Care of the Surgical Patient

Question 1

preoperative phase

Answer 1

from the decision of surgery to transfer into the operating room

Question 2

Intraoperative phase

Answer 2

from transfer to the operating room to admission to the PACU

Question 3

postoperative phase

Answer 3

starts at admission to the PACU and ends when completely recovered from surgery.

Question 4

Emergency surgery

Answer 4

needed to be done immediately; life threatening situation

Question 5

urgent

Answer 5

not an emergency; requires prompt intervention 24-48 hours

Question 6

elective

Answer 6

non urgent, non acute problem, not life threatening but surgery is preferred treatment

Question 7

optional

Answer 7

not critical to survival or function

Question 8

diagnostic

Answer 8

to make or confirm a diagnosis

Question 9

ablative

Answer 9

to remove a diseased body part

Question 10

restorative

Answer 10

to restore function to a traumatized or malfunctioning tissue

Question 11

palliative

Answer 11

to relieve or reduce intensity of an illness; is not curative

Question 12

constructive

Answer 12

to restore function in congenital anomalies Ex. cleft palate

Question 13

transplantation

Answer 13

to replace organs or structures that are diseased or malfunctioning.

Question 14

Minor degree of risk

Answer 14

low risk to patient; fewer complications; often same day surgery

Question 15

Major degree of risk

Answer 15

high risk to patient; more complicated; increased blood loss; vital organs involved; increased risk of post operative complications

Question 16

What are some advantages of same day surgery?

Answer 16

Same day procedures-cheaper
less stress
less risk of HAI’sq

Question 17

What are some disadvantages of same day surgeries

Answer 17

need more knowledge base & proper education
baseline info
limited activity at home and need more social support

Question 18

What are some components of pre-surgical testing?

Answer 18

CBC, Basic metabolic panel, chest X-Ray, EKG/ECG,

Question 19

What information would be included in a current problem nursing assessment?

Answer 19

What are they having surgery on

Question 20

What information would be included in a vital signs nursing assessment

Answer 20

VITALS

Question 21

Antibiotics

Answer 21

mycins–potentiate MS relaxants

Question 22

Anticoagulants

Answer 22

Increase bleeding time, problem with cloting, should be stopped several days prior to surgery

Question 23

Aspirin NSAIDS

Answer 23

same as anticoagulants

Question 24

Antihypertensives

Answer 24

When used with anesthetics can cause hypotension

Question 25

Diuretics

Answer 25

Loss of K+ . Hypokalemia will cause cardiac problems and arrhythmia. (getting rid of excess water)

Question 26

Corticosteroids

Answer 26

Steroids--when stopped suddenly will cause CV collapse; also anti-inflammatory and will delay wound healing.

Question 27

Tranquilizers

Answer 27

potentiate narcotics and barbiiturates which will decrease BP and cause CNS depresssion

Question 28

Support system

Answer 28

sociocultural needs

Question 29

Sedatives

Answer 29

diazepam (Valium); midazolam (versed), lorazepam (Ativan) to alleviate anxiety and decrease recall of events related to surgery

Question 30

Anticholinergics

Answer 30

Atropine and Glycopyrrolate (Robinul) decrease pulmonary/oral secretions and prevent laryngospasm

Question 31

Narcotic Analgesics

Answer 31

Morphine to facilitate patient sedation and relaxation and to decrease the amount of anesthetic agent needed.

Question 32

Neuroleptanalgesic agents

Answer 32

fentanyl citrate-droperidol (Innovar) cause a general state of calmness and sleepiness

Question 33

H2-histamine receptor antagonist

Answer 33

cimetidine (Tagamet) and ranitidine (zantac) to decrease gastic acidity and volume

Question 34

General anesthesia

Answer 34

Inhalation or Intravenous--produces CNS depression, analgesia, relaxation and reflex loss.

Question 35

Patients are not arousable, are unable to maintain breathing and require mechanical ventilation. Cardiovascular function may be impaired.

Answer 35

General Anesthesia

Question 36

Beginning stage of anesthesia

Answer 36

initial feeling of detachment as the client is receiving the medication and is starting to work on the body.

Question 37

Excitement stage of anesthesia

Answer 37

the person is excited and may be taking, crying or shouting

Question 38

surgical anesthessia

Answer 38

the patient is unconscious and still the medication is doing what it is suppossed to do.

Question 39

medullary depression

Answer 39

too much anesthesia has been administered or it is being broken down differently in the body.

Question 40

Regional Anesthesia

Answer 40

Local anesthetic injected around nerves

Question 41

Patient is awake and aware of surroundings. This has a less systemic effect. it is good for the elderly and those with cardiac and respiratory problems.

Answer 41

regional anesthesia

Question 42

epidural anesthesia

Answer 42

agent is injected into the epidural space that surrpounds the dura mater of the spinal cord.

Question 43

what is an advantage of epidural anesthesia

Answer 43

no headache

Question 44

what are some disadvantages of an epidural

Answer 44

need more precise technical administration. Can be used post operative also for pain control.

Question 45

spinal anethesia

Answer 45

agent injected through the dura mater and into the subarachnoid space surrounding the spinal cord.

Question 46

Produces anesthesia to lower extremities, perineum and lower abdomen. Side effects are headache and hypotension

Answer 46

spinal anesthesia.

Question 47

Hypoxia

Answer 47

inadequate ventilation due to airway occlusion, anadvertent intubation of esophagus instead of trachea.

Question 48

What are some causes of respiratory depression

Answer 48

medications, aspiration of secretion or vomitus, the positioning of the patient on the table.

Question 49

Hypoxia can cause

Answer 49

brain damage in minutes-patient must be monitored carefully-O2 levels, pulse ox, peripheral circulation.

Question 50

how is Hypothermia intenionally cuased

Answer 50

bypass surgery

Question 51

how is hypothermia unintentionally caused

Answer 51

low room temp, cold IV fluids, inhaling cold gases, open body cavity, decreased muscle activity, age, medications,

Question 52

How do you rewarm a patient with hypothermia

Answer 52

graduallly. Room temperature, warm IV fluids, dry sheets. Monitor patient slowly.