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NSG 320 - MED SURG > Topic 2: Pre/Post-Op > Flashcards

Topic 2: Pre/Post-Op Flashcards

(85 cards)

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1
Q

perioperative period

A

the total surigal episode

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2
Q

inpatient hospital setting

A

-same day admission
-patients who are already in the hospital

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3
Q

ambulatory surgery

A

includes outpatient, same-day, or short-stay surgery that does not require an overnight hospital stay (returns home on the same day)

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4
Q

Level 1 Trauma

A

will take everything, including multisystem trauma (stabbing, shooting, car accident)
-in house 24/7 OR team

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5
Q

level 2 trauma

A

will take single system traumas (fractured leg, head injury)
-OR tema 24/7

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6
Q

level 3 trauma

A

no longer has any in hous staff or physicians
provide limited services (no neuro or cardiac surgery)
-access to an on call OR team

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7
Q

level 4 trauma

A

no onsite staff, limited services for walk in patients only

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8
Q

elective surgery

A

not an emergency, has been schedules and there is plenty of time to prepare

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9
Q

urgent surgery

A

the patient must go to surgery/OR within 6 hours for a life or limb threatening surgery. These patients tend to be stable, and wait in the ER.

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10
Q

emergent surgery

A

These are the true emergencies where there will be loss of life or limb within one hour if the patient isn’t taken to surgery.
-These patient tend to be very unstable, are often airlifted by helicopter to a trauma center, and come from the ER or ICU

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11
Q

diagnostic surgery

A

Determines origin and cause of disorder

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12
Q

curative surgery

A

Resolves health problem by repairing or removing cause

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13
Q

restorative surgery

A

Improves client’s functional ability

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14
Q

palliative surgery

A

Relieves symptoms of disease process, but does not cure

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15
Q

prevention surgery

A

reduce risk of developing a condition (removal of a mole before it becomes malignant)

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16
Q

cosmetic surgery

A

Alters/enhances personal appearance

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17
Q

When does the preoperative phase begin and end?

A

Begins when patient is scheduled for surgery

Ends at time of transfer to Operating Room/Surgical Suite

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18
Q

what does the nurse assess for a preop patient

A

-baseline data for comparison
- identification and documentation
- drug reconciliation & allergies
-checks if the patient is educated about info from surgeon and post op procedures
-asses anxiety and promote patient coopertion

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19
Q

what is included in the education for pre op

A

Information about informed consent, dietary restrictions, bowel and skin preparations, exercises after surgery, and plans for pain management promote patients’ participation and help achieve the desired outcome.

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20
Q

what tool is used in helping nursed to rememeber the many things that must be done when getting a client ready for surgery

