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Med Surg I > Wk 3 Perioperative Nursing/Preop > Flashcards

Wk 3 Perioperative Nursing/Preop Flashcards

1
Q

When does a patient go into the intraoperative phase?

A

When they enter the OR and go to the PACU

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2
Q

6 reasons a patient might have surgery

A 
Diagnosis
Cure
Palliation
Prevention
Exploration
Cosmetic Improvement
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3
Q

What is ambulatory surgery?

A

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

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4
Q

What is a same-day admit surgery?

A

Patient has surgery, is admitted for post-op

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5
Q

What is inpatient-admitted surgery?

A

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

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6
Q

What are 3 risks with elective surgery?

A

Bleeding
Infection
Anesthetic exposure

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7
Q

What is a semi elective surgery?

A

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

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8
Q

What are 2 examples of a semi-elective surgery?

A

Cholecystectomy for gallstone removal

Uterine artery ablation for postmenopausal bleeding from fibroids

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9
Q

What is an urgent surgery?

A

Must be done within 24 hours to prevent further complications

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10
Q

What is emergency surgery?

A

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

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11
Q

What are 2 examples of an emergency surgery?

A

GI bleed

Subdural hematoma

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12
Q

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

A 
Do they understand the surgery?
Previous surgeries/sedations?
Family health history? 
Current medications/illegal drug use
Allergies
Pregnancy
Tobacco use
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13
Q

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

A 
latex 
Poinsettia plant
anaphylaxis during surgery
food allergies
season allergies
asthma
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14
Q

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

A

Kiwis
Bananas
Avocados
Chestnuts

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15
Q

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

A

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

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16
Q

What is a review of symptoms?

A

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

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17
Q

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

A 
Atelectasis
Infection
Prolonged mechanical ventilation
Respiratory failure 
Bronchospasm 
Exacerbation of underlying lung disease
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18
Q

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

A

Smoker

COPD

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19
Q

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

A

Increase myocardial oxygen demand

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20
Q

What are neurological problems to assess for?

A

Hearing
Vision
Cognition (what is their baseline?)

21
Q

What are two GU problems to assess for?

A

Renal function

Pregnancy

22
Q

What are two hepatic problems to assess for?

A

Clotting

Metabolism issues

23
Q

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

A

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

24
Q

What are two integument problems to assess for?

A

Rashes
Pressure ulcers
Any sign of skin breakdown

25
Q

What is a musculoskeletal problem to assess for?

A

Activity restrictions

26
Q

What are two endocrine problems to assess for?

A

Diabetes

Thyroid problems

27
Q

What is an immune problem to assess for?

A

Steroid use

28
Q

Why are steroids a problem for anesthesia?

A

Increases BS
Delays wound healing
Impaired skin integrity

29
Q

What are fluid and electrolyte problems to assess for?

A

N/V/D

Narrow margin of fluid safety with older patients

30
Q

What are some nutritional issues to assess for?

A

Obesity

Malnutrition

31
Q

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

A

history & physical

32
Q

What will you teach your patient before surgery?

A

Noise, lights, temperature, pre op area

What it will look like to get ready for surgery

33
Q

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

A

Preop area, caregiver rules

what to do during surgery

34
Q

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

A

The surgeon

35
Q

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

A 
Dx
Purpose of surgery
Risks 
Alternative treatments
Risks of not treating
Who is conducting the procedure
Short and long term costs
36
Q

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

A

Pain
Length of stay
Recovery time

37
Q

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

A

Loss of function
Activity restriction
Scarring

38
Q

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

A

significant comprehension

39
Q

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

A

the surgeon

40
Q

What is the role of the nurse concerning informed consent?

A

Witness the patient’s signature

Act as a patient advocate

41
Q

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

A

Patient is a minor
Patient is unconscious
Patient is mentally incompetent

42
Q

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

A

A true medical emergency

43
Q

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

A

at least 2 hours

44
Q

What is the preop recommendation for breast milk?

A

at least 4 hours

45
Q

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

A

at least 6 hours

46
Q

What is the preop recommendation for a regular meal?

A

at least 8 or more hours

47
Q

Preoperative intake recommendations are specific to…

A

the procedure

48
Q

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

A

Fill out the perop check list

Med Surg I (41 decks)

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