6 Assessment Modules Flashcards
Risk factors for VTE?
Positioning / immobilizing during surgery
Injured blood vessels
Retraction devices compressing tissue
Nurses role for VTE?
Identifying risk factors
Collaboration
Advocating for patient needs
VTE prophylaxis
How does VTE occur?
Blood clot forms inside deep vein in extremity or pelvis
What is a PE?
A blood clot that breaks free in the vein and travels though pulmonary system through the heart and occludes arteries
- DVT primary cause
Mechanical prophylaxis for VTE?
SDCs
Early ambulation
Foot / ankle exercises
- increasing blood flow
Why are SCDs ordered during surgery?
Anesthesia causes loss of muscle tone which leads to dilation of leg veins
- minimizing dilation helps prevent DVT
Pharmacologic prophylaxis for VTE?
Anticoagulant
Nurse needs to administer as prescribed, while assessing for potential contradictions
Ex. Bleeding, pregnancy
Why is GERD relevant health history?
Risk of aspiration
Bariatric pre-op assessment considerations for OR?
Comorbidites OSA ? - difficult airway Skin integrity - ?rash in skin folds Positioning - inability to lie flat Reducing stigma
What is cricoid pressure?
Used in endotracheal intubation
Reduces risk of aspiration
Helps visualize larynx by application of of pressure to cricoid cartilage at neck occluding esophagus
Geriatric positioning?
Probe to pressure injures
- redistributing pads
Arms at < 90 to decrease stress on nerves
Safety straps
Bump under hip to avoid compressing inferior vena cava
Adequate team members for repositioning
SCDs
Intra operative considerations for bariatric patients?
Be alert for slippage
Increased risk of RSI’s
Repositioning / pressure points
Considerations of pediatric patient for surgery?
Recognizing different stages of development that may affect assessment
Neonatal - increased risk of heat loss, hypoglycemia, dehydration
Infant - preventing injuries
Toddler - regression, avoid losing trust
Preschool - fear of loss of control, fear of pain, regression
School age - age appropriate to give education to them, privacy
Adolescence- more aware, give honest/accurate info, privacy (remove parents)
Pre op assessment of paediatric patients
Patient focused model - involves family Loose teeth Skin assessment - acne, signs of child abuse Preg testing for appropriate age Consent Height and weight - med admin
Intra op phase for paediatric patients?
Bringing security items Parent present for induction Supplies - appropriate size Thermoregulation Fluid balance positioning
Post op considerations for paediatric?
Temp maintenance (hypothermia) Delirium - inconsolable (need O2) Parental presence Security items Pain
Perioperative care of older adult?
> 65yrs old
Sensitivity to meds
Underlying cognitive dysfunction
Hearing/vision/mobility impaired
Positioning of older adult in OR?
Increased risk of injury
Joint stiffness - never force
Padding - avoid compression of nerves and pressure injuries
Older adults risk of hypothermia?
Temp < 36
Warming blankets, forced air warmers, warm fluids
- increase risk of blood loss, SSI, and hospital stays
Increased risk d/t decreased muscle mass, impaired thermoregulation, lower metabolic rate, decreased vascular activity
Older adults non medical concerns with surgery?
Changes in function/ADLs
Financial concerns
Transport
Stress on family
- know available resources available
Challenges with care of older adult during surgery?
Require more post op care Comirbidites Poor outcomes - delirium -UTIs - pressure sores - falls - functional decline
What is advanced care directive?
Living will
Patient wishes
DNR
