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Nursing 206 > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What is the definition of surgery?

A

The art of science of treating diseases, injuries, and deformities by operation and instrumentation

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2
Q

What is our job as a nurse when it comes to surgery?

A

-Prep pt for surgery
-Caring for pt before, during, and after surgery

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3
Q

What is included in the perioperative period?

A

-Preoperative period
-Intraoperative period
-Postoperative period

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4
Q

-ectomy

A

removal of

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5
Q

-lysis

A

destruction of

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6
Q

-orrhaphy

A

repair or suture of

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7
Q

-oscopy

A

looking into

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8
Q

-ostomy

A

creation of an opening

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9
Q

-otomy

A

cutting into

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10
Q

-plasty

A

repair or reconstruction of

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11
Q

What is the purpose of a diagnosis?

A

Used to determine the presence and extent of a condition

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12
Q

What is the purpose of a cure?

A

Eliminating or repairing the pathological condition

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13
Q

What is the purpose of palliation?

A

Alleviation of symptoms without a cure

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14
Q

What is the purpose of prevention?

A

Removal of something that may be an issue
-Ex: colonoscopy

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15
Q

What is the purpose of cosmetic improvement?

A

Altering of physical appearance
-Ex: burn scar, breast reconstruction after a mastectomy

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16
Q

What is the purpose of exploration?

A

Determines the nature or extent of disease

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17
Q

Why is explorative surgery least common?

A

Some symptoms that occur can be handled non-invasively

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18
Q

What are the common purposes of surgery?

A

-Diagnosis
-Cure
-Palliation
-Prevention
-Cosmetic improvement
-Exploration

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19
Q

How is surgical setting determined?

A

-Type of surgery
-Complications
-Pt status
-Elective or emergent

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20
Q

What are characteristics of elective surgery?

A

-Carefully planned event
-Same day admission
-Acute/chronic medical conditions
-Same day/outpatient
-Minimally invasive (laparoscopic, endoscopic)
-24-hr stay after surgery
-Home with a caregiver (at least 24 hrs as safety concern)
-Decreased cost (no extra labs, scans, foods, etc)
-Recover at home

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21
Q

What are different places for elective surgery?

A

-Ambulatory clinic
-Endoscopy clinics
-Physicians’ offices
-Outpatient surgery units in hospitals

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22
Q

Are HAI occurrences increased or decreased with Elective surgery?

A

Decreased, less time spent in center

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23
Q

What are the 3 types of anesthesia?

A

-Local
-Regional
-General

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24
Q

What is local anesthesia?

A

-Minimal
-Only numb to the specific area
Ex: wisdom teeth removal

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25
Q

What is regional anesthesia

A

Occurs around the complete area
-Ex: shoulder surgery

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26
Q

What is general anesthesia?

A

All over the body

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27
Q

What happens to a patient’s stress and anxiety levels when they undergo emergency surgery and why?

A

-Levels increase
-Pt doesn’t have time to prepare or think about the risks and benefits of surgery

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28
Q

What is the nurse’s role in patient care when it comes to the reason for surgery?

A

-Help with education for post surgery
-Plan prep for before surgery (like diet changes)

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29
Q

True or False:
Nurses education patient about the surgery

A

False- the doctor is the only one to be educating patient about surgery

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30
Q

What is the nurse’s role in patient care when it comes to the results of preop diagnostic tests?

A

Have to ensure that we notify the physician and keep pt up to date on:
-Labs
-Chest c-rays
-CT scans

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31
Q

What is the nurse’s role in patient care when it comes to the risks and complications of the procedure?

A

Want to ensure pt and family understand the plan

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32
Q

What is the nurse’s role in patient care when it comes to communication before surgery?

A

Ensure that we talk to pt about pre-surgical teaching and medications

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33
Q

What is the nurse’s role in patient care when it comes to documentation regarding surgery?

A

-Always make sure this is done
-Nurses can only witness after the doctor has talked to the pt

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34
Q

What do you need to obtain in a preoperative interview with the patient?

A

-Health info
-Drug and food allergies
-Provide and clarify info for surgery/anesthesia
-Assess client’s emotional state and readiness for surgery (expected pt outcomes)

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35
Q

What are examples of anticoagulants?

A

-Heparin
-Eloquis
-Warfarin

36
Q

What question should you ask yourself when speaking to a patient before surgery?

A

Has the patient received enough information to make an informed decision [about the surgery]?

37
Q

What are the overall goals of a preoperative interview?

A

-Establish baseline data (vitals) for comparison in other surgery phases
-Determine pt’s psychological and physiological status prior to surgery
-Identify and document surgical site
-Identify any and all meds that may impact outcome of surgery
-Review pre-diagnostic results (normal vs abnormal)
-Identify culture and ethnic factors to determine plan of care
-Verify pt is well informed

38
Q

What are the typical reasons why patients experience anxiety before surgeries?

A

-Lack of knowledge
-Uncertainty of outcomes
-Past experiences or stories
-Conflict with religious or cultural beliefs

39
Q

What are common fears of patients going into surgery?

A

-Fear of death (most common)
-Fear of pain and discomfort (2nd most common)
-Fear of altered body image
-Fear of anesthesia
-Fear of disruption of life functioning

40
Q

True or False:
Hope can be a method of coping

A

True- it is a positive attribute

41
Q

What subjective data do you need to obtain from a patient preoperatively regarding their past health history?

A

-Past hospitalizations
-Previous surgeries and dates
-Problems with previous surgeries
-Last menstrual period/# of pregnancies
-Family hx (especially bad outcomes)
-Current meds (including herbal products/dietary supplements)
-Allergies/drug intolerances
-Substance abuse

42
Q

What is a drug intolerance?

A

Experiencing side effects from taking medications
-Ex: experiencing the side effect of dizziness when taking BP meds
-Ex: Experiencing muscle cramps when taking cholesterol meds

43
Q

What is a true allergy?

A

-Swelling
-Rash
-Anaphylaxis

44
Q

What objective data do you need to obtain from the patient preoperatively?

A

-Physical examination
-Recent H& P
-Diagnostic studies

45
Q

When should a H & P be obtained preoperatively?

A

In advance or day of surgery

46
Q

Who can collect an H&P?

A

-Physician
-Surgeon
-Anesthesiologist
***RNs cannot collect this

47
Q

What does an H&P do preoperatively?

A

-Helps determine physical status rating for anesthesia
-Helps identify perioperative risks
-Can influence decision for surgery

48
Q

What diagnostic studies need to be collected preoperatively?

A

-Coagulation profile if on antiplatelet drug
-Potassium level if on diuretic (3.5-5 range)
-Pregnancy test for all women of childbearing age
-EKG with history of dysrhythmias, hypertension
-Blood glucose test if diabetic
- +MRSA - presurgical antibiotics (help treat before there is a bigger infection)

49
Q

What systems are included in a thorough head to toe assessment?

A

-Cardiovascular
-Respiratory
-Neurological
-Urinary
-Hepatic
-Integumentary
-Musculoskeletal
-Endocrine
-Immune
-Nutritional status
-Fluids and electrolytes

50
Q

What factors affect teaching to patients?

A

-Physical
-Psychological
-Sociocultural
-Learner

51
Q

Why are written materials used in preoperative teachings?

A

-Used to review/reinforce instruction at home
-Focuses on safety

52
Q

What are the benefits of preoperative teaching?

A

-Increases pt satisfaction
-Reduces fear, anxiety, stress
-Decreases development of complications
-Decreases length of stay
-Decreases recovery time after discharge

53
Q

How does preoperative teaching decrease the development of surgical complications?

A

Teaching is so effective that pt feels informed enough to be able to recognize abnormalities quicker and know how to continue care

54
Q

What is sensory teaching?

A

Ensure we talk to patient about the environment of the operating room
Ex: room is cold, lights are bright, how everything looks, etc

55
Q

What is process teaching?

A

Discuss admission/admission area
Ex: What the area looks like, when they should arrive, what items they can bring with them, where the caregiver stays

56
Q

What is procedural teaching?

A

Explaining what types of clothes to wear, status change, fluid and food restrictions (these can interfere with anesthesia and puts pt at risk for aspirations)

57
Q

What are preoperative teachings for general surgery?

A

-Deep breathing
-Coughing
-Early ambulation
-Contradictions or specific needs
-Monitoring devices used post-op
-PCA (Pt Controlled Analgesic)
-Rate pain

58
Q

What is one of the best things to do for a patient post-operatively?

A

Early ambulation

59
Q

What is a PCA?

