Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUR 131 > Class 2 TLO 2.6 Safety/Perioperative > Flashcards

Class 2 TLO 2.6 Safety/Perioperative Flashcards

1
Q

Surgical risk/considerations factors

A 
Smoking
Age
Nutrition
Obesity
Obstructive sleep apnea
fluid/electrolyte imbalance
Postoperative N/V
Venous thromboembolism
Low socioeconomic status
ETOH/substance abuse
Diabetes
Immunosuppression
Nicotine use
Renal/liver disorders
Respiratory disorders
Medications/OTC
Thromboembolism
Hypothermia
Surgical site Infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Response to surgical stress

A 
GAS
vasoconstriction
increased pulse, BP, cardiac output
Na and H20 retention
increased gastric acidity
broncho dilation
protein catabolism
increased blood glucose
increased
cortisol, inflammatory response
increased metabolic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Components of medical history

A 
past illnesses/surgeries
primary reason why seeking medical care
medical conditions
surgical medical risks
family history (anesthetic complications
medications/OTC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Four types of anesthesia

A

General anesthesia
Regional Anesthesia
Conscious sedation
Monitored anesthesia care (MAC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

General anesthesia

Advantages vs Disadvantages

A

Advantages:
Rapid excretion = prompt reversal
All ages
All types of surgery

Disadvantages:
Circulatory
Respiratory
Hepatic/renal side effects
Malignant hyperthermia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is Malignant hyperthermia

A

Rare genetic disorder

Can develop during/after surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Manifestations of Malignant Hyperthermia

A 
Unexplained rise in ETCO2
Rapid temp rise as high as 109.4
Tachycardia
Tachypnea
Muscle stiffness
Cardiac dysrhythmias
If left untreated:
hyperkalemia
myoglobinuria
DIC (Disseminated intravascular coagulation)
CHF
bowel ischemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Malignant Hyperthermia NI

A 
Oxygen admin
IV access
Dantrolene admin (muscle relaxant)
Measures to decrease body temp
Urinary cath I/O
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is regional anesthesia

A

Produces analgesia
Reflex loss/muscle relaxation in area of body
No loss of consciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Regional anesthesia

4 types

A

Local nerve infiltration- numbing local nerves
Nerve block- numbing at nerve trunk, larger areas
Epidural block- injected into epidural space with cath, can be left in place
Spinal anesthesia- similar to epidural but is single shot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Conscious sedation

A 
Altered LOC
Maintain own airway
Responds to stimuli
Reversal agents handy
Initiate rescue intervention if needed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Monitored Anesthesia Care (MAC)

A

Safe admin of max depth of sedation in excess of that provided during conscious sedation
Ability to adjust from full consciousness to general anesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Preop Consideration

PATIENT RISKS

A 
Medication interactions
Thromboembolism
Hypothermia
Surgical site infection
Pressure injuries/positioning
Cardiac event
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Common lab test for surgery

A 
CBC
Hemoglobin A1C
PTT/PT/INR
UA
CMP
Liver function test
Hematocrit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Common diagnostic for surgery

A

Chest X ray

ECG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Post surgical complications

ATELECTASIS

A 
Incomplete expansion of lung tissue
Inadequate ventilation/retention of secretions
S/S
elevated RR
fever
SOB/restlessness/anxiety
dimished Ls/crackles
productive cough
NI
cough and deep breathing
ambulate
inspirex
17
Q

Post surgical complications

PNEUMONIA

A 
Inflammation of lung tissue caused by infection, retained secretions, foreign substance
S/S
chills/fever
tachycardia, tachypnea
productive cough
dyspnea, SOB, chest pain
crackles/wheezes
NI
V/S, O2 sat, O2 as ordered
elevate HOB
inspirex
hydration
18
Q

Post surgical complications

DVT

A 
Formation of blood clot in association with inflammation deep veins
S/S
cramping in calf/thigh
localized tenderness
redness/edema
slightly increased temp
dull aching pain when ambulating
NI
early ambulation
anticoags
IPC's/TED hose
elevate FOB
avoid crossing legs
tight clothing
19
Q

Post surgical complications

PULMONARY EMBOLUS

A 
Dislodged blood clot or other substance that lodges in pulmonary artery
S/S
dyspnea
sudden chest pain
anxiety/restlessness
rapid respiration
tachycardia
drop in BP
cyanosis
NI
notify doctor STAT
O2 saturation
HOB up
20
Q

Post surgical complications

HEMORRHAGE

A 
Excess loss of blood
S/S
depends on amount
restlessness/anxiety
weak/rapid pulse
cool/clammy skin
rapid breathing
decreased urine output
NI
pressure on bleeding
notify doctor
IV fluids
21
Q

Post surgical complications

HYPOVOLEMIC SHOCK

A 
Lack of blood flow to vital organs
S/S
altered LOC/confusion
restlessness
tachycardia
tachypnea
weak thready pulse
hypotension
low urine output
cool/clammy pale skin
NI
IVF
V/S
O2
notify provider
22
Q

Post surgical complications

GASTROINTESTINAL

A 
N/V, constipation, abdominal distention, paralytic ileus (non mechanical bowel obstruction with no bowel sounds)
S/S
hypoactive/absent BS
no flatus
enlarged abdomen
pain
NI
medicate
ambulate
insert NG if ordered
NPO until return of bowel sounds
23
Q

Post surgical complications
URINARY RETENTION
URINARY TRACT INFECTION

A 
Retention:
S/S
inability to void/empty
restlessness
bladder distention
UTI:
S/S
dysuria
itching
cloudy/foul smelling urine
possible fever
NI
monitor I/O
encourage fluids
provide privacy to urinate
assess distention
bladder scan
cath if ordered
24
Q

Post surgical complications

WOUND INFECTION

A 
Inflammation /drain from wound r/t microorganisms
S/S
swelling/redness/heat
pain
fever >100.4 (low grade temp= <100.1)
foul smelling drainage/change in color
****usually appears 3-6 days after surgery
IN
notify provider
aseptic/sterile with dressing change
antibiotics as ordered
teach s/s of infection
25
Q

Post surgical complications

WOUND DEHISCENCE

A 
Separation of one or more layers of the wound
S/S
pop or tearing sensation
increase serosanguinous drainage
usually occurs 6-8 day after surgery
NI
adequate nutrition
binders/splinting
avoid straining
26
Q

Post surgical complications

WOUND EVISCERATION

A

Protrusion of organs/tissues through the separation of incision
S/S
visible protrusion of organs
NI
cover with sterile gauze moistened with sterile saline
notify provider

27
Q

Nicotine use
Associated risk
NI

A 
Increased risk for respiratory complication due to increased mucous secretions and a decreased ability to expel them
-pneumonia
-atelectasis
-bronchitis
NI
support efforts to quit
monitor resp status
cough/deep breathing
ambulate
promote fluids
nicotine patch

NUR 131 (38 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions