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From Flashcardlet first semester > Exam 7 Post op > Flashcards

Exam 7 Post op Flashcards

1
Q

PACU

A

Post
Anestassia
Care
Unit aka Recovery

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2
Q

Stages of Post-op

A

Phase I-immediately after surgery
Phase II-no close monitoring
Phase III-prep for discharge

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3
Q

PACU environment

A

Clean, quiet, no permanent walls

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4
Q

Nursing Management

A

Provide care until anesthesia wears off
Pt is oriented, stable vs, and not bleeding
Constantly assessing

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5
Q

Primary Consideration

A

Maintain a patent airway

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6
Q

How to maintain a patent airway

A

Assess by putting hand near face/nose
Bed elevated 15-30 degrees
May require suction
If vomit, turn on left side

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7
Q

Signs of Hypovolemic shock

A

Pale Cool Moist skin Clammy Rapid respirations Low BP Concentrated urine Rapid/weak/thready pulse
Cyanosis

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8
Q

Classification of Hemorrhage

A 
Primary
Intermediary
Secondary
Capillary/Venous/Arterial
Evident/Concealed
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9
Q

Primary Hemorrhage

A

Occurs at time of surgery

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10
Q

Intermediary Hemorrhage

A

1st few hours after surgery when BP come up and may push clot loose

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11
Q

Secondary Hemorrhage

A

After surgery if suture slips

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12
Q

Capillary Hemorrhage

A

Slow general ooze

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13
Q

Venous Hemorrhage

A

Dark colored bubbles out quickly

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14
Q

Arterial Hemorrhage

A

Bright red and spurts with heartbeat

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15
Q

Evident Hemorrhage

A

On surface and can be seen

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16
Q

Concealed hemorrhage

A

Can not be seen. in body cavity

17
Q

How to monitor cardiovascular stability

A

Monitor vs/LOC/rhythm/skin/ s&s of shock
Assess all IV lines
Monitor for hemorrhage
Monitor for hypertension/dyssrhythmia/hypoxia/hypothermia

18
Q

Ways to help with pain and anxiety

A

Assess pt comfort
Control environment
Admin pain med
Family visits

19
Q

Controlling N/V

A

Immediately turn on left side

Help control without sedating

20
Q

Medications used to control N/V

A 
Metoclopramide (Reglan)
Prochlorperazine (compazine)
Promethazine (Phenergan)
Dimenhydrinate (Dramamine)
Hydroxyzine (Vistaril, Atarax)
Scopolamine (Transderm-Scop)
Ondansetron (Zofran)
21
Q

Dealing with Elderly

A 
Monitor carefully & frequently
Inc chance of confusion/delirium
Causes for confusion - hypoxia,pain,hypotension,hypoglycemia, & fluid loss
Assess meds
Ensure hydration
Reorient
22
Q

When are you ready to discharge

A

Stable VS Orientation x3 Uncompromised pulmonary Adequate O2 sat Urine output 30 ml No N/V Minimum Pain

23
Q

Pars Evaluation Guide

A 
Scored when enter PACU q 15 min
Activity (2 1 0) move on command/spontaneously
Resp (2 1 0) TDBC
Circulation (2 1 0) BP normal
Consciousness (2 1 0) fully awake
O2 sat (2 1 0) 92% with room air

Must be 8-10 to discharge

24
Q

Assessment for Post op Complication

A 
Assess VS q 15 min
Monitor q 4 hours
Assess airway/respirations
Assess cardiovascular status
Assess pain
25
Q

What should the assessment include?

A

O2 IV Tubes VS Circulation General Airway/Suction Position resp/O2 sat/ breath sounds surgical wound LOC Neuro functioning spinal anes (extremities) dressing/drains/drainage I&O iv site/ iv fluids comfort pain standard precautions

26
Q

Responsibilities of PACU nurse

A

Review important info and the baseline assessment
Assessments/Interventions
Provide report & transfer pt to next location
Communicate with pt

27
Q

What is reported when transferring?

A

What was done in PACU
demographic data types/amt of med
medical dx meds for pain
procedure done if pt has voided
co-morbid condition what info pt/family got
allergies unexpected intra-op events
est. blood loss

28
Q

Equipment needed

A 
Bed (surgical)      IV equipment
Emesis Basin      Pads
Blankets           Drainage receptors holders
O2                 Monitoring devices
Post op charting
29
Q

Floor nurse responsibilities

A 
Bed position         Spirometer
Make connections     Bowel Sounds
Airway                      Family
VS                          TCDB
Surgical Dsg.           I&O/Safety
Pain                        Oral care    Activity
30
Q

Ambulatory surgery

A 
Written instructions
Complication to report
phone numbers & who to call
Prescriptions to fill
Rules & how long to follow them
31
Q

Types of surgical drains

A

Penrose-open
Jackson-Pratt-closed
Hemovac-closed

32
Q

Wound healing mechanisms

A

First-intention-suture
Second-intention-granulation
Third-intention-granulation –> suture

33
Q

Factors that affect healing

A 
Age    Meds    Edema    Overactivity  
Handling of tissue   Systemic disorders
Hemorrhage   Immunosuppressed state
Hypovolemia   Wound stressors
Nutrition   Foreign Bodies   Oxygen deficit
34
Q

Purpose of post op dressing

A 
Provide healing environment
Absorb drainage
Splint or immobilize the wound
Protect from injury & contamination
Promote hemostasis
Promote pt's physical & mental comfort
35
Q

Changing post op dressing

A 
Surgeon changes 1st
Get dressing materials
Wash hands
Maintain sterile technique
Assess wound
Apply dressing & taping methods
Include pt response & teaching
Document findings & teaching
36
Q

Dehiscence

A

Parial/Complete seperation of outer layer of wound.

Causes: poor suturing, distention, excess vomiting/coughing, dehydration, and infection

37
Q

Evisceration

A

Total separation of layers & protrusion of organs/viscera thru open wound.

From Flashcardlet first semester (43 decks)

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