Exam 2: Preoperative Nursing Flashcards
The Preoperative Assessment of a Patient Includes?
Data Collection (health history), Medications, alcohol and tobacco use, date of LMP for female, Review of all body systems (resp, GI, CV, MS, GU, check for dentures, caps or loose teeth, check for presence of acute infections.
A patient preparing for surgery, expresses to you they are fearful about going under anesthesia and worry they will not wake up. What would your nursing dx be for this patient?
Fear related to fear of death and anesthesia.
As you are going through the preoperative assessment with your patient they are very anxious about having to have surgery and be cut open, what would your nursing dx be for this patient?
Anxiety related to the surgical experience.
As you prepare your patient for surgery to remove a tumor from their hippocampus, they are upset and crying that they’re memory will be altered and they will loss portions of their memory after the surgery, what would your nursing dx be for this patient?
Grieving related to the possible loss of function.
What are some risk factors for surgery?
Diabetes Mellitus, CAD, Alcoholism, COPD, Obesity, Electrolyte imbalance, medications, smoking, DVT
What is informed consent in surgery?
Grants permission for a specific surgical procedure. It is a legal document, is voluntary. No meds can be given before signing. It can be withdrawn at any time.
What is an anesthesiologist
a physician who specializes in administering anesthesia and supervises certified registered nurse anesthetists (CRNAs) in the operating room.
What does preoperative mean?
begins with the decision for surgery and ends with the transfer to the OR
What is debridement?
necrotic and infected tissue is removed before infected wounds are closed
What does intraoperative mean?
begins with the transfer to the OR and ends with admission to perianesthesia care unit (PACU)
What does postoperative mean?
begins with the admission to the PACU and continues until recovery is complete.
What is general anesthesia?
causes the patient to lose sensation, consciousness, and reflexes, acts directly on the central nervous system.
What is evisceration?
When viscera spills out of the abdomen
What is serosanguineous?
consisting of blood and serous fluid
What is adjunct?
an adjunct agent is a medication used with the primary anesthetic agents, these include opioids to control pain, or muscle relaxers to avoid movement of muscles during surgery, antiemetics to control nausea or vomiting, and sedatives to supplement anesthesia.
What is local anesthesia?
blocks nerve impulses along the nerve where it is injected. Results in a lost of sensation to a region of the body. There is no loss of consciousness
Topical anesthetic
something that is sprayed down the throat, applied to mucus membranes, numbs mucus membranes
IOA
Very rare condition. Intraoperative awareness. Put under general anesthesia , few days later report they remember the conversation the surgical team was having
Conscious sedation
Patient is not asleep and can respond to verbal stimulation, numb and have no sensation of the procedure-used during a colonoscopy procedure.
Malignant hyperthermia
rare, life threatening complication, person has a reaction to anesthetic agent, considered genetic transmitted trait. Body temp rapidly climbs and they can’t control it. Dantrolene is given (only drug that can reverse this condition)
Who is the only person that can explain a procedure to a patient?
A surgeon
If a patient suffers from a life threatening injury and requires surgery so they will not die do you need informed consent?
No
Before anesthesia what is the most important vital signs?
Height and weight, this will determine the amount and type of anesthesia the patient will get
How many witnesses do you need for telephone consent?
Two witnesses
how often should you turn your patient and have them cough and do deep breathing exercises?
every two hours
What two ways can you prevent wrong site for surgery?
surgeon marking the site area and multiple ID checks and verification.
What does NPO mean
nothing by mouth
How can you prevent DVTs
leg exercises
What is a time out for surgery?
This is when the whole surgical team agrees on the patients name, the procedure they are having and the operation site
Are you awake during local anesthesia?
Yes
What does regional anesthesia mean?
numbed specific area, possibly awake, example is an epidural or spinal block
How does an incentive spirometer help?
Expands lungs and increases a patients lung volume
What is coumadin and what are the instructions for use before surgery?
A blood thinner, it is held 24-72 hours before surgery
Who determines the final type of anesthesia you will receive?
The final decision is made by the surgeon based on the recommendations by the anesthesiologist.
What is conscious sedation?
The patient is awake and monitored during this time
What are the two most common types of drugs used for conscious sedation
Versed (Midazolam) and Propofol
Does Versed cause amnesia
Yes
Does Propofol cause amnesia?
no
What is an emancipated minor?
Under the age of 18 but not subject to parental consent
If a patient requires a narcotic before surgery when should they sign the informed consent?
Before the medication is given.
