Chapter 16, 17, 18 Key Points Flashcards
Key Point
Ask patient if an advance directive has been completed
Key Point
Ask patient to explain in his or her own words what surgical procedure is being done and why.
Key Point
If the patient’s explanation of the procedure is not consistent with theKey Point documentation, notify the surgeon and request that he or she speak to the patient
Key Point
Use at least TWO appropriate identifiers to identify the patient. DO NOT USE ROOM NUMBER OR BED NUMBER TO IDENTIFY PATIENT.
Key Point
Ensure that the patient is wearing proper id
Key Point
Ensure that the patient is not asked to sign an operative permit or any other legal document after the preoperative drugs have been given. They cannot sign if they are drugged up. It doesn’t count.
Key Point
After the patient has received preoperative drugs, keep the side rails up and the bed in low position.
Key Point
Communicate to the surgeon and anesthesia personnel any physical or laboratory change that may alter the patient’s response to drugs, anesthesia, or surgery.
Key Point
Teach the patient specific interventions to perform after surgery to prevent complication (incision splinting, deep breathing exercises, ROM exercises)
Key Point
Pace your interview to match the learning needs and style of individual patient
Key Point
Encourage the patient to express his or her feelings regarding the surgical procedure or its possible outcome.
Key Point
Explain and provide written information for all diagnostic procedures, restrictions, and follow up care to the patient and his or her family.
Key Point
Check that documentation for any procedure to be performed on one of a paired organ or extremity clearly indicates which organ or extremity is involved.
Key Point
If required, ensure that dentures and any other personal items are removed from the patient before he or she is transferred to the surgical site.
Key Point
If someone breaks the sterile field or sterile technique, inform the OR staff.
Key Point
Report to the surgeon any discrepancy between what type of surgery the patient says is going to be performed and what the informed consent form indicates.
Key Point
Use a highlighter and highlight any known allergies.
Key Point
Always perform an accurate sharps and sponge count with the scrub nurse or surgical technologist.
Key Point
Use aseptic technique during all dressing changes.
Key Point
Use established criteria to determine when a patient is ready to leave the post anesthesia care unit for discharge to home or a med surg nursing unit.
Key Point
Allow the patient to express feelings about any change in physical appearance or lifestyle as a result of surgery.
Key Point
Reassure patients that taking pain medication when needed, even opiods, does not make them drug abusers
Key Point
Offer alternative therapies for relaxation, pain reduction and distraction, such as massage, music therapy and guided imagery.
Key Point
Begin EVERY assessment of the patient after surgery by checking the airway and breathing effectiveness.
Key Point
The incision site should be inspected each shift
Key Point
In the event of dehiscence or evisceration, have the patient lie flat (supine) with knees bent to reduce intra-abdomional pressure; apply sterile, nonadherent dressing materials to the wound; and follow steps outlined in chart 18-5
Key Point
Teach patient about any drugs to be continued after discharge from the facility.
Key Point
Instruct the patient and family about the clinical manifestations of complications and when to seek assistance.
