unit V Flashcards
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1
Q
Time decision is made to have surgery until transported to the OR
A
Preoperative
2
Q
Administration of anesthesia through completion of surgery
A
Intra-operative
3
Q
Post anesthesia care unit until recovery is complete
A
Post operative
4
Q
Peri operative nursing is a planned process based on?
A
The nursing process Assess Planning Implement Evaluate
5
Q
Standardized policies and procedures are important for?
A
Pt safety
Easier to teach pt
Help maintain quality of practice
Continuity of care for total surgical experience
6
Q
Pt admitted & surgery performed in the hospital surgical suite
A
Inpatient
7
Q
Approximately 80% of surgeries are now?
A
Outpatient aka
Ambulatory surgery
8
Q
What are some advantages of out patient surgery?
A
Less costly
Inpatient beds for very I’ll
9
Q
Disadvantages of outpatient
A
Responsible for own pre op preparation
10
Q
Name some criteria for out patient surgery
A
Age
General health
Pt willingness
Insurance requirements
11
Q
Simple surgery that presents little risk to life
Performed in dr office
A
Minor surgery
12
Q
Involves extensive reconstructive or alteration in body part
A
Major surgery
13
Q
Performed to determine cause of symptoms or verify diagnosis
A
Diagnostic or exploratory surgery
14
Q
Removal of diseased part, repair damaged or malformed area, removal of early stage rumors
A
Curative surgery
15
Q
Removal of diseased part
A
Ablative
16
Q
Strengthen a weakend area
A
Restorative surgery
17
Q
Repair malformations or improve function/appearance
A
Constructive or reconstructive surgery
18
Q
Relieves symptoms without curing disease
A
Palliative
19
Q
Replace an organ
A
Transplant
20
Q
Surgery performed due to major trauma or hemorrhage of internal organs, done to save life or body part
A
Emergency: unplanned
21
Q
Requires surgical intervention within 24-48 hrs
A
Urgent: unplanned
22
Q
Indicated for health problems but not necessary immediately to preserve life or function
Ex. Knee replacement
A
Required: planned
23
Q
Scheduled weeks or months in advance, if delayed there are no adverse effects
A
Elective: planned
24
Q
Removal of an organ or gland
A
Ectomy
25
Suturing or stitching
Orrhaphy
26
Providing an opening
Ostomy
27
Otomy
Cutting into
28
Scopy
Looking into
29
What must the pt sign before surgery?
Informed consent form
30
The consent form protects who?
Pt, hospital, staff & surgeon
31
Who has to fully explain the procedure including risks & benefits
The physician
32
How long is an informed consent good for?
60 days
33
What is the first thing you assess?
Anxiety level
34
What are the three phases in the perioperative period
Per operative
Intra operative
Post operative
35
Good nutrition is essential for ?
Wound healing & infection
36
What is the purpose of nursing associations?
Gain new knowledge and improve nursing care
37
Free standing surgical unit
Not connected to the hospital in any way
| Independently owned and operated
38
Simple surgery that presents little risk of life
Minor surgery
39
Involves extensive reconstruction or alteration of body part
Major surgery
40
Name the factors that affect risk
```
Age
General health
Nutrition
Medications
Mental status
```
41
When can treatment be given with out consent
Immediate life threat to life or health, condition cannot be delayed
42
What decrease level of anxiety?
Information, understanding of what's going on
43
Why do we do pre op teaching?
Reduces anxiety
Requires less anesthesia & analgesia
Lowers infection rates
Lowers pulse & b/p
44
What information ate you giving to the pt during pre op teaching
```
Purpose of surgery
Tests need to be done
Pre op routines
Schedules
What to expect after surgery
Post op therapies
```
45
How will you know that the pt understands your teachings?
Return demonstration
| Verbalized
46
What is a collection of subjective & objective data that provides baseline information
Physiological preparation
47
Why is physiological preparation used
Identify & correct any risks factors
Est. baseline data for comparison
Plan pre op care
Select anesthesia
48
Baseline data includes
```
General health/previous surgeries
Allergies
Rx/smoking/ETOH
Prothesis
Mobility limitations
Body size
LOC
Height weight
```
49
During the physical assessment what are you looking for in the Respiratory system?
```
Hx of resp allergies
Asthma
COPD
smoking hx
Lung sounds
Breathing exercises
```
50
During the physical assessment what are you looking for in the cardiovascular system
```
Angina
MI
HTN
Peripheral vascular disease (DVT)
VS (all pulses, heart rate & rhythm)
```
51
If you have a pt with abnormal potassium what could this cause?