A

-Pt Controlled Analgesic
-Pain pump that is connected to IV/IV pole
-Physician has an order of how much pain meds/at what rate the pt can receive meds
-Pt presses button to administer meds when feeling pain

60
Q

True or False:
Every time the pt presses the PCA button, they receive the pain medications

A

False- this is preset and ordered by doctor and requires 2 checks

61
Q

What are some preoperative teachings for ambulatory surgery?

A

-Telephone before/after to reinforce teaching
-Give directions
-Arrival time
-Specific instructions
-Restricting fluids/NPO

62
Q

What is the definition of informed consent?

A

Active, shared decision-making process between the physician and recipient of care

63
Q

Who is responsible for obtaining informed consent?

A

Surgeons are responsible for obtaining (they’re name goes on the signature line for provider)
**Nurses can be asked to witness and serve as pt advocate

64
Q

What needs to be adequately disclosed to pt for informed consent?

A

-Diagnosis
-Nature and purpose of the proposed treatment
-Risks and consequences of the proposed treatment
-Probability of a successful outcome
-Availability, benefits, and risks of alternative treatments
-Prognosis if treatment is not instituted

65
Q

What event do patients have to show a clear understanding of the information prior to undergoing?

A

Prior to receiving sedation because it impairs pt cognition & therefore they cannot make informed consent

66
Q

True or False:
A true medical emergency can override the need to obtain consent

A

True

67
Q

True or False:
The next of kin may given consent when immediate medical treatment is necessary to preserve life, or prevent serious impairment to life or limb

A

True

68
Q

Can an emancipated minor give consent?

A

Yes

69
Q

Who cannot give consent?

A

-Minors (under 18)
-Unconscious
-Mentally incompetent

70
Q

Who takes precedent over next of kins?

A

-POA (Power of Attorney)
**If you don’t have a POA, then you would use your next of kin

71
Q

What is on the day of surgery checklist?

A

-Preoperative teaching
-Assessment
-Communication of pertinent findings
-Ensure all preop orders are done and charted
-Informed consent
-H&P
-Labs, diagnostic tests
-Documented consultations
-Baseline VS
-Skin prep

72
Q

What are preoperative medications?

A

-Benzodiazepines
-Anticholinergics
-Opioids
-Antidiabetics
-Antimetics
-Antibiotics

73
Q

What do benzodiazepines do?

A

-Decrease anxiety, induce sedation
-Ex: Valium, Ativan

74
Q

What do anticholinergics do?

A

-Reduce secretions
-Ex: Scopolamine, Atropine
***Side effect: dry mouth

75
Q

What do opioids do?

A

-Decrease pain
-Anesthetic needs
-Ex: Fentanyl, Morphine

76
Q

What do antidiabetics do?

A

-Stabilize blood glucose
-Ex: insulin

77
Q

What do antimetics do?

A

-Decrease nausea
-Ex: Zofran

78
Q

What do antibiotics do?

A

-Prevent post-op infections
-Can be given as a single dosage or within 30-60 mins of incision occurring (usually given IV)
-Given if: hx or arrhythmias, joint surgery, wound contamination possibilities

79
Q

What does culture determine in culturally competent care?

A

-Expression of pain
-Family expectations
-Ability to verbally express needs
-Family included in all decisions (respect these decisions)
-Contact translator if needed for communication

80
Q

True or False:
A family member can be used to help interpret for the patient

A

False- rely on hospital provided translator

81
Q

What are facts of ambulatory care in an intraoperative care setting?

A

-Minimally invasive
-Endoscopes, robotics
-Decreased blood loss
-Decreased incision size
-Decreased pain & recovery time
-Decreased length of hospital stay

82
Q

What are the rules of the semi-restricted area?

A

-Preparation room
-Staff in clean surgical attire dedicated to surgery use (clean, hospital provided scrubs)
-Shoe covers, surgical head cover, mask, face shield

82
Q

What are the rules of the unrestricted area?

A

-Main registration area
-Street clothes interact with those in scrub attire
-Ex: Holding areas, locker rooms, nurse’s station

83
Q

What are the rules of a restricted area?

A

-Surgical suite or operating room
-Sterile core
-Traffic minimized
-Filters and controlled ventilated air flow

84
Q
A
84
Q
A

Nursing 206 (4 decks)

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