Exam 1 Flashcards
Cultural awareness
-Process of conducting a self examination on ones own biases toward other cultures and the in ln depth exploration of ones cultural and professional background
- also involves being aware of the existence of racism and other “ism” in healthcare
Cultural knowledge
Learning or becoming educated about the beliefs and values of other cultures and diverse ethnic groups
Young adults
-Between late teens and mid to late 30s ( emerging adulthood: from late teens to mid 20s, where people face major life transitions and decisions with focus on independence)
Young adult: physical changes
-Complete physical growth by age 20, exception for pregnant and lactating women
- they are usually active, experience illness use frequently than older adults, tend to ignore physical symptoms and often postpone seeking healthcare
- physical strength peaks and physical characteristics of them begin to change us middle age approaches and changes in weight and muscle mass occur because of diet, exercise, and lifestyle patterns
Young adult: cognitive changes
- formal and informal educational experiences general life experiences, and occupational opportunities dramatically increase their conceptual, problem-solving, and motor skills
- Continually evolving and adjusting to change, decision making process needs to be flexible. The more secure they are in their rolesthe more flexible and open they are to change
Young adults: psychosocial changes
- They are often caught between wanting to prolong some of the freedom of adolescents and assume adult commitments
- lifestyle changes: your role in health promotion is to identify unique modifiable factors and provide gender specific and culturally specific patient education and support to reduce unhealthy lifestyle behaviors.
Middle adults
- Ages 35 -64
- during this period personal and career achievements have often already been achieved
- many find Joy in helping their children and other young people become productive und responsible adults
Sandwhich generation
When they are helping their aging parents while also being responsible for their own children
Middle age: physical changes
-many physiological changes occur between 40-65 yrs.
- visible changes: graying hair, wrinkling skin, thickness of waist. Also decrease in hearing and vision. These changes nave impact on self- concept and body image
- significant changes are menopause in women and climactic in men
Team nursing
Care provided by a group of people led by an Rn, often including an LPN and APs
- requires effective team leadership, collaboration, and communication
Primary nursing
One Rn assumes the responsibility for a caseload of patients from admission to discharge. When nurse isn’t scheduled, directions are left for other Rn to follow
Surgical risk factors: smoking
Patients who smoke are at higher risk for developing pneumonia, atelectasis, delay wound healing. Chronic smoking increase the amount and thickness of airway secretions, increasing risk for aspiration
Informed consent
- Must be done before patient receives any form of sedation to ensure clear level of consciousness at the time of signing it.
- surgeries cannot be performed legally or ethically until patient fully understands a surgical procedure and all implications,except for emergencies
- its the surgeons responsibility to explain procedure, associated risks, benefits, alternatives, and possible complications before getting patient oral and document consent
Placed in medical record after signing it
Preoperative teaching
-depends on the type of surgery scheduled, whether procedure inpatient or outpatient, and patients ability to attend and learn content
-Include family members in pre-op. Teaching, they often have better retention of pre-op. Teaching and will be with patient and able to help in recovery
-they need to know the signs of complication and when to call their surgeons
- post-op. Exercises and early ambulating help prevent pulmonary und vascular complications and deconditioning
-Instructions begin before surgery.use teach-back method to confirm understanding
Administering preoperative medications:
- Usually given by Rn before patient leaves for the OR, but before administering verify consent form signed, especially with meds. That alter consciousness
- provider may order preanesthetic drugs to reduce patient anxiety, reduce amount of general anesthesia required, respiratory tract secretions and risk of nausea, remitting, and possible aspiration
Eliminating wrong site and wrong procedure
Three principles of protocol:
- a preoperative verification ensuring all relevant documents and lab results are available before procedure and type of surgery is consistent with patient expectations
- marking operative site with in indelible ink to mark left and right distinctions, multiple structures, and levels of spine
- a “time out” before starting procedurefor final verification of correct patient, procedure site, and any implants. All members of procedure team perform the “time out”
( 2 and 3 are usually performed before patient enters OR
- the person who’s performing the surgery must mark the site and involve patient it possible
Circulating nurse
An Rn that doesn’t scrub in and uses the nursing process in the management of patient care activities in the OR suite.
