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NRSG 102: Med Surg 1 > Exam 4: Chapter 17 - Preoperative Nursing Management > Flashcards

Exam 4: Chapter 17 - Preoperative Nursing Management Flashcards

1
Q

Preoperative phase begins when

A

the decision to proceed with surgical intervention is made and ends with the trasnfer of the patient onto the operating room bed

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2
Q

Intraoperative phase begins when

A

the patient is transferred onto the OR bed and ends with admission to the PACU

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3
Q

Postoperative phase begins with

A

the admission of the patient to the PACU and ends with a follow-up evaluation in the clinical setting or home

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4
Q

Examples of surgeries to facilitate a diagnosis?

A

Diagnostic procedure such as a biopsy, exploratory laparotomy, or laparoscopy

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5
Q

Examples of surgeries for cures?

A

Excision of a tumor or an inflamed appendix

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6
Q

Examples of surgeries for repair?

A

Multiple wound repair

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7
Q

Examples of reconstructive or cosmetic surgeries?

A

Mammoplasty or a facelift

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8
Q

Examples of Palliative surgeries?

A

To relieve pain or corect a problem - such as debulking a tumor to achieve comfort, or removal of a dysfunctional gallblader

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9
Q

Examples of rehabilitative surgeries?

A

Total joint replacement surgery to correct crippling pain or progression of degenerative osteoarthritis

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10
Q

Surgeyr can also be classified upon the degree of urgency involved:

A

Emergent, Urgent, Required, Elective, and Optional

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11
Q

What is Emergent Surgery?

A

Patient requires immediate attention; disorder may be life threatening

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12
Q

Emergent Surgery Indications?

A

Without delay

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13
Q

Examples of Emergent Surgery

A

Severe Bleeding

Bladder Obsturction

Gunshot

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14
Q

What is Urgent Surgery?

A

Patient requires prompt attention

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15
Q

Urgent Surgery Indication?

A

Within 24-30 hours

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16
Q

URgent Surgery Examples

A

Acute gallbladder infection

Kidney or ureteral Stones

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17
Q

What is required surgery?

A

Patient needs to have surgery

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18
Q

Required Surgery Indications?

A

Plan within a few weeks or months

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19
Q

Required Surgery Examples?

A

Prostatic Hyperplasia without Bladder Obsturction

Thyroid Disorders

Cataracts

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20
Q

What is Elective Surgery?

A

Patient should have surgery

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21
Q

Elective Surgery Indications?

A

Failure to have surgery not catastrophic

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22
Q

Elective Surgery Examples

A

Repair of Scars

Simple Hernia

Vaginal Repair

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23
Q

What are Optical Surgery?

A

Decision rests with patient

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24
Q

Optional Surgery Indication

A

PErson Preference

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25
Q

Optional Surgery Example

A

Cosmetic Surgery

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26
Q

The nurse may ask the patient to sign the consent form and witness the signature; however it is

A

the surgeons responsibility to provide a clear and simple explanation of what surgery will ential prior to the patient giving consent

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27
Q

If a patient states that they are allergic to _____ there may be an association with an allergy to latex

A

kiwi, avocado, or banana, or cannot blow up balloons

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28
Q

What can lead to significant problems in patients with comorbid medical condition or in older adults?

A

Dehydration, Hypovolemia, and Electrolyte Imbalance

29
Q

Why is Dentition important?

A

Decayed teeth or dental prostheses may become dislodged during intubation

Condition of mouth important because this can become a source of postoperative infection

30
Q

Alcohol can do what to the body post-surgery?

A

Ingesting even moderate amount of alcohol can weaken patietns immune system and increase chance of postoperative complications

31
Q

Drugs can do what to the body?

A

Impede the effectiveness of some medications

32
Q

REspiratory Status: Patient educated about

A

breathing exercises and use of an incentive spirometer to achieve optimal respiratory function prior to surgery

33
Q

REspiratory Status: Surgery postponed for

A

elective cases if the patient has a respiraotry infection.

