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Med Surg 1 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

preoperative phase

A

when the decision is made to do surgery till operation

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2
Q

intraoperative phase

A

in the operating room

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3
Q

postoperative phase

A

when the patient is admitted to PACU until the patient is released by the doctor from care

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4
Q

purposes for surgery

A

diagnostic, explorative, reconstruction, curative, transplant, or palliative (just to better quality of life)

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5
Q

urgency of surgery

A

emergent (right now), urgent (waiting 24- 48 hours), required (needs done within weeks/ months), elective (nothing is going to happen if you wait)

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6
Q

ectomy

A

removal

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7
Q

ostomy

A

creating an opening

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8
Q

plasty

A

repair or reconstruction

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9
Q

orraphy

A

suture or repair

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10
Q

scopy

A

looking into

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11
Q

nurse is responsible for ________ pre-op

A

knowing about the surgery, patients response to the stress, assess diagnostic testing, and provide a baseline to identify risks and complications

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12
Q

DNR may be _____ for surgery

A

suspended

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13
Q

pre-op diagnostic testing

A

CBC= RBC WBC platelets, EKG or ECG, glucose test, types and screen for blood replacement

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14
Q

sensory information

A

what the patient will feel hear smell and see

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15
Q

process information

A

the general flow

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16
Q

procedural information

A

exactly what’s going on with specific details

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17
Q

ways to prepare pt for surgery with teaching

A

walk through the surgical events, pain managment, deep breathing leg exercises, turing in bed

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18
Q

preop medications are used to

A

aid anesthetic, minimize respiratory tract and gastric secretions, relax pt, and reduce risk of infection

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19
Q

preop medications are the _____ thing you do

A

last

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20
Q

preop check list includes

A

documentation of diagonistic tests complete, preop medications given, VS complete, safety data (ID band, jewelry removed, last void, detures removed, informed consent, allergies, mark site)

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21
Q

most important goal preop

A

establish baseline data

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22
Q

nurses role in the informed consent is

A

to get the pt signiture and be a witness

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23
Q

3 zones of surgical suit

A

unrestircted area (street clothes), semi restricted area (scrubs and caps), restricted area (full gear)

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24
Q

holding area nurse

A

reviews chart, preop procedures (IV lines), cares for pt while in this area

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25
Q

circulating nurse

A

should be an RN, coordinates and oversees clients care while in OR, sets up the OR, does documentation, positions pt, preps site

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26
Q

scrub nurse

A

is sterile, preps instrament table, gowns rest of team, monitors aseptic technique

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27
Q

patient skin prep

A

makes skin as free as possible from microorganisms, starts with scrubing at the surgical site and is extended outward in a circular fashion

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28
Q

surgical time out

A

to verify the right pt procedure and site, ask the pt

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29
Q

the most comon potential threat to pt safety related to electrical devices are

A

electric shock and burns

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30
Q

when are instrument counts done?

A

before the procedure, before closure of a body cavitivy, before wound closure, at skin closure, and with staff change by both scrub and circulating nurse

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31
Q

classifications of anesthesia

A

general (sleep), regional (epidural), local (at site, lidicain for IV), monitored anesthesia care MAC (colonoscopy)

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32
Q

catastrophic events in OR

A

anaphylactic reactions, malignant hyperthermia

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33
Q

anaphylactic reactions

A

severe allergic reaction, causes hypotension tachycardia and bronchospasms

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34
Q

malignant hyperthermia

A

genetic, hyperthermia and rigidity of muscles hypotension heart arrhythmias
occurs when given certain anesthetic agents

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35
Q

treatment of MH

A

stop inhalation agents, 100% O2, give dantrolene sodium IV, cooling techniques, monitor closely

36
Q

initial assessments in PACU

A

respitory and cardiovascular status, level of consciousness, pain managment, gastrointestinal, genitrourinary, skin integrity/ incision, temperature, activity, IV, drains and tubes

37
Q

assessment from PACU to unit

A

stable VS, orientation, uncompromised pulmonary function, urine output, N/V, minimal pain

38
Q

hypoxemia (decreased O2)

A

restlessness, dyspnea, diaphoresis, trachycardia, hypertension, cyanosis

39
Q

atelectasis

A

collapse of alveoli and the surrounding airways, crackles and cough

40
Q

pneumonia

A

inflammation of lung parenchma caused by virus bacteria or other organism

41
Q

potential problems post op

A

hemorrhage, shock, thrombophlebitis, pulmonary embolism, fluid retention, syncope

42
Q

cardiac problems on the clinical unit

A

fluid retention from stress response, fluid overload when IV is too rapid, fluid deficit from inadequate fluid replacement

43
Q

hemorrhage

A

restlessness, weak rapid pulse, hypotension, tachycardia, cool clammy skin, reduced urine output

44
Q

interventions for hemorrhage

A

apply pressure to site that is bleeding, notify MD, administer O2, administer IV fluids and blood replacement, prep for return to surgery if needed

45
Q

interventions for shock

A

elevate legs, notify MD, determine and treat cause, monitor VS and intake/output, administer IV fluids Blood replacement and colloid solutions as prescribed

46
Q

deep vein thrombosis

A

Virchow’s triad- venous stasis, hypercoagubility, injury to vessel.

