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Med Surg > Chapter 4 pre-op/intraop care > Flashcards

Chapter 4 pre-op/intraop care Flashcards

1
Q

what is included in the preoperative phase of surgery ?

A

decison-> operating table

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2
Q

what is included in the intraoperative phase of surgery?

A

operating table -> PACU

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3
Q

what is included in the postoperative phase of surgery?

A

PACU -> clinic or home

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4
Q

what are the five types of surgery? examples ?

A
  1. cosmetic; liposuction
  2. curative; hysterectomy
  3. palliative; colostomy
  4. Diagnostic; breast biopsy
  5. restorative; knee-replacement surgery
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5
Q

what are the three different categories for the urgency of surgery ?

A
  1. elective: planned for correction of a nonacute problem (cataract removal, hemorrhoidectomy)
  2. urgent: requires prompt intervention, may be life-threatening if delayed more than 24-48 hrs ( bladder obstruction, kidney stone, intestinal obstruction)
  3. requires immediate intervention because of life threatening cause (gunshot/stab wound, severe bleeding)
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6
Q

what are the 2 degrees of risk of surgery categories? explain them

A

minor- procedure without significant risk; often done with local anesthesia (implantation of venous access device, muscle biopsy)
major- procedure of greater risk; usually longer and more extensive ( mitral valve replacement, pancreas transplant)

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7
Q

what are the 2 extent of surgery categories? explain them

A
  1. simple- only the most overtly affected areas are involved in surgery (simple/partial mastectomy)
  2. radical- extensive surgery beyond the area obviously involved; directed at finding root cause ( radical prostatectomy, hysterectomy)
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8
Q

some common pre-op labs ?

A
  • CBC
  • glucose
  • PT
  • blood type
  • liver function ‘
  • renal - BUN, creatinine
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9
Q

what are some preop teachings?

A
  • more teaching better patient outcomes
  • have advocate with patient
  • written instructions for pre-op procedure and day of surgery
  • elderly
  • teach what to expect after surgery as well
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10
Q

Pre-op teaching and considerations ?

A

consent - surgeon vs nurse foods/fluids- NPO 8 hrs
prep for elimination
IV
pain
skin prep
teach what to do after surgery
surgical team/ OR
anesthesia

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11
Q

consent for surgery key points ?

A
  • surgeon explains procedure, risks, and benefits, nurse ONLY witnesses the patient’s signature
  • patient must be fully competent and give consent freely with no coercion
  • consent form attached to px chart sent with px to OR
  • nurse must ALWAYS check that a consent form was signed before giving preop meds
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12
Q

what are some nursing goals for patient undergoing surgery?

A
  • px prepared physically and emotionally
  • able to demonstrate deep breathing, coughing, and leg exercises,
  • able to verbalize understanding of the procedure and expectations of preop period
  • able to maintain fluid and electrolyte balance throughout preop period
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13
Q

what are some nursing activities performed during intraoperative care?

A
  • assist in positioning the patient
  • emotional support
  • proper function of equipment
  • set up sterile field
  • documentation
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14
Q

some interventions (Time-outs) that protect the patient form injury

A
  • verify client
  • check hx, documents, client id, implants, prosthesis
  • Mark procedure site with surgeons’ initials
  • time out for the team, correct patient, procedure side and site
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15
Q

what are the different types of anesthesia?

A
  1. local/blocks (regional)
  2. epidural (regional)
  3. conscious sedation
  4. general
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16
Q

what is local anesthesia (regional type) used for?

A

minor procedures like tissue biopsy, surface cyst excision, insertion of pace makers
- px with local anesthesia transferred to the nursing unit and does not need care in post anesthesia unit (PACU)

17
Q

what are the stages of general anesthesia?

A

induction- unconsciousness is induced
maintenance- the period during which surgical procedure is performed
emergence- surgery is completed and the patient is prepared to return to consciousness, blocking agents reversed

18
Q

what is regional anesthesia?

A

-accomplished by administering nerve block
- more economical than general
- may be accomplished by injecting the spinal, epidural, caudal, or peripheral nerve area

19
Q

what is epidural anesthesia?

A

spinal or epidural blocks are used for high-risk patients undergoing pelvic or lower extremity surgery
- epidural blocks are widely used in obstetric procedures

20
Q

some elder care points?

A

accurate height and weight of elderly px important for the calculation of anesthetic agents and med dosage
- kidney function declines in elderly people and drugs are not eliminated from the body
- reduced dosages are often needed

21
Q

possible complications of surgery?

A

-stroke, bleeding
- death, infection
- hyperthermia, hypothermia
- fluid volume excess/ deficit

Med Surg (12 decks)

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