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nursing 20030 > preoperative nursing > Flashcards

preoperative nursing Flashcards

(54 cards)

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1
Q

describe whats include in the assessment portion of preoperative nursing phase

A

-history and physical (H&P)
-identification of risk factors and allergies
-medication and treatment assessment
-facilitating/reviewing diagnostic tests
-identification of teaching and psychosocial needs
-assessing for postsurgical support and referral needs

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2
Q

whats included in preoperative history assessment?

A

-developmental considerations
-medical history (comorbidities)
-surgical history
-allergies and meds (substance use such as ETOH, illicit drugs, nicotine)
-nutritional status
-ADLs and occupation
-sociocultural needs
-support system (learning and discharge needs)

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3
Q

history

what surgical history is important r/t surgery

A

-trach - may intubate different route
-malignant hyperthermia (also check fam history)

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4
Q

history

why are meds important to know preoperatively?

A

-some can interact with anesthesia
-ppl on blood thinners are gonna bleed out

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5
Q

history

what socialcultural needs are important to know preoperatively?

A

-will they receive blood products?
-who is the decision maker?

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6
Q

history

when should you have history and physical done before surgery?

A

30 days prior

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7
Q

physical exam

what are the compenents of the physical exam?

A

-general survey
-integumentary
-respiratory
-cardiovascular
-neurological
-GI/GU
-musculoskeletal

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8
Q

physical exam

describe general survey

A

-vital signs (want to figure out baseline bc anesthesia decreases bp)
-height and weight (most anesthesia is weight dosed)

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9
Q

physical exam

integumentary

A

look to make sure skin is intact

is there increased risk for skin infection?

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10
Q

physical exam

cardiovascular

A

-regular heartbeat?
-CHF?
-ejection fraction (how much blood is being pumped out? if its too low there is risk for volume overload)

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11
Q

physical exam

neurological

A

-establish A&O baseline
-crainial nerve function

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12
Q

physical exam

GI/GU

A

do they urinate and shit regularly? what are their normal patterns?

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13
Q

key considerations

comorbidities associated with CV system

A

HTN, MI, HF, arrythmias, CVA, thrombocytopenia, anemia

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14
Q

key considerations

comorbidities associated with respiratory system

A

COPD, asthma, pneumonia, bronchitis, URI

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15
Q

key considerations

comorbidities

A

-CV
-respiratory
-renal or heptic disease
-diabetes

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16
Q

meds

antibiotics in surgery

A

increase effect of anesthesia = more sleepy

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17
Q

meds

antiarrhythmics in surgery

A

decrease contractility

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18
Q

meds

anticonvulsants in surgery

A

effect metabolism of drugs

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19
Q

meds

antiHTN drugs in surgery

A

effect during anesthesia

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20
Q

meds

diruretics in surgery

A

-decrease BP and cause electrolyte shifts

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21
Q

meds

NSAIDS in surgery

A

increase bleeding risks

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22
Q

meds

ginsing in surgery

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A

increase hypoglycemia

23
Q

what are some risk factors in surgery?

Study These Flashcards
A

-age
-nutritional status (malnutrition and obesity)
-fluid and electrolyte imbalance
-pregnancy
-previous surgical or anesthesia complications

24
Q

what bloodwork is important for surgery?

Study These Flashcards
A

-complete blood count (CBC)
-basic metabolic panel (BMP) or complete metabolic panel (CMP)
-coagulation studies
-blood type
-HCG

25
# bloodwork describe CBC
-WBC, RBC, HBG, HCT, platelets -increase in WBC = risk for infection -increased platelets = clot decreased platelets = continue to bleed and bleed
26
# bloodwork what is included in BMP/CMP
-electrolytes -BUN and creatinine -glucose -liver function
27
# bloodwork what is included in coagulation studies
-PT/INR (tells if pt will continue to bleed) -PTT
28
# bloodwork what is HCG
prenancy test
29
# lab values RBCs
-men: 4.6-6.2 million/mm3 -women: 4.2-5.4 million/mm3
30
# lab values Hgb
-men: 13-18 g/dl -women: 12-16 g/dl
31
# lab values Hct
-men: 42-52% -women: 35-47%
32
# lab values WBCs
4500-11000/mm3
33
# lab values platelets
150-450 x 10^9/L
34
name some serum electrolytes
-Na+ -K+ -Cl- -HCO3- -glucose
35
# serum electrolyte values Na+
135-145 mmol/L
36
# serum electrolyte values K+
3.5-5.0 mmol/L
37
# serum electrolyte values Cl-
95-105 mEq/L
38
# serum electrolyte values HCO3- | bicarb
22-26 mEq/L
39
# serum electrolyte values glucose
70-110 mg/dl
40
# renal function labs creatinine
0.7-1.4 mg/dl
41
# renal function labs BUN
10-20 mg/dl
42
# coagulation studies prothrombin time (PT)
9.5-12 seconds
43
# coagulation studies international normalized ratio (INR)
0.76-1.27 (when not anticoagulated) 2-3 (when anticoagulated)
44
# coagulation studies activated partial thromboplastin time (aPTT)
20-39 seconds
45
# coagulation studies anti-factor Xa Assay
0.3-0.7 units/ml (when anticoagulated)
46
what imaging tests are used preoperatively
-CXR -joint or bone Xrays -CT -MRI
47
whats included in cardiac workup
-EKG -cardiac stress test -sleep study
48
what are some preoperative nursing diagnoses
-knowledge deficit -anxiety -pain -risk for infection -impaired physical mobility -disturbed body image -disturbed sleep pattern
49
describe planning
-setting goals with the pt that are realistic and will help lead to a successful and complication free surgical experience -many preoperative nursing interventions involve setting expectations and providing information
50
describe implementation
-teaching -postoperative referrals
51
describe teaching
-general info -communicating expectations/protocols -providing anticipatory guidance -verifying informed consent
52
describe postoperative referrals
-case management/social work -DME (durable medical equipment) -homecare, skilled nusing care -prescriptions -postoperative apppointments
53
what are some day of surgery preparations?
-NPO status, IV -bowel prep/ empty bowel and bladder -preoperative meds -hygiene and skin prep -removal of dentures, jewelery, hearing aids -documentation completion and review -provide directions and emotional support for patient and significant others
54
describe document review
-consent -advanced directives -preoperative checklist

nursing 20030 (31 decks)

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