Exam 3 Peri-Operative

Question 1

Explain Pre-Op Care

Answer 1

• pre-op will be centered on the checklist, consent, and patient understanding of the surgery they are to have.
• begins when the decision to proceed with surgical intervention is made and ends with the transfer of the patient onto the operating room (OR) bed
• Checklist: know that one exists (page 423)
• Consent: Freely given without coercion, must be 18, staff must witness signature
• Understanding of surgery: Discuss advance directives, patient education on benefits of controlling pain, time with patient/family and give therapeutic touch.

Question 2

Explain Intra-Op Care

Answer 2

• begins when the patient is transferred onto the OR bed and ends with admission to the PACU (post anesthesia care unit)
• The intra-op will focus on the “time-out” to ensure the right part of the patient is being operated on
• “Time out” is when you stop and make sure you’re operating on the right person and right place and they know their roles
• “Time out” is right before the surgery takes place. The circulating nurse calls it…and all members of the procedure (surgeons, anesthetists, nurse, etc) stop action and participate. This is literally right before the surgery is to take place. It’s to basically go over and reassure everyone who the patient is, surgical site, and the planned procedure. If there is more than one procedure, you pause and do it for each one.

Question 3

Explain Post-Op Care

Answer 3

• post-op will be focused on the safe awakening of the patient from anesthesia and what to do if the patient is not breathing well or if they are bleeding from their incision, or if their vital signs are not stable.
• begins with the admission of the patient to the PACU and ends with a follow-up evaluation in the clinical setting or home
• Safe Awakening: Maintain ventilation and prevent hypoxemia and hypercapnia. (page 457)
• Patient not breathing: (page 457) Hypopharyngeal obstruction. Tilt head back with neck supportive and open the jaws to open airway. Use a tongue suppressor. Use a endotracheal tube,
• Patient bleeding from incision: (page 459) If bleeding is evident.
  
  1. Sterile gauze pad and a pressure dressing are applied.
  2. Site of the bleeding is elevated to heart level if possible.
  3. Patient is placed in the shock position.
  4. If hemorrhage is suspected but cannot be visualized, the patient is taken back to the OR for emergency exploration
• Vital signs not stable: shock might ensue, give IV fluids, specifically lactated Ringer solution, 0.9% sodium chloride. Give O2