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M.H.R School Of Nursing > Unit 5 Pre-op > Flashcards

Unit 5 Pre-op Flashcards

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1
Q

Phases of Surgery

A
  • Preoperative
  • Intra-operative
  • Post-operative
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2
Q

Preoperative

A

time decision is made to have surgery until transported to the OR

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3
Q

Intra-operative

A

administration of anesthesia through completion of surgery

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4
Q

Post-operative

A

Post-anesthesia care unit until recovery is complete

Can be years!

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5
Q

Surgery

A

planned anatomical alteration of the human organism designed to arrest, alleviate, or eradicate some pathological process

anatomical alteration of the body

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6
Q

Palliation/ Palliative

A

Does NOT cure; Alleviates symptoms
relieves symptoms without curing disease

Think Hospice

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7
Q

Perioperative period

A

(encompasses 3 phases)—around the surgery

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8
Q

Perioperative Nurse

A

allows nurse to function in variety of roles within the surgical process–> CONTINUITY OF CARE

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9
Q

Inpatient

A

patient admitted and surgery performed in the hospital surgical suite

must stay in hospital at least over night

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10
Q

Ambulatory Surgery

A

Outpatient

~70-90% of surgeries are not outpatient

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11
Q

Free Standing

A

not affiliated w/ hospital; independently owned & operated

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12
Q

Hospital affiliated facility

A
  • Sep. department (for all 3 phases)

* Located w/in hosp complex or satellite office

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13
Q

Minor Surgery

A

simple surgery that presents little risk to life (may not be minor to patient!)

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14
Q

Major Surgery

A

involves extensive reconstruction or alteration in body part

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15
Q

Diagnostic/Exploratory

A

to determine cause of symptoms or verify diagnosis

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16
Q

Curvative

A

removal of diseased part, repair damaged or malformed area, removal of early stage tumors

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17
Q

Ablative

A

removal of diseased part ** total !!!

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18
Q

Restorative

A

strengthen a weakened area

bone pinning, herniorrophy (suture repair of hernia), mitral, valve replacement

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19
Q

Constructive/reconstructive

A

repair malformations or improve function/appearance.