A

pre-operative check list

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21
Q

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 or patterns

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22
Q

lab testing: ABGs, pulse oximetry

A

Respiratory and metabolic function, oxygenation status

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23
Q

lab testing: blood glucose

A

metabolic status, diabetes mellitus

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24
Q

lab testing: BUN, creatinine

A

renal function

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25
lab testing: chest x-ray
lung disorders, cardiac enlargement, HF
26
lab testing: CBC- RBCs Hgb, Hct, WBCs
anemia, immune status, infection
27
lab testing: electrocardiogram
heart disease, dysrhythmias
28
lab testing: electrolytes
metabolic status, renal function, diuretic side effects
29
lab testing: hCG
pregnancy
30
lab testing: liver function tests
liver status
31
lab testing: PT, PTT, INR, platelet count
coagulation status
32
lab testing: pulmonary function studies
pulmonary status
33
lab testing: serum albumin
nutritional status
34
lab testing: type and crossmatch
blood available fro replacement
35
lab testing: urinalysis
renal atatus, hydration, urinary tract infection
36
what lab test are VERY impotant to a surgeon
CBC because you need to know the PT and INR for BLEEDING TIME
37
what lab test are very important for a diabetic patient
BG and electrolytes
38
why is a stress response important to know before surgery
the stress response can be magnified, directly impact the body, and recovery can be affected.
39
what htree conditions ust be met for consent to be valid
adequate disclosure clear inderstansing of the information give consent voluntarily
40
what is the surgeons responsibility for legal preparation
inform the patient of why the surgery is needed, what the expected outcomes would be, and what the potential complications may be up to and including death. SURGEON IS RESPONSIBLE FOR OBTAINING CONSENT
41
what is the nurses responsibility for legal preparation
ensure the consent has been signed by both the patient and surgeon. WITNESS
42
when does the nurse need to make sure that the patient has signed for prior to consent
prior to any administration of sedation... this impairs their cognition so they are not legally responsible to sign.
43
what is is mandatory when surgery is performed on an organ/body part that has two of something...
site marking (The surgeon or designee (PA, assistant...) are responsible to mark it, so it can still be seen after the surgical drapes are applied.)
44
what are the two types of pre-op medications
regular medications pre-op medications required for surgery
45
what should be done about regular medications before an operation
Consult with physician and anesthesia provider for instructions
46
Pre-Op medications required for surgery
this prepares the client's body physically and psychologically
47
pre-op meds: antiemetics
decreases N/V
48
pre-op meds: benzodiazepines
to reduce anxiety, to induce sedation
49
pre-op meds: opioids
to relieve discomfort during pre op procedures decrease amnount of anesthetic needed for induction
50
pre-op meds: histamine H2 receptor antagonist
to increase gastric pH decrease gastic volume
51
pre-op meds: antacids
increase gastric emptying
52
pre-op meds: antichonlinergics
decrease oral and respiratory secretions (atropine provides sedation
53
Pre-op meds: antibiotics
prevents post op infection
54
pre op client preparation
-Leave valuables with family or lock up with security -Tape rings in place if cannot be removed (ring cutter) -Ensure patient is wearing ID band(s)
55
what do we remove before surgery
Dentures Prosthetic devices Hearing aids Contact lenses Fingernail polish Artificial nails All jewelry
56
pre-op teaching: sensory information
Noise levels, smells, OR cold, blanket given, everyone in masks, ask questions, lights in OR bright, sound of machines and their purpose
57
pre-op teaching: procedural information
What to bring and wear to surgical center, changes in time of surgery, fluid and food restriction, bed and safety strap, physical prep: (bowel, skin), purpose of freq. vital signs assessment, anesthesia administration procedure, insertion of IV lines
58
pre-op teaching: exercises
Perform ROMs
59
pre-op teaching: process information
information about the general flow of surgery & where will caregivers can wait during surgery
60
Deep breathing exercises
demonstrating technique of deep breathing & coughing will assist pt in performing post-op.
61
incentive spirometry
a common postoperative breathing therapy using a specially designed spirometer to encourage the patient to inhale and hold an inspiratory volume to exercise the lungs and prevent pulmonary complications
62
when does post-op care begin
*Begins with completion of surgery and transfer to PACU, ambulatory care unit, or ICU
63
what are the priority interventions of the nurse post-op
A: Asses and airway B: Breathing and blood C: circulation and change in LOC S: Safety
64
what assessment data is included in the PACU
*level of consciousness, temperature, pulse, respirations, oxygen saturation, blood pressure, and evaluation of the surgical area for bleeding (clotting).
65
after the intitial assesment upon admisssion to the PACU, how often are vital signs and heart sounds assesed
every 15 minutes until stable
66
post surgical bleeding is one of the most important things to check, why
it can cause the patient to go into hypovolemic shock
67
what does the nurse assess for fluid and electrolye imbalances
I&Os Daily weights hydration status electrolytes
68
What is counted as input and output on the In/Out Sheet?
iv fluid vomit urine wound drainage oral intake NG tube drainage
69
when should a nurse report inadequate urine output
if its <30 mL/hr
70
BAIR Hugger
Patient warming device used for Hypothermia because of after surgery causes shivering that increases oxygen demand and can induce hypoxemia.
71
what should a nurse do if their patient has paralytic ileus
insert an NG tube (low intermittent suction)
72
what medications are used to reduce N/V
*Ondansetron (Zofran) *Meclizine (Antivert, Dramamine) *Scopolamine patch
73
after surgery bowel sounds can be delayed for up to 24 hours, so what would the nurse monitor
monitor for bowel sounds
74
why are NG inserted
*Decompress and drain stomach *Promote GI rest *Allow lower GI tract to heal *Provide enteral feeding route *Monitor any gastric bleeding *Prevent intestinal obstruction
75
how often should the nurse asses NG tube drainage
every 8 hours
76
when is impaired wound healing most often seen after surgery
between 5 to 10 days after surgery
77
if there is wound dehiscence or eviceration, what should the nurse do
Notify the surgeon and remain with the patient if wound dehiscence or evisceration occurs. o Have the patient lie flat (supine) with knees bent to reduce intra-abdominal pressure. o Apply sterile, nonadherent, or saline dressing materials to the wound.
78
who performs the first dressing change
The surgeon usually performs the first dressing change to assess the wound, remove any packing, and advance or remove drains.
79
what technique is used during all dressing changes
aseptic technique
80
Physical & Emotional Signs of Acute Pain
*Increased pulse and blood pressure *Increased respiratory rate *Profuse sweating *Restlessness *Confusion (older adults) *Wincing, moaning, crying
81
complementary and alternative therapies for pain
*Positioning *Massage *Relaxation/diversion techniques
82
when is hypoxemia most common after surgery
*Highest incidence occurs on 2nd postoperative day
83
what are the interventions for hypoxemia
*Airway maintenance *Monitor (Spo2) *Semi-Fowler's position *Oxygen therapy, breathing exercises *Mobilization as soon as possible
84
how often should the nurse ass the tissue integrity of the incison site
each shift or at least every 8 hours and monitor for signs of infection.
85

NSG 320 - MED SURG (63 decks)

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