Week 2 Perioperative Flashcards

Question

Preoperative Instructions to prevent complications

Answer 1

Diaphragmatic breathing Coughing and splinting Leg exercises turning to side Getting out of bed

Answer 2

Pt identification Correct informed consent time out Verify records Results of diagnostic tests Allergies include latex Monitoring and modifying physical environment Safety measures Verification of blood

Answer 3

Cognition Fears Effect on meds Risks Loss of self protective mechanisms Loss of Senses Advocate Cultural Diversity Education is very important

Answer 4

Older Patients increased for risk for complications of surgery due to Increased due to coexisting conditions Aging, heart, pulmonary systems Decreased homestatic mechanisms Changes in responses to drugs, anesthetic agents due to aging changes

Answer 5

Patient Circulating Nurse- Does not scrub in Scrub role- Assist the doctor Surgeon RFNA Anesthsiologist, Anesthetist

Answer 6

Surgical environment - Unrestricted zone - Semi restricted zone - Restricted Zone Surgical Asepsis Environmental Controls

Answer 7

Control flow of patients and staff

Answer 8

Peripheral support area, surgical sink, scrub in area, wearing surgical attire

Answer 9

Surgical room, only accessible through a semi- restricted area

Answer 10

Absence of all microbes within any type of invasive procedure

Answer 11

Set of specific practices and procedures performed to make equipment and area free from all microbes and to maintain that sterility

Answer 12

All material in sterile field sterile Gowns sterile in front from the chest to level of sterile field , sleeves from 2 inches above elbow to cuff Only top of draped tables considered sterile Items dispensed by methods to preserve sterility Movements of surgical team are from sterile to sterile or from unsterile to unsterile only

Answer 13

Movement at least 1 foot distance must be maintained Sterile barrier breached- contaminated Every sterile field is constantly maintained Health Hazards Laser risks Exposure to blood and bodily fluids Fume exposure

Answer 14

Anesthesia Awareness Nausea and Vomiting Anaphylaxis Hypoxia and Resp. complications Hypothermia Malignant Hyperthermia DIC Infection

Answer 15

Fast rise in body temperature and severe muscle contractions Treated with Dantrolene

Answer 16

Inhibits muscle contractions by increasing the release of calcium from the sarcoplasmic reticulum.

Answer 17

TX of chronic spasticity and prophylaxis against malignant hyperthermia

Answer 18

Small blood clots from throughout the body, coags are set up , PT cant stop bleeding in other areas

Answer 19

Increase of ETCO2 Cardiac arrythemias Muscle rigidity Hypoxia Profuse Sweating Masseter Muscle Rigidity Metabolic Resp. Acidosis Mottling of Skin Tachycardia Unstable arterial pressure

Answer 20

Acute Renal Failure Circulatory Failure Dark Colored Urine due to myglobinuria DIC Elevated CK Elevated Myglobin Hyperkalemia Hyperthermia Rhabdo Severe Cardiac Arrythemias

Answer 21

Abnormal Protein on surface After exposure to anesthetic, abnormal amount of calcium accumulates in muscle cells, muscles stiffen and are consistently contracting and dramatic increase in body temperature

Answer 22

Usually not diagnosed until after event occurs, always important to ask about reactions to anesthesia for self and family members present

Answer 23

Indicator of genetic abnormality High risk population a family history, history of heat stroke, hyperthermia and hyperthermia after exercise

Answer 24

Stop Contributing Medication Mix and administer Dantrolene Cool body Temperature Administer O2 Control HR and BP Correct abnormalities of electrolytes

Answer 25

Allergic Reactions and Drug toxicity Cardiac Dysrhythmias CNS changes Trauma Hypotension Thrombosis

Answer 26

Comfortable as possible Operative Field must be adequately exposed Position must not obstruct or compress respirations, vascular supply, or nerves Extra Safety precautions for older adults Patients who are thin or obese Light Restraint before induction in case of excitement - straps, cushions, wedges

Answer 27

Provide care for patient until patient has recovered from effects of anesthesia Patient has resumption of motor and sensory function is oriented, has stable VS, shows no evidence of hemmorhageof other complications of surgery Vital to perform assessment

Answer 28

Reveiw pertinent information, baseline assessment upon admission unit Assess ABCs Reassess VS, patient status every 15 min Transfer report, to another unit or discharge pt to home

Answer 29

Primary Consideration, necessary to maintain ventilation, oxygenation Provide Supplemental Oxygen Assess Breathing by placing hand near face to feel movement of air Keep of HOB elevated 15 to 30 degrees unless contraindicated May require sunctioning If vomiting occurs turn pt to side

Answer 30

Do not remove oral airway until evidence of gag reflex returns Oropharyngeal airway

Answer 31

Monitor all indicators of CV Assess all IV lines Potential for hypotension Potential for hemmorrhage Potential for hypertension and dysrhythemias

Answer 32

Pallor Cool moist skin Rapid RR Cyanosis Rapid and weak thready pulse Decreasing pulse pressure Low blood pressure Concentrated Urine

Answer 33

Intervene of Nausea at first indication of nausea Medications Assessment of preoperative nausea, vomiting risk, prophylactic treatment Zofran, Reglan, Promethazine, Phenergan

Answer 34

Assess Patient comfort Control environment ; quiet, low lights, noise level Administer analgesics as indicated, usually short acting opiods IV Family visit, dealing with family anxiety

Answer 35

Decreased physiological reserve Monitor carefully frequently Increased confusion Dosage Hydration Increased likelihood of post operative confusion, delerium hypoxia, hypotension, hypoglycemia Reorient as needed Pain

Answer 36

Discharge planning, discharge assessment Provide written verbal instructions regarding follow up care, complications, wound care, activity, medications, diet Give prescriptions, phone numbers Discuss actions to take if complications occur

Answer 37

Give instructions to patient, responsible adult who will accompany patient Patients are not to drive home or be discharge to home alone Sedation, anesthesia, may cloud memory, judgement, effect ability

Answer 38

Receiving the patient from PACU Nursing Management 1st 24 hrs Focused Assessment Pain Management Respiratory GI GU Mobility DVT/PE Infection Anxiety

Answer 39

First Intention - Surgical incision Second Intention - Edges of wound can't be brought back together - union by adhesion of granulating surfaces Third Intention -Union of a wound that is closed surgically several days after injury - the wound is left open until contamination has been markedly reduced and inflammation has subsided Factors that affect wound healing

Answer 40

Consists of perforated round or flat tube connected to negative pressure collection device

Answer 41

Round silicone tube with channels that carry fluid to a negative pressure collection device

Answer 42

Soft rubber tube Hemovac- accordion like negative pressure wound therapy

Answer 43

Adhesive that helps keep the wound closed

Answer 44

Provide Healing Treatment Absorb Drainage Splint immobilize Protect Promote homeostasis Promote patient's physical, mental comfort

Answer 45

Clean Clean Contaminated Contaminated Dirty First Dressing changed by surgeon Types of dressing materials Sterile technique Assess wound Applying Dressing, taping methods PT response PT teaching Documentation

Answer 46

Activity intolerance Impaired skinintegrity ineffective thermoregulation Risk for imbalanced nutrition Risk for constipation Risk for urinary retention Risk for injury Anxiety Risk for ineffective management or therapeutic regimen

Week 2 Perioperative Flashcards

(71 cards)