chapter 37 Leda for nursing'

Question 1

elective?

Answer 1

voluntary. (such as when a hernia repair is scheduled a week away)

Question 2

emergency surgery?

Answer 2

often necessary in trauma cases in which serious consequences will occur if surgery is not done.

Question 3

palliative surgery?

Answer 3

pain or complication relieving . is performed to make patient more comfortable.

Question 4

diagnostic surgery?

Answer 4

biopsy of a mass, is done to provide data for a diagnosis of a problem.

Question 5

reconstructive surgery?

Answer 5

(a mammoplasty after a mastectomy), is done to restore appearance or function.

Question 6

curative surgery?

Answer 6

alleviates (cures) a problem, such as when a gallbladder that is full of stones, causing blockage or pain, is removed.

Question 7

what should the body temperature be maintained during and after surgery?

Answer 7

96.8 degrees to 100.4 degrees.

Question 8

what age groups are more at a higher risk for complications of surgery and why?

Answer 8

infants and elders because either immature body system or decline in function of various body systems. ( both are at risk for dehydration and overhydration)

Question 9

other types of patients who are at higher risk during and after surgery?

Answer 9

those with bleeding disorders, cancer, heart disease, chronic respiratory disease, liver disease, immune disorder, chronic pain, upper respiratory infection, or fever, or who abuse street drugs.(obesity, cardiovascular problems, smoking, alcohol, excessive fear, malnutrition, dehydration.

Question 10

perioperative?

Answer 10

refers to the care of the patient from the time of the decision to have surgery through recovery from the procedure.

Question 11

laser?

Answer 11

light amplification by the stimulated emission od radiation. it is a tube that contains a medium such as carbon dioxide or another active gas , which is energized by electricity.

Question 12

fiberoptics surgery>

Answer 12

allows the use of endoscope’s with high resolution video cameras passed through a very small incision for and every increasing variety of surgical procedures.

Question 13

robotic surgery?

Answer 13

is seen as a key of less invasive, less traumatic surgeries for the future. it is operated from a nearby computer screen.

Question 14

anesthesia?

Answer 14

the loss of sensory perception. has been in use for surgical procedures since the 1840s

Question 15

what are the goals of anesthesia administration?

Answer 15

1. to prevent pain 2. to achieve adequate muscle relaxation 3. to calm fear, ease anxiety, and induce forgetfulness of an unpleasant experiences

Question 16

general anesthesia?

Answer 16

induced by the administration o fan inhalant gas or by medication introduced intravenously. ( deep sleep state with muscle relaxation and is nor aware of anything going on in operating room.

Question 17

what are the four stages of general anesthesia ? Pg. 751

Answer 17

stage 1: begins with the administration of the anesthesia agent and ends when the patient becomes unconscious.( hearing is amplified at the end of this stage)
stage2.excitement phase. muscles become tense but swallowing and vomiting reflexes are still present. breathing may become irregular.
stage 3. surgical anesthesia state. onset of regular breathing. vital functions are depressed, eyes are fixed, and reflexes are lost.
4. complete respiratory depression. the patient is maintained by the anesthesia machine, which supplies oxygen and a set rate of breaths.

Question 18

consciousness?

Answer 18

awareness of one’s surroundings.

Question 19

local anesthesia?

Answer 19

used for minor procedures such as superficial tissue, biopsies, surface cyst excision, insertion of a pacemaker.

Question 20

what are the 4 phases of care of the surgical patient/

Answer 20

preoperative, intraoperative, postanesthesia immediate care, postoperative care.

Question 21

who is responsible for obtaining an informed surgical consent?

Answer 21

the surgeon

Question 22

what should you do if the patient does not understand the procedure, or has further questions for the surgeon.?

Answer 22

refer the matter back to the surgeon.

Question 23

what should be done if a patient is needed for emergency surgery. and he is not conscious or able to give consent?

Answer 23

attempt to call immediate family is made. telephone permission may be given if there are two witnesses on extension lines. if no family can be found, the opinion of a second surgeon regarding surgery is sought.

Question 24

prosthesis?

Answer 24

artificial body part.

Question 25

autotransfusion?

Answer 25

transfusion of ones own blood. it is acceptable by the jehovahs witness as long as their is a continuously closed circuit for collection and reinfusion.

Question 26

stasis?

Answer 26

stoppage of flow.

Question 27

thrombophlebitis?