47
Q

clinical manifestations of DVT

A

most asymptomatic, pain/swelling on calf or thigh, slight fever with chills and perspiration, circulation distal to the DVT may be compromised

48
Q

pulmonary embolism

A

sudden dyspnea, sudden sharp chest or upper abdomen pain, cyanosis, tachycardia, decreased BP

49
Q

interventions for PE

A

notify MD, monitor VS, administer O2 and medication

50
Q

maximal post op pain occurs between ___ and ___ hours after surgery

A

12, 36

51
Q

wound dehiscence

A

partial to complete separation of wound edges

52
Q

wound evisceration

A

protrusion of internal organ through incision and onto the skin

53
Q

Hemoglobin

A

vehicle for oxygen and c02 transport (gas carrying capacity of RBC), increased levels can be from smoking

54
Q

hemoglobin normal levels

A

male 14-18 g/dl, female 12-16 g/dl

55
Q

hematocrit

A

percent of RBC compared to total blood volume, normally 3times the hemoglobin value

56
Q

normal levels hematocrit

A

male 40%-54%, female 38%- 47%

57
Q

Red blood cell count normal levels

A

male 4.5-6, female 4-5

58
Q

MCV

A

mean corpuscular volume

59
Q

MCH

A

mean corpuscular hemoglobin

60
Q

MCHC

A

mean corpuscular hemoglobin concentration

61
Q

RDW

A

red blood cell distribution width

62
Q

MVC MCH MCHC RDW are used to

A

classify anemia and understand the cause

63
Q

White blood cell count

A

number of leukocytes in 1 cubic mm of blood, the body’s main line of defense

64
Q

WCB normal levels

A

5000- 10,000 mm3

65
Q

white blood cell count differential

A

measures % of each type of leukocyte

66
Q

lymphocytes are ____ to ___ % of WBC

A

20, 40 (t cells and b cells from fighting chronic infection or acute viral infection)

67
Q

neutrophils

A

50-70% (acute infection or trauma), are the first responder, immature (blasts) juvenile (bands) mature (polys)

68
Q

order (by amount) of WBC

A

Neutrophils, Lymphocytes, Monocytes, Eosinophil, and Basophils (Never Let Momma Eat Beans)

69
Q

platelet count

A

needed for blood clotting, adult level 150,000-400,000 mm3

70
Q

C-reactive protein

A

helps diagnose inflammatory diseases infection and widespread malignancy

71
Q

Prothrombin Time (PT)

A

assessment of extrinsic coagulation by measurement of factors I II V VII and X, measures amount of time for clot formation

72
Q

Warfarin (Coumoadin)

A

decreases clotting, oral, PT INR

73
Q

Heparin

A

decrease clotting, given sub q or IV, antidote is protamine sulfate

74
Q

Prothromdin time normal value

A

11-12.5 seconds (with full anticoagulation therapy 1.5-2 times control)

75
Q

International Normalized Ratio

A

standard system of reporting PT, therapeutic INR is 2-3.5

76
Q

Active Partial Thromboplastin Time

A

asses the intrinsic system for clotting, normal values 30-40 seconds

77
Q

Blood Urea Nitrogen

A

primarily used to determine renal function, normal levels 10-20 mg/dl

78
Q

creatinine

A

tells if renal disease/ out side factors don’t effect, male levels 0.6-1.2 mg/dl, female levels 0.5-1.1 mg/dl

79
Q

if BUN is elevated with normal Creatinine

A

sign of dehydration

80
Q

if bun and creatinine are elevated

A

kidney failure

81
Q

to infuse blood you need at least a ____ gauge needle

A

18

82
Q

blood should be transfused at no more than

A

2ml/min

83
Q

whole blood infusion should be done in

A

3-4 hrs

84
Q

RBC infusion should be done in

A

2-4 hrs

85
Q

fresh frozen plasma should be given

A

as quickly as possible

86
Q

hemolytic reaction

A

given the wrong blood, starts with lower back pain

Med Surg 1 (4 decks)

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