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Flashcards in unit V Deck (115)
1

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

Preoperative

2

Administration of anesthesia through completion of surgery

Intra-operative

3

Post anesthesia care unit until recovery is complete

Post operative

4

Peri operative nursing is a planned process based on?

The nursing process
Assess
Planning
Implement
Evaluate

5

Standardized policies and procedures are important for?

Pt safety
Easier to teach pt
Help maintain quality of practice
Continuity of care for total surgical experience

6

Pt admitted & surgery performed in the hospital surgical suite

Inpatient

7

Approximately 80% of surgeries are now?

Outpatient aka
Ambulatory surgery

8

What are some advantages of out patient surgery?

Less costly
Inpatient beds for very I'll

9

Disadvantages of outpatient

Responsible for own pre op preparation

10

Name some criteria for out patient surgery

Age
General health
Pt willingness
Insurance requirements

11

Simple surgery that presents little risk to life
Performed in dr office

Minor surgery

12

Involves extensive reconstructive or alteration in body part

Major surgery

13

Performed to determine cause of symptoms or verify diagnosis

Diagnostic or exploratory surgery

14

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

Curative surgery

15

Removal of diseased part

Ablative

16

Strengthen a weakend area

Restorative surgery

17

Repair malformations or improve function/appearance

Constructive or reconstructive surgery

18

Relieves symptoms without curing disease

Palliative

19

Replace an organ

Transplant

20

Surgery performed due to major trauma or hemorrhage of internal organs, done to save life or body part

Emergency: unplanned

21

Requires surgical intervention within 24-48 hrs

Urgent: unplanned

22

Indicated for health problems but not necessary immediately to preserve life or function
Ex. Knee replacement

Required: planned

23

Scheduled weeks or months in advance, if delayed there are no adverse effects

Elective: planned

24

Removal of an organ or gland

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