatments
  • Prognosis if treatment is not instituted

NS 313- Med Surg Exam 1 (10 decks)

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