Exam 1 Flashcards
What are some requirements Prior to Surgery?
Hx & Physical Exam
Voiding 💛
Diagnostic studies 🩻xray🤰🏽peg test, EKG, Labs 🆎
Consent Form 📝
Identify surgical site 🦵🏽⭕️✔️
Patient Identification 🪪
Who is responsible for obtaining consent?
Surgeon!
(Don’t sign as a witness if you were NOT there 🚫)
Day of surgery checklist ✔️
Hospital gown 🏥👗
Skin prep
Pulse ox on pt
ID & Allergy band
No makeup 💄
Remover Jewlery 💍, 🦷dentures, 👂🏼aids, prosthesis 🦿, contacts, 👓 , 📱
(Give to family or document 📄 what your holding for them)
Time out for the Team, Check these! ✔️
Correct patient 🪪
Correct procedure
Correct side and site 🖊️
Agreement that everything is ready to go
When the RN gets a patient from recent surgery, what is important to know?
Type of anesthesia the patient received 🤿💉
What is a possible complication, post surgery?
Hypothermia 🥶❄️
(Up to 12hrs post surgery)
Monitor temperature 🤒
Use warming blanket
Can lead to impaired wound healing ❤️🩹
What is Malignant Hyperthermia
Rare metabolic disorder
Fast ⬆️ in body 🌡️
➡️ severe muscle 💪🏽 contractions
Can treat with Dantrolene 💊 and 🧊
What are the PACU ABC’s?
Airway 👅🐽-
obstruction?
Breathing 🫁-
Supplemental oxygen, quality
Circulation-
Bleeding 🩸, skin color and 🌡️, peripheral pulses, cap refill, vitals
What are some postoperative complications?
Airway obstruction- drowsy & supine
Atelectasis- encourage cough
Pneumonia
Pulmonary Embolism
(Sx- Tachycardia, tachypnea, ⬇️O2, hypotension, bronchospasm)
Hemorrhage🩸 (w/in 24hrs)
Hypotension
Cardiac Dysrhythmias🫀
Infection 🦠
Constapation💩/ Paralytic Ileus
Low Urine production (+0.5mL/kg/hr)
Urinary retention 🫄
Delirium (hypoxia)
Body Image (amputations)
Wound (dehisance/evisceration)
Non-pharmacological pain 😖 interventions
Heat/cold therapy 🔥🧊
Repositioning
Distraction
🎶 music
Massage
Meditation
Pharmacologic 💊Pain interventions
Opioids💊
Non-opioids (APAP/NSAIDS)
Antiemetics
Antidepressant
Antispasmodics
Anti-anxiety
Nerve block 💉
Surgical Discharge Criteria
Mobile & Alert
No driving 🚫🏎️
Minimal N/V 🤢🤮
Voided if appropriate to surgical procedure 🚽
Understands written discharge instructions 📋🤔
Post Op Discharge Teaching
Side effects of meds 💊
Activities allowed & prohibited 🚫 🏋🏽♀️
Diet restrictions 🐖🍩
Report symptoms!
Follow-up care 👨🏻⚕️
Wound care ⚕️
The patients stress pre-surgery can cause?
Elevated serum glucose
Common duties of a Circulating Nurse 🧑⚕️
Ensures supplies & equipment are available
Assists with induction of anesthesia
Transfers pt to the OR bed
✔️chart & relates pertinent data
Documents intraoperative care
Identify & Assess the patient
Measures 🩸& urine output
Applies monitoring devices
Coordinates intraoperative care
Monitors aseptic technique ✂️
Accompanies pt to postanesthesia recovery area
Common Duties of a Scrub Nurse 🧼
Assists with draping
Keeps track of irrigation solutions 💧 used for circulating blood loss
Passes instruments to surgeon ✂️
Prepares instrument table 🥄
Organizes sterile equipment
➕Counts sponges, needles & instruments
What labs are in a CBC?
(complete blood count)
WBC & platelet count
Hemoglobin (Hgb)
Hematocrit (Hct)
What is a normal WBC lab level?
5,000-10,000
What is the normal Hemoglobin?
Female 💃: 12-16
Male 🕺🏻: 14-18
(low= anemic)
What is a normal Hematocrit?
Female 🚺 37%-47%
Male 🚹 42%-52%
What is a normal Platelet lab value?
150,000 - 400,000
Manifestations of Anemia
SOB, tachypnea
Tachycardia, 🫀palpitations
Ortho syncope, fatigue
HA, Dizziness
Sensitivity to ❄️🥶
Pallor
Yellowing 💛to eyes & skin
What is sickle cell anemia?
Hereditary
Sickled RBCs
Cell lysis ➡️ anemia
Triggers:
Hypoxia, dehydration, ❄️ cold, strenuous exercise 🏋️♂️, infx 🦠, stress, blood 🩸 loss, altitude sickness
Pain ➡️ tissue ischemia
Sickle Cell Nursing Interventions ⚕️
Oxygen
IV fluids 💧
Pain meds 💊
Warm compress
Avoid high altitudes 🏔️ & 🏋🏽♀️
What can cause Iron deficiency anemia besides malnutrition?
Heavy menstruation
Ulceration 🕳️
Malignancy
GI bleed 🩸
Celiac Disease 🚫🍞
Irritable bowel Disease
S&S of Iron deficiency anemia
Atrophic glossitis (red 👅)
Pallor & checkouts
(Cracking 👄)
Brittle 💅🏼
Anemia Nursing Interventions
Ferrous Sulfate 💊(black 💩, liquid can stain 🦷, can cause constapation)
⬆️iron foods- Meat, 🍳, leafy 🥬
Blood 🩸 transfusions
What is B12 Deficiency?
Pernicious Anemia
Can cause paresthesia of 👋🏽& 🦶
(Fall risk)
Common in GI disease
Who is a Folate Deficiency common with?
People with:
Malabsorption syndromes
Anorexia
Alcohol use 🍻🍷
Drug use
(Take Folic Acid vitamin)
What is Polycythemia Vera?
⬆️🩸RBC
Hct > 55%
Blood is thick & can form clots (PE)
HA
HTN
Fatigued
Pruritis 🔥👋🏽
Treatment:
Low dose ASA
Hydration 💧
Therapeutic phlebotomy
What is the role of erythropoietin in the regulation of RBC?
To stimulate RBC 🩸 production
What is a common assement finding with a pt with a ⬇️ hemoglobin?
Pallor & fatigue
C/o fatigue, Dyspnea on exertion, numbness & tingling in fingers & toes correlates with what condition?
Vitamin B12 deficiency anemia
