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MEDICAL SURGICAL > Chapter 1 (Part 4) > Flashcards

Chapter 1 (Part 4) Flashcards

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USMLE® Step 1 flashcards
1
Q

Patient’s autonomous decision about whether to go surgical procedure.

A

Informed consent

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2
Q

Legal mandate

A

Informed consent

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3
Q

Purpose of Informed consent

A
  1. To protect the patient from unsanctioned/unauthorized surgery
  2. To protect surgeon from claims of an unauthorized operation or battery
  3. It helps to ensure that the patient understands the surgery to be performed
  4. To indicate that the patient’s decision was made without pressure.
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4
Q

Informed consent is necessary in the following

A
  1. Invasive procedure such as surgical incision
  2. Procedures requiring sedation or anesthesia
  3. Non-surgical procedures such as arteriography that carries more than a slight risk to the patient
  4. Procedures involving radiation
  5. Radiologic procedures, particularly if contrast dye is required
  6. Blood product administration
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5
Q

A valid informed consent includes:

A
  1. Voluntary (at least 18 yrs. old)
  2. Patient who is incompetent
  3. Informed subject
  4. Patient is able to comprehend
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6
Q

Individual who is not autonomous and cannot give or with-hold consent

A

Patient who is incompetent

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7
Q

Consent should be in writing; contains explanation of procedures, risk, description of benefits and alternatives

A

Informed subject

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8
Q

Goals:
1. Assessing and correcting physiologic and
psychologic problems as it may increase
surgical risk
2. Provide health teaching
3. Instruct & demonstrate exercises that will
benefit the patient during post op period
4. Planning for discharge & any projected
changes in lifestyle due to surgery

A

Preoperative phases (assessing to transferring)

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9
Q

PRE-ADMISSION TESTING

A

 Initiate initial preoperative assessment
 Initiate education appropriate to
patient’s needs
 Involves family in interview
 Verifies completion of preoperative
diagnostic testing
 Verifies understanding of surgeon
specific orders
 Discusses and reviews advance directive
documents
 Begins discharge planning by assessing
patient need for post operative
transportation and care

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10
Q

Initiate initial preoperative assessment

A

Pre-admission testing

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11
Q

Initiate education appropriate to patients needs

A

Pre admission testing

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12
Q

Involves in family interview

A

Pre-admission testing

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13
Q

Verifies completion of preoperative diagnostic testing

A

Pre-admission testing

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14
Q

Verifies understanding of surgeon specific order

A

Pre-admission testing

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15
Q

Discusses and reviews advance directive documents

A

Pre-admission testing

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16
Q

Begins discharge planning by assessing patient need for post operative transportation and care

A

Pre-admission testing

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17
Q

ADMISSION TO SURGICAL CENTER

A

 Complete preoperation assessment
 Assess for risk of post-op complication
 Report unexpected findings or any deviation from normal
 Verifies that operative consent has been
signed
 Coordinates patient education and POC,
with nursing staff, & other health team
member
 Reinforces previous education
 Answers patient’s & family questions

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18
Q

Complete pre-operation assessment

A

ADMISSION TO SURGICAL CENTER

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19
Q

Assess for risk of post-op complication

A

ADMISSION TO SURGICAL CENTER

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20
Q

Report unexpected findings or any deviation from normal

A

ADMISSION TO SURGICAL CENTER

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21
Q

Verifies that operative consent has been signed

A

ADMISSION TO SURGICAL CENTER

22
Q

Coordinates patient education and POC with nursing staff, & other health team member

A

ADMISSION TO SURGICAL CENTER

23
Q

Reinforces previous education

A

ADMISSION TO SURGICAL CENTER

24
Q

Answers patient and family questions

A

ADMISSION TO SURGICAL CENTER

25
Q

IN THE HOLDING AREA

A

 Identifies patient using 2 identifiers
 Assess patient’s status, baseline pain,
and nutritional status
 Reviews medical records
 Verify surgical site that has been
marked per institutional policy
 Establish IV line
 Administer medication if prescribed
 Takes measures to ensures patient’s
comfort
 Provides psychological support
 Communicate patient’s emotional status
to the other appropriate members of
Health Care Team

26
Q

Identifies patient using 2 identifiers

A

IN THE HOLDING AREA

27
Q

Assess patients status, baseline pain, and nutritional status

A

IN THE HOLDING AREA

28
Q

Reviews medical records

A

IN THE HOLDING AREA

29
Q

Verify surgical site that has been marked per institutional policy

A

IN THE HOLDING AREA

30
Q

Establish IV line

A

IN THE HOLDING AREA

31
Q

Administer medication if prescribed

A

IN THE HOLDING AREA

32
Q

Takes measures to ensures patient’s comfort

A

IN THE HOLDING AREA

33
Q

Provides psychological support

A

IN THE HOLDING AREA

34
Q

Communicate patient emotional status to the other appropriate member of the health care team

A

IN THE HOLDING AREA

35
Q

PREOPERATIVE ASSESSMENT

A
  1. The goal is for the patient to be healthy
    as possible
  2. Presence of pain
  3. Nutritional & fluid & electrolyte balance
  4. Dentition
  5. Drug or alcohol use
  6. Cardiovascular function (X-ray, ECG)
  7. Pulmonary Function (X-ray, pulmonary
    function test, Intensive Spirometry)
  8. Renal & Hepatic unction (Creatinine,
    BUN)
  9. Endocrine Function (check for hormonal
    imbalance)
  10. Neurologic Function (prevent delirium)
  11. Hematologic Function (CBC)
  12. Use of medication
  13. Presence of trauma &infection
  14. Psychosocial factors
  15. Spiritual & cultural beliefs
36
Q

The goal is for the patient to be healthy
as possible

A

PREOPERATIVE ASSESSMENT

37
Q

Presence of pain

A

PREOPERATIVE ASSESSMENT

38
Q

Nutritional & fluid & electrolyte balance

A

PREOPERATIVE ASSESSMENT

39
Q

Dentition

A

PREOPERATIVE ASSESSMENT

40
Q

Drug or alcohol use

A

PREOPERATIVE ASSESSMENT

41
Q

Cardiovascular function (X-ray, ECG)

A

PREOPERATIVE ASSESSMENT

42
Q

Pulmonary Function (X-ray, pulmonary
function test, Intensive Spirometry

A

PREOPERATIVE ASSESSMENT

43
Q

Renal & Hepatic unction (Creatinine,
BUN)

A

PREOPERATIVE ASSESSMENT

44
Q

Endocrine Function (check for hormonal
imbalance)

A

PREOPERATIVE ASSESSMENT

45
Q

Neurologic Function (prevent delirium)

A

PREOPERATIVE ASSESSMENT

46
Q

Hematologic Function (CBC)

A

PREOPERATIVE ASSESSMENT

47
Q

Use of medication

A

PREOPERATIVE ASSESSMENT

48
Q

Presence of trauma &infection

A

PREOPERATIVE ASSESSMENT

49
Q

Psychosocial factors

A

PREOPERATIVE ASSESSMENT

50
Q

Spiritual & cultural beliefs

A

PREOPERATIVE ASSESSMENT

MEDICAL SURGICAL (28 decks)

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