Answer 27

blood clot causing inflammation of a vessel.

Question 28

how often should deep breathing and coughing be performed?

Answer 28

2 hours for 72 hours after general anesthesia.

Question 29

what are preoperative medications given for what reasons?

Answer 29

reduce anxiety, promote restful state.countereact nausea and reduce emesis, decrease secretion of mucus and other body fluids.

Question 30

what does warming the patient before surgery do?

Answer 30

can reduce risk of surgical wound infection by 57%

Question 31

what is the recovery period of anesthesia?

Answer 31

2 to 6 hours.

Question 32

how many times should the vital signs be taken?

Answer 32

vital signs and careful assessment are performed every 15 minutes for 1 hour, every 30 minutes for 2 hours, every hour for 4 hours, then every 4 hours until the patient is totally recovered from anesthesia and vital signs have returned to normal.

Question 33

what is priority measure to protect the patient?

Answer 33

maintain an open airway.

Question 34

what are some common types or drains?

Answer 34

hemovac, penrose, Jackson- pratt, chest tube, t-tube.

Question 35

atelectasis?

Answer 35

collapse of alveoli in the lungs. exist after anesthesia.

Question 36

thrombosis?

Answer 36

blood clot.

Question 37

mL per hour of urine?

Answer 37

60 mL over a 2 hour period, the surgeon is notified.

Question 38

what may potassium cause?

Answer 38

may cause hyperkalemia if kidney function is not adequate.

Question 39

how will drainage occur more easily?

Answer 39

tubing kept above the level of the stomach.

Question 40

embolus?

Answer 40

clot that travels and lodges in a vessel. to the lung, hear, or brain. [ exercise is vital to prevent circulatory problems.] ps. do not rub legs.. to promote circulation. this may disrupt a clot that has formed and cause an embolus.

Question 41

paralytic ileus?

Answer 41

failure of forward movement of bowel contents.

Question 42

how many times should rang of motion be done?

Answer 42

four times a day.

Question 43

pneumonia?

Answer 43

inflammation and consolidation of the lung with exudate.

Question 44

dehiscene?

Answer 44

separation of the layers of the surgical wound.

Question 45

evisceration?

Answer 45

extrusion of the viscera through the surgical incision.

Question 46

when does preoperative care take place?

Answer 46

takes place from the time the clients are scheduled for surgery until care is transferred to the operating suite.

Question 47

what does preoperative care include?

Answer 47

it includes thorough data collection of the clients physical, emotional, and psychosocial status prior to surgery.

Question 48

why might surgery be done?

Answer 48

to perform restorative, curative, palliative, and cosmetic purposes.

Question 49

what are some risk factors of surgery?

Answer 49

infection, anemia, hypovolemia from dehydration or blood loss, electrolyte imbalances through inadequate diet, age, pregnancy, respiratory disease.

Question 50

diagnostic procedures?

Answer 50

pg. 996 in ATI

Question 51

who is responsible to obtain consent?

Answer 51

provider. nurse is not to obtain consent in any circumstances. the nurse may not however provide any new or additional information, that was not previously given by the provider. The nurse CAN clarify any information that remains unclear after provider explanation.

Question 52

Providers responsibility for consent?

Answer 52

description of professional who will be performing and participating in treatment. describe potential harm, pain, discomfort that may occur. options for other treatments. the right to refuse treatment.

Question 53

the clients responsibility for consent/

Answer 53

voluntarily sign. no coercion involved. receive enough information to make a decision.

Question 54

nurse responsibility for consent?

Answer 54

ensure provider gave necessary information. notify provider if patient has additional questions and reinforcement. record use of interpreter.

Question 55

when administrating preoperative medications what should you have pt. do?

Answer 55

have pt. void before administration
monitor response to medication
raise side rails to prevent injury
ensure preoperative checklist is complete

Question 56

what are complications of sedatives?

Answer 56

respiratory depression, drowsiness, dizziness

Question 57

complications of opioids?

Answer 57

respiratory depression, drowsiness, dizziness, constipation.

Question 58

complications of IV infusions?(lactated ringer’s)

Answer 58

heart failure, hypernatremia

Question 59

gastrointestinal medications(antiemetic, antacids, H2, receptor blockers)

Answer 59

alkalosis, cardiac abnormalities, drowsiness.

Question 60

what should be done with clients with severe anxiety and panic?

Answer 60

reassurance will be necessary and sedation medication may be given.