Wk 3 Perioperative Nursing/Preop

Question 1

When does a patient go into the intraoperative phase?

Answer 1

When they enter the OR and go to the PACU

Question 2

6 reasons a patient might have surgery

Answer 2

Diagnosis
Cure
Palliation
Prevention
Exploration
Cosmetic Improvement

Question 3

What is ambulatory surgery?

Answer 3

Patient comes in, has surgery, and goes home same day

Question 4

What is a same-day admit surgery?

Answer 4

Patient has surgery, is admitted for post-op

Question 5

What is inpatient-admitted surgery?

Answer 5

Patient admitted to hospital first, then has surgery, and stays admitted

Question 6

What are 3 risks with elective surgery?

Answer 6

Bleeding
Infection
Anesthetic exposure

Question 7

What is a semi elective surgery?

Answer 7

Scheduling should be considered a priority but it doesn’t have to be within the next 24 hours

Question 8

What are 2 examples of a semi-elective surgery?

Answer 8

Cholecystectomy for gallstone removal

Uterine artery ablation for postmenopausal bleeding from fibroids

Question 9

What is an urgent surgery?

Answer 9

Must be done within 24 hours to prevent further complications

Question 10

What is emergency surgery?

Answer 10

Should be within 24 hours, preferably less than 2 to prevent further deterioration

Question 11

What are 2 examples of an emergency surgery?

Answer 11

GI bleed

Subdural hematoma

Question 12

What are 7 things you should ask a patient before they are having surgery?

Answer 12

Do they understand the surgery?
Previous surgeries/sedations?
Family health history? 
Current medications/illegal drug use
Allergies
Pregnancy
Tobacco use

Question 13

What are some allergies you should ask a patient about before they have surgery? (6)

Answer 13

latex 
Poinsettia plant
anaphylaxis during surgery
food allergies
season allergies
asthma

Question 14

What are 4 foods that have the same substances as latex that you should ask you patient if they are allergic to?

Answer 14

Kiwis
Bananas
Avocados
Chestnuts

Question 15

What is a good habit to end your pre-op interview with?

Answer 15

Is there anything I should know or that you would like to tell me?

Question 16

What is a review of symptoms?

Answer 16

Inventory of body systems obtained through a series of questions seeking to identify signs/symptoms of disease

Question 17

What are 6 pulmonary risks that you should assess for, for a patient undergoing surgery

Answer 17

Atelectasis
Infection
Prolonged mechanical ventilation
Respiratory failure 
Bronchospasm 
Exacerbation of underlying lung disease

Question 18

What are two examples of someone at risk for prolonged mechanical ventillation?

Answer 18

Smoker

COPD

Question 19

If a patient has cardiac problems, we don’t want to do anything that will…

Answer 19

Increase myocardial oxygen demand

Question 20

What are neurological problems to assess for?

Answer 20

Hearing
Vision
Cognition (what is their baseline?)

Question 21

What are two GU problems to assess for?

Answer 21

Renal function

Pregnancy

Question 22

What are two hepatic problems to assess for?

Answer 22

Clotting

Metabolism issues

Question 23

Why is metabolism issues an important problem to assess for concerning the hepatic systmem?

Answer 23

If they don’t metabolize medications correctly it will affect how much of a medication they get

Question 24

What are two integument problems to assess for?

Answer 24

Rashes
Pressure ulcers
Any sign of skin breakdown

Question 25

What is a musculoskeletal problem to assess for?

Answer 25

Activity restrictions

Question 26

What are two endocrine problems to assess for?

Answer 26

Diabetes | Thyroid problems

Question 27

What is an immune problem to assess for?

Answer 27

Steroid use

Question 28

Why are steroids a problem for anesthesia?

Answer 28

Increases BS Delays wound healing Impaired skin integrity

Question 29

What are fluid and electrolyte problems to assess for?

Answer 29

N/V/D | Narrow margin of fluid safety with older patients

Question 30

What are some nutritional issues to assess for?

Answer 30

Obesity | Malnutrition

Question 31

What is something that must be in the patient's chart before they go into the OR, as required by the Joint Commission?

Answer 31

history & physical

Question 32

What will you teach your patient before surgery?

Answer 32

Noise, lights, temperature, pre op area | What it will look like to get ready for surgery

Question 33

What will you teach your patient's caregivers before surgery?

Answer 33

Preop area, caregiver rules | what to do during surgery

Question 34

Whose responsibility is it to obtain informed consent before a surgical procedure?

Answer 34

The surgeon

Question 35

What should be on the informed consent document? (7 things)

Answer 35

``` Dx Purpose of surgery Risks Alternative treatments Risks of not treating Who is conducting the procedure Short and long term costs ```

Question 36

What is considered part of the short term costs of surgery? (3 things)

Answer 36

Pain Length of stay Recovery time

Question 37

What is considered part of the long term costs of surgery? (3 things)

Answer 37

Loss of function Activity restriction Scarring

Question 38

Signing an informed consent is a voluntary process, meaning the patient must demonstrate __ __

Answer 38

significant comprehension

Question 39

Who should discuss with the patient the issues of informed consent to the patient?

Answer 39

the surgeon

Question 40

What is the role of the nurse concerning informed consent?

Answer 40

Witness the patient's signature | Act as a patient advocate

Question 41

What are scenarios that written permission may be given to a legal representative of responsible family member? (3 things)

Answer 41

Patient is a minor Patient is unconscious Patient is mentally incompetent

Question 42

What is a scenario where you wouldn't need consent for surgery?

Answer 42

A true medical emergency

Question 43

What is the pre-op fasting recommendation for clear liquids?

Answer 43

at least 2 hours

Question 44

What is the preop recommendation for breast milk?

Answer 44

at least 4 hours

Question 45

What is the preop recommendation for non-human milk, and a light meal?

Answer 45

at least 6 hours

Question 46

What is the preop recommendation for a regular meal?

Answer 46

at least 8 or more hours

Question 47

Preoperative intake recommendations are specific to...

Answer 47

the procedure

Question 48

What will you need to do as the nurse for a patient who is preoperative?

Answer 48

Fill out the perop check list