- they monitor the surgery closely and also manages patient positioning, antimicrobial skin prep., meds., implants, placement and function of IPC devices, specimens, warming devices and surgical counts of instruments and dressiness
- they don’t wear OR gown
Both circulating and scrub nurse work together to ensure patient safety by minimizing rise of error.
Scrub nurse
Either an Rn or surgical tech who’s certified
-they need thorough knowledge of Eden step of surgical procedure because the work in the surgical field with surgeon. They need to anticipate each instrument and supply item needed by surgeon
Both circulating and scrub nurse work together to ensure patient safety by minimizing rise of error.
General anesthesia
Patient loses all sensation, consciousness, and reflexes
- muscle relax and experience amnesia
- given through IV infusion and inhalation routes through the tree phases of anesthesia: induction, maintenance, and emergence
- surgeries requiring GA involves major procedures with extensive tissue manipulation
Regional anesthesia
Loss of sensation in an area of the body by anesthetizing sensory pathways
- done by injecting a local anesthetic along the pathway of a nerve from the spinal cord
- requires careful monitoring during and after for return of sensation and movement
- serious complications like respiratory paralysis occurs if level of anesthesia rises, moving upward spinal cord. Elevation of upper body helps prevent it
- also necessary to frequently observe position of extremities and condition of skin
Local anesthesia
Loss of sensation at the desired site, by inhibiting peripheral nerve conduction
- commonly used in ambulatory surgery
- also cm be used in addition to general or regional
- anesthetic agent inhibits nerve conduction until drug diffuses into circulation
- injected or applied topically
- monitor continually during local procedure
Moderate (conscious) sedation
IV moderate sedation, used routinely for short term surgical, diagnostic, and therapeutic procedures that don’t require complete anesthesia but rather depressed level of consciousness
- patient maintains spontaneous ventilation and patent airway and require no intervention during it
- they respond appropriately to physical and verbal stimuli
Immediate postoperative recovery Phase 1
- When PACU nurse receives patient during hand-off, where they obtain data from surgical team to prep for proper support of pt. Recovery status
-after hand-off, PACU nurse conducts complete systems assessment - patient begins to gradually awaken. Try arousing them by calling their name or gently touching them
- greatest concern airway obstruction, needs ongoing assessments
- you determine patient status and readings for discharge from PACU by comparing baseline vitals with intra-and pre-operative data
Malignant hyperthermia (MH)
An inherited muscle disorder, an acute life-threatening complication of certain drugs used for general anesthesia
- reaction begins in skeletal muscles exposed to the drugs causing increased Ca levels in muscle cells and increased muscle metabolism
- may start immediately after anesthesia introduction, several hours into procedure, or after anesthesia is completed
- symptoms: tachycardia, dysrhythmias, muscle rigidity of jaw und upper chest, hypotension, tachypnea,etc.
- survival depends on early diagnosis and immediate action
- dantrolene sodium, muscle relaxant, only drug specifically for treatments of MH
Prophylactic surgery
Removes potentially cancerous tissue to prevent cancer development
- performed when patient was either an existing premalignant condition or strong predisposition for development
Diagnostic surgery
Removal of all or part of suspected lesion for examination and testing to confirm or rule out cancer diagnosis
- treatment isn’t initiated without tissue confirmation of cancer diagnosis
Curative surgery
Remove all cancer tissue
- surgery alone can result in a cure when all visible and microscopic tumor is removed
- most effective for small localized or non-invasive skin cancer
Debulking surgery
Removes part of tumor if removal of entire tumor isn’t possible
- decreases size of tumor and number of cancer cells which may help alleviate symptoms, increase survival time
Palliative surgery
Focus on providing symptom relief and improving quality of life but not curative
ReconstructiveI restorative surgery
Increase function, enhances appearance, or both