Plastic, cleft palate, plastic surgery, breast reconstruction

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20
Q

-ECTOMY

A

removal of an organ or gland

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21
Q

-lysis

A

destructive

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22
Q

-orrhaphy

A

suturing or stitching

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23
Q

-ostomy

A

providing an opening

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24
Q

-otomy

A

cutting into

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25
-plasty
formation or plastic repair
26
-scopy
looking into
27
Emergency Surgery
unplanned – preformed immediately to save life*** - to save life or body part Performed due to major trauma or hemorrhage of internal organs.
28
Informed Consent
- Prior to any non-emergency surgery - Must Have: clear understanding of the surgery, risks, and benefits w/ clear judgment –no impairments * - Surgery cannot legally be performed until patient understands and signs consent - protects: patient, hospital, staff, & surgeon - valid for 60 days - must be witnessed
29
Urgent Surgery
Unplanned. Requires surgical intervention within 24-48 hrs
30
Required Surgery
Planned; Required | Indicated for health problems but not immediate
31
full explanation of the procedure in terms the patient can understand prior to signing is performed by
the physician
32
Elective
- planned; desired | - Scheduled weeks or months in advance
33
AORN
Asc. Of Operating Room Nurses | Purpose: gain new knowledge and improve nursing care in the OR; Develop standards of practice for the OR
34
Subjective Data
Pt level of understanding/perceptions
35
Subjective Data Assessments
* Site/ type of surgery/ reason for surgery * extent of hospitalization, limitations * pre-op/ post-op routines/ tests required * surgical experiences/ specific concerns about present surgery * religion or cultural beliefs * family/significant other source of support
36
WBC
Total White Blood Cell Count Fight Infection 4,000-10,000 (4-10 on lab print out)
37
Neutrophils
2nd line of defense
38
Lymphocytes
1st line of defense
39
Potassium
Major Cation within cells 3.5-5.0 **Minor Changes have significant consequences Abnormal Ranges increase risk of cardia arrhythmia • Excreted by the kidneys
40
Sodium (Na+)
maj determinant of extracellular osmolality | Norm: 136-145
41
Carbon Dioxide
* Norm: 23-30 mEq | * pH status of pt and other electrolytes
42
Cl-
* 98-106 MeQ * → indication of acid-base balance * Maintain electrical neutrality with Na+
43
Ca+
7.6-10.4 mg/dl | parathyroid funx, ca+ metabolism, monitor renal funx
44
Collection of subjective & objective data provides
``` baseline information (DAY 2) • identify & correct any risk factors • establish baseline data for comparison • plan & institute pre-op care • select anesthesia ```
45
Pre-op physical assessment includes
* physical assessment * pre-surgical test results * identification of surgical risk factors
46
Baseline Data Includes
* General health/previous surgeries * Allergic responses * Medications/smoking/ETOH * prosthesis: dentures, glasses, etc * disabilities/impairments * mobility limitations * body size & structure * level of consciousness * mental status/ coping/support * pregnant * Body surface area
47
smoking history -->
↓ ciliary action to remove secretions | irritating to tracheobronchial passages →lyringo spasms
48
Hepatic
detoxifies drugs - primary concern for anesthesia
49
malnutrition
state of impaired functional ability of essential nutrients & calories within cells
50
obesity
excessive accumulation of fat ↑surgical risk • Adipose tissue is avascular • More adipose tissue, more technical difficulty – longer anesthesia time – higher risk of intraop complications
51
adrenocortical stress response
results in sodium & water retention/ potassium loss
52
Radiation Therapy
* Side effects that may affect surgery/healing * -thin skin layers * -breaks down collagen for less healing potential * -scars tissue-fibrotic & changes vascularity * ****Ideally, wait 4-6 weeks after radiation to do surgery.****
53
Overall goal of pre-op period
to ensure patient is mentally & physically prepared for surgery
54
Purposes of Pre-op Medication
Prevents N/V, autonomic reflex response, post-op infections -- antibiotics Decreases anesthetic requirements,respiratory & GI secretions –> prevents aspiration; anticholorgenic Relieves apprehension & anxiety -->Promotes sedation & amnesia -->Facilitates induction of anesthesia
55
Pre-op Medications:
• ordered by anesthesiologist or surgeon
56
Antibiotics & anti-emetics:
given 30-60 minutes prior to surgery
57
Once pre-op meds are given:
* patient to remain in bed with side rails up, call bell in reach * DOCUMENT: explained to patient need to remain in bed
58
What to expect when love one comes out of surgery
* Not awake * Say incoherent things * Pale * Special Equipment * Frequent Vital Signs
59
BUN
* 10-20 | * Monitors Kidney Function
60
• Creatine
* 0.5-11 | * Monitors Kidney Fun
61
Urinalysis
• UTI, renal function, diabetes
62
• Type & Cross Match
• High risk for blood loss, sufficient blood for pt during surgery
63
ABG's
arterial blood gases
64
• Pregnancy Test
Female pt of childbearing age
65
• Clotting Factor
* PTT – Prothrombin Time | * PT/INR- Pro Time/ International Ratio – normally between 1&2
66
• Bleeding Time
how long… done on “wheel”
67
FBS
* Fasting Blood Sugar | * Thick blood → decrease flow → increase clot
68
Albumin/Protein
important for osmotic press. w/ in vascular space | • Measure of Nutrition
69
• ALT
(alanine aminotransferase)
70
(alanine aminotransferase)
Norm: 4-6 | Liver enzyme → indicates any damage to liver
71
EKG
measures heart electrical activity • Rate, Rhythm & other factors • ID Pre-existing cardiac problems • Pt >40 years/ or hist of heart disease
72
PFT
pulmonary function
73
Anticholinergics & benzodiazepines:
given just prior to OR
74
Hematocrit
% of total red blood volume made up of RBC • M: 42-52% • F: 37-47%
75
Platelets
essential to blood clotting | • 150,000-400,000
76
Bowel Prep
empty bowel of fecal material ' Collapse or “decompress” bowel so not obstruct access to organs or be nicked during surgery; prevents incontinence & contamination of surgical; prevents post-op constipation r/t decreased peristalsis; prevents uncomfortable straining first dew days post-op → dangerous for rectal, prostate & eye surgery; PERISTALSIS DOES NOT RETURN FOR 24 HOURS
77
Objective Data: clues to anxiety level
* speech patterns -rept themes * degree of interactions with others * physical-pulse/ respirations,hand movements, perspiration, activity level, frequent voiding * change in sleep patterns
78
biggest fear
will not wake up
79
a stressor, a potential or actual threat to body integrity; Always a major experience for pt
surgery

M.H.R School Of Nursing (32 decks)

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