Chapt 2 Flashcards
How are nursing diagnoses made for periop
knowledge ofthe precodure combined with assessment data
What is an example of a Trans of Info tools that isnt SBAR
IPASStheBATON
What do preop actions focus on
pat assessment pat and fam teaching emotional support planning care for intra and post op communicating with other HC pros
Where does most of the assessment data during preop come from
chart reveiw
pat and fam interview
observation
communication from other HC pros
What are some common patient outcomes
freedom from infection freedom from injury skin integrity, electrolyte balance, patient participation in the rehabilitation process.
What is a consideration for prophylaxic antibiotics for surgical incisions with obese pats
they will need a larger loading dose because it takes more antibiotics to get the target level in the tissues where the incision will happen
What are SSI’s
surgical site infections
Besides obese people who else might be at a higher risk for SSI’s
people with comorbidities like diabetes
What is the protocol for preventing wrong site surgs
identifying the patient
validating the
intended procedure with the patient
informed consent
results of diagnostic testing;
marking the operative site.
perform a time-out to address any questions
What are the critical physiologic assessment data
medical diagnoses medications any comps from past surgeries vital signs diagnostic and lab work age substance abuse allergies skin conditions NPO status and compliance weight height BMI porstheses sensory or mobility impairments
What are the critical physiological assessment data
understanding of the procedure coping abilities support system readiness to learn anxiety related to the surg knowledge of post op routine cultural or spiritual beliefs related tothe surg
What are the most common preop diagnosis
knowledge def
anxiety
Right as the pat is transfered into the Operating room and is placed on the bed the room is considered what
contaminated to the pat
What injuries is the pat at most risk of during the intraop period
Transport and transfer
• Positioning
• Equipment injuries such as a pneumatic tourniquet
• Chemical agents such as skin-prep solutions
• Use of X-ray, electrosurgery, or laser
• Fluid deficit
• Impaired gas exchange related to general anesthesia
• Retained surgical items
What constitutes a wrong site surgery
surgery on the wrong pat side level site or with the wrong surgery
What are some risk factors for wrong site surgeries
Unapproved abbreviations, cross-outs
illegible handwriting
• Missing consent, history, and physical examination, or surgeon’s operative orders • Inconsistent use of site-marking protocol
• No time-out process
rushing during timeout
distractions during timeout
timeout done before prep and drape of pat
not everyone participates in the timeout
• Rushing during patient verification
• Change of patient position
• Inadequate patient verification by the surgical team
• Lack of intraoperative site verification when multiple procedures are performed by the same surgeon
• Ineffective hand-off communication or briefing process
• Site markings removed during prep or draping
• Staff members are not empowered to speak up
• Marketplace pressure to increase surgery amounts
What are some events that need to recorded at a specific time
patient in room
anesthesia start time
incision time
What do you need to verify when recording times for specific events
that the anesthesia provider is using the same time
What should you record when documenting an event that someone else did
record the person that did the intervention
When should teaching start
when the prospect of surgery is discussed
What should preadmission teaching focus on
prepping for surgery
participation in postop rehab/recovery
What should preop teaching include
What to expect (pre and post) Include pre-op regimen (NPO, etc.) Where will they be when they wake up? Post op regimen Demonstrate things
Because learning can be diminished in times of stress, what should we do
Goodman, Terri; Goodman, Terri; Spry, Cynthia; Spry, Cynthia. Essentials of Perioperative Nursing (p. 69). Jones & Bartlett Learning. Kindle Edition.
include fam whenever poss
What is an intervention that may be able to reduce anxiety adn fear of a surgery with children
allowign them to handle objects that are used during the surgery