Cardiac arrhythmia
52
During the physical assessment what are you looking for in the renal system
Decrease function increases toxicity
Check I&O
May need electrolyte replacement prior to surgery
53
What lab values are used to check for renal function
BUN
Creatin
(Check kidney function)
54
During the physical assessment what are you looking for in the endocrine system
Diabetic risks
Delayed wound healing
Lab tests-ketones in urine
55
During the physical assessment what are you looking for in the hepatic system
(liver)
Metabolizes Rx
PRIMARY concern for anesthesia
56
During the physical assessment what are you looking for in the neurological system
Orientation
Alertness
Hx of seizures, epilepsy
57
During the physical assessment what are you looking for in the musculoskeletal system
Positioning
| Airway management
58
During the physical assessment what are you looking for in the immune system
Hx of HIV
Autoimmune disease
Chemotherapy (risk for infection)
Steroids (lowers immune system)
59
What is important in determing pt outcomes during & after surgery
Surgical risk factors
60
The degree of surgical risk depends on
Physical & mental condition
Extent of pre existing disease
Severity of required operation
61
Why is at the greatest surgical risk
Very young
| Very old
62
Protein is an essential component for?
The building & repair of tissues and to fight infection
63
Why is obesity a high risk
Excessive amt of fat
Longer anesthesia time
High risk intra op complications
64
What side effects can radiation have
Decrease of collagen
| Delayed wound healing
65
What is the overall goal of pre op period
Ensure pt is mentally & physically prepared for surgery
66
What is your expected outcome of the surgery
Decrease complications & length of stay in hospital
67
During the physical preparation the evening prior why do you want to prep the bowel
Decompress the bowel, so not to obstruct access to the organs, prevents incontinence or contamination
68
During the physical preparation the evening prior, what does skin preparation do
Decreases the # of microorganisms at the surgical site.
69
During the physical preparation the evening prior, what does sleep & rest provide?
Manage stress
| Reduce anxiety
70
During the physical preparation the evening prior, why are pt's NPO after MN?
Nothing by mouth after midnight
| Reduces possibility of vomiting & aspiration during anesthesia
71
During the physical preparation of the day of surgery you can not enter the OR without?
History & physical & OR checklist
72
Name purposes of pre op Rx.
```
Relieves anxiety
Provides analgesia
Prevents N & V
Prevents post op infections
Decreases anesthetic requirements
Prevents gag reflex
Decreases respiratory & GI secretions
```
73
Pre op rx's are ordered by?
Anesthesiologist or surgeon
74
Antibiotics and anti emetics are given when?
30-60 minutes prior to surgery
75
When are anticholinergics & benzodiazepines given
Given just prior to OR
76
Once pre op Rx's are given what must happen
Pt must remain in bed with side rails up, call bell in reach
77
Normal WBC count
4,000-10,000
| 4-10
78
The whit blood cells are made up of what 5 components
```
Neutrophils
Lymphocytes
Monocytes
Basophils
Eosinophils
```
79
What do whit blood cells do?
Fight infection
80
Basophils & eosinophils do what?
Activate allergy response
81
Monocytes do what?
Eat bacteria (long lasting)
82
Neutrophils & lymphocytes do what?
Fight infection
| Last short time 6 hrs
83
Neutrophils
Eat, clean up bacteria
84
Lymphocytes
Fight chronic or bacteria infections
85
Normal RBC count
Male 4.7-6.1
| Female 4.2-5.4
86
What do hemoglobin do?
Carry oxygen
87
Normal hemoglobin levels
Male 14-18
| Female 12-16
88
If your WBC count is low, what kind of disease could it be?
Chronic
89
If your WBC count is high, it can be a sign of ?
Acute infection
90
Hematocrit
Percentage of total blood volume made up by RBCs
91
What is the normal hematocrit %
Male 42-52%
| Female 37-47%
92
Platelets
Essential for blood clotting
93
Normal platelet count
150,000-400,000
94
If your RBC count is low what could be the cause
Blood loss
| Not making enough blood
95
Sodium (Na+)
Normal 135-145
| Balance between dietary intake and renal excretion
96
If you have an imbalance of electrolytes what could happen?
Cardiac problems
97
Potassium (K+)
Normal 3.5-5.0
| Imbalance can cause cardiac arrhythmia or cardiac arrest
98
Carbon dioxide (CO2)
Normal 23-30
| Assists with Ph balance
99
Chloride (Cl)
Normal 98-106 mEq
| Acid base balance
100
Calcium (Ca+)
Normal 7.6-10.4 mg/dl
101
BUN
Blood urea nitrogen
Normal 10-20
Monitors kidney function
102
Increase of BUN could indicate?
Dehydration
103
Creatin
Normal 0.5-1.1
| Monitors kidney function
104
What labs monitor kidney function
Creatinine & BUN
105
Urinalysis is used to identify ?
UTI, renal function, diabetes
106
If pt is at high risk for blood loss what lab is ordered?
Type & cross match
107
ABG
Arterial blood gases
Oxygenated blood
Drawn by respiratory
108
FBS
70-100
109
PTT, PT/INR, bleeding time
Clotting factors
| Done for surgery or if on blood thinners
110
Albumin/protein
Measure of nutrition
111
ALT
Normal 4-36
| Monitors liver function
112
CXR
Chest x ray
| Examine condition of heart & lungs
113
EKG
Measures hearts electrical activity
| Over age of 40 & heart Hx
114
PFT
Pulmonary function test
115
A planned anatomical alteration of the body
Surgery
