Flashcards in unit V Deck (115)
Time decision is made to have surgery until transported to the OR
Administration of anesthesia through completion of surgery
Post anesthesia care unit until recovery is complete
Peri operative nursing is a planned process based on?
The nursing process
Standardized policies and procedures are important for?
Easier to teach pt
Help maintain quality of practice
Continuity of care for total surgical experience
Pt admitted & surgery performed in the hospital surgical suite
Approximately 80% of surgeries are now?
What are some advantages of out patient surgery?
Inpatient beds for very I'll
Disadvantages of outpatient
Responsible for own pre op preparation
Name some criteria for out patient surgery
Simple surgery that presents little risk to life
Performed in dr office
Involves extensive reconstructive or alteration in body part
Performed to determine cause of symptoms or verify diagnosis
Diagnostic or exploratory surgery
Removal of diseased part, repair damaged or malformed area, removal of early stage rumors
Removal of diseased part
Strengthen a weakend area
Repair malformations or improve function/appearance
Constructive or reconstructive surgery
Relieves symptoms without curing disease
Replace an organ
Surgery performed due to major trauma or hemorrhage of internal organs, done to save life or body part
Requires surgical intervention within 24-48 hrs
Indicated for health problems but not necessary immediately to preserve life or function
Ex. Knee replacement
Scheduled weeks or months in advance, if delayed there are no adverse effects
Removal of an organ or gland
Suturing or stitching
Providing an opening
What must the pt sign before surgery?
Informed consent form
The consent form protects who?
Pt, hospital, staff & surgeon
Who has to fully explain the procedure including risks & benefits
How long is an informed consent good for?
What is the first thing you assess?
What are the three phases in the perioperative period
Good nutrition is essential for ?
Wound healing & infection
What is the purpose of nursing associations?
Gain new knowledge and improve nursing care
Free standing surgical unit
Not connected to the hospital in any way
Independently owned and operated
Simple surgery that presents little risk of life
Involves extensive reconstruction or alteration of body part
Name the factors that affect risk
When can treatment be given with out consent
Immediate life threat to life or health, condition cannot be delayed
What decrease level of anxiety?
Information, understanding of what's going on
Why do we do pre op teaching?
Requires less anesthesia & analgesia
Lowers infection rates
Lowers pulse & b/p
What information ate you giving to the pt during pre op teaching
Purpose of surgery
Tests need to be done
Pre op routines
What to expect after surgery
Post op therapies
How will you know that the pt understands your teachings?
What is a collection of subjective & objective data that provides baseline information
Why is physiological preparation used
Identify & correct any risks factors
Est. baseline data for comparison
Plan pre op care
Baseline data includes
General health/previous surgeries
During the physical assessment what are you looking for in the Respiratory system?
Hx of resp allergies
During the physical assessment what are you looking for in the cardiovascular system
Peripheral vascular disease (DVT)
VS (all pulses, heart rate & rhythm)
If you have a pt with abnormal potassium what could this cause?
During the physical assessment what are you looking for in the renal system
Decrease function increases toxicity
May need electrolyte replacement prior to surgery
What lab values are used to check for renal function
(Check kidney function)
During the physical assessment what are you looking for in the endocrine system
Delayed wound healing
Lab tests-ketones in urine
During the physical assessment what are you looking for in the hepatic system
PRIMARY concern for anesthesia
During the physical assessment what are you looking for in the neurological system
Hx of seizures, epilepsy
During the physical assessment what are you looking for in the musculoskeletal system
During the physical assessment what are you looking for in the immune system
Hx of HIV
Chemotherapy (risk for infection)
Steroids (lowers immune system)
What is important in determing pt outcomes during & after surgery
Surgical risk factors
The degree of surgical risk depends on
Physical & mental condition
Extent of pre existing disease
Severity of required operation
Why is at the greatest surgical risk
Protein is an essential component for?
The building & repair of tissues and to fight infection
Why is obesity a high risk
Excessive amt of fat
Longer anesthesia time
High risk intra op complications
What side effects can radiation have
Decrease of collagen
Delayed wound healing
What is the overall goal of pre op period
Ensure pt is mentally & physically prepared for surgery
What is your expected outcome of the surgery
Decrease complications & length of stay in hospital
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
During the physical preparation the evening prior, what does skin preparation do
Decreases the # of microorganisms at the surgical site.
During the physical preparation the evening prior, what does sleep & rest provide?
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
During the physical preparation of the day of surgery you can not enter the OR without?
History & physical & OR checklist
Name purposes of pre op Rx.
Prevents N & V
Prevents post op infections
Decreases anesthetic requirements
Prevents gag reflex
Decreases respiratory & GI secretions
Pre op rx's are ordered by?
Anesthesiologist or surgeon
Antibiotics and anti emetics are given when?
30-60 minutes prior to surgery
When are anticholinergics & benzodiazepines given
Given just prior to OR
Once pre op Rx's are given what must happen
Pt must remain in bed with side rails up, call bell in reach
Normal WBC count
The whit blood cells are made up of what 5 components
What do whit blood cells do?
Basophils & eosinophils do what?
Activate allergy response
Monocytes do what?
Eat bacteria (long lasting)
Neutrophils & lymphocytes do what?
Last short time 6 hrs
Eat, clean up bacteria
Fight chronic or bacteria infections
Normal RBC count
What do hemoglobin do?
Normal hemoglobin levels
If your WBC count is low, what kind of disease could it be?
If your WBC count is high, it can be a sign of ?
Percentage of total blood volume made up by RBCs
What is the normal hematocrit %
Essential for blood clotting
Normal platelet count
If your RBC count is low what could be the cause
Not making enough blood
Balance between dietary intake and renal excretion
If you have an imbalance of electrolytes what could happen?
Imbalance can cause cardiac arrhythmia or cardiac arrest
Carbon dioxide (CO2)
Assists with Ph balance
Normal 98-106 mEq
Acid base balance
Normal 7.6-10.4 mg/dl
Blood urea nitrogen
Monitors kidney function
Increase of BUN could indicate?
Monitors kidney function
What labs monitor kidney function
Creatinine & BUN
Urinalysis is used to identify ?
UTI, renal function, diabetes
If pt is at high risk for blood loss what lab is ordered?
Type & cross match
Arterial blood gases
Drawn by respiratory
PTT, PT/INR, bleeding time
Done for surgery or if on blood thinners
Measure of nutrition
Monitors liver function
Chest x ray
Examine condition of heart & lungs
Measures hearts electrical activity
Over age of 40 & heart Hx
Pulmonary function test