34
Q

REspiratory Status: Patients who smoke are urged to stop

A

30 days before surgery to significantly reduce pulmonary adn wound healing complications

35
Q

REspiratory Status: Patients who smoke are likely to experience

A

poor wound healing, a higher incidence of SSI, and complications that include VTE and Pneumonia

36
Q

CArdiovascular Status: Preparation includes

A

ensuring that the cardiovacular system can support the oxygen , fluid, and nutriitonal needs of the perioperative period

37
Q

CArdiovascular Status: If patietn has uncontrolled hypertension,

A

surgery may be postpond until the blood pressure in udner control

38
Q

Hepatic and Renal Function: Presurgical goal is

A

optimal function of the liver and urinary systems os the medications, anesthetic agents, body wastes, adn toxins are adequately metabolized and removed from the body

39
Q

CArdiovascular Status: Disorders of the liver may substantially affect how

A

anesthetic agents are metabolized

40
Q

CArdiovascular Status: Acute liver disease associated with

A

high surgical mortality;preoperative improve in liver function is a goal

41
Q

CArdiovascular Status: Kidneys involved in excreting

A

anesthetic medications and their metabolites; therefore, surgery is contradicted when patient has acue nephritis, acute renal insufficiency with oliguria or anuria

42
Q

Endocrine Function: Patient undergoing surgery is at risk for both

A

hypoglycemia and hyperglycemia

43
Q

Endocrine Function: Hypoglycemia may develop during

A

anesthesia or postoperatively from inadequate carbohydates or excessive administration of insulin

44
Q

Endocrine Function: Hyperglycemia can

A

increase the risk of surgical wound infection, and may result from the stress of surgery which can trigger increased levels of catecholamine

45
Q

Endocrine Function: Patients with uncontrolled thyroid didsorders are at risk for

A

thyrotoxicosis or respiraotry failure

46
Q

Immune Function: Lab tests used to test infection include

A

WBC and the Urinealysis

47
Q

Immune Function: Immunosuppression is common with

A

corticosteroid therapy , organ transplation, radiation therapy, chemotherapy, and disorders affected the immune system

48
Q

What should not be used 7-10 ddays before surgery?

A

Aspirin. It inhibits platelet aggregation and increases the risk of bleeding

49
Q

What occurs during PAT?

A

REsources made available related to patient education such as audiovisual resources, written instructions, telephone numbers

50
Q

Education should go beyond descriptions of the procedure and should include

A

explanations of the sensations the patient will experience.

51
Q

Nursing Interventions: Providing Psychosocial Inerventions Examples

A

REducing Anxiety, Decreasing Fear

Respecting Cultural, Spirtual, Religious Beliefs

52
Q

What should the pt do if thoracic or abdominal incision is anticipated and they want to minimize pressure and control pain?

A

Patient should put palms of both hands together , interlacing fingers snugly

53
Q

If the ptient does not cough effectively, what can occur

A

Atelectasis (Collapse of the Alveoli), Pneumonia, or other lung complications may occur

54
Q

Preoperative Instructions to Prevent Postoperative Complications

A 
Diaphragmatic Breathing
Coughing
Leg Exercises
Turning to the side
Getting Out of Bed
55
Q

What is Imagery?

A

The patient concentrates on a pleasant experience or restful scene

56
Q

What is Distraction?

A

Patient thinks of a enjoyable story or recites a favorite poem or song

57
Q

What is Optimistic Self-REcitation:

A

Patient recites optimistic thoughts “I know all will go well”

58
Q

What is a Music Coping Strategy?

A

Patient listens to soothing music

59
Q

Protecting patients from injury is one of the major roles of the periopertive nurse. Adherence to what is crucial?

A

AORN-recommended practices and the Joint Commission’s National Patient SAfety Goals

60
Q

Summary of the 2016 National Patieetn Safety Goals

A

Identify Pts Correctly

Improve Staff Communication

Use Medicines Safely

Prevent Infection

IDENTIFY PATIENT SAFETY RISKS

Prevent mistakes in surgery

61
Q

The purpose of withholding food and fluid before surgery is to prevent

A

aspiration

62
Q

For Example Adults may be advised to fast for

A

8 hours after eating fatty food and 4 hours after ingesting milk products

63
Q

Healthy patients are allowed clear liquids up to

A

2 hours before an elective procedure

64
Q

Enemas are not commonly prescribed preoperatively unless the patient is undergoing

A

abdominal or pelvic surgery

65
Q

A cleansing Enema or Laxative may be prescribed at what time?

A

The eveneing before surgery and may be repeated the morning of surgery

66
Q

A dressing is place on what during surgery?

A

The Coccyx, because they want to prevent a pressure ulcere. This is taken off in the recovery room

67
Q

All patients should ___ immediately before going to the OR

A

Void

68
Q

Expected Patient Outcomes

A

Decrease Anxiety and Fear

Understanding Intervention

No Evidence of Preoperative Complications

NRSG 102: Med Surg 1 (52 decks)

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