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Interventions Test 2 > Intra-Op & Post-Op > Flashcards

Intra-Op & Post-Op Flashcards

1
Q

role of intraoperative nurse (4)

A

1) provide emotional support
2) ensure safe environment & prevent injury
3) maintain asepsis (ESP in wound/surgical site)
4) promote wound healing

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2
Q

role of circulating nurse (RN)

A
  • documents procedure on computer, calls for X-rays, ppl sterile
  • manages care
  • ensures safety
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3
Q

role of scrub nurse (RN or LPN or Scrub tech)

A
  • think/anticipate what surgeon might need
  • “scrubs in”
  • instruments & equipment COUNT
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4
Q

Intra-operative Nursing;

Assessment

A
  • TIME OUT
  • verification of client
  • necessary documentation (allergies, labs, vitals)
  • client comfort
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5
Q

Grounding pad used for what

A

-help prevent risk of pt getting burned

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6
Q

intra-operative nursing interventions

A
  • monitor vital signs
  • safety
  • needle & sponge count
  • maintain surgical asepsis
  • monitor skin on grounding pad
  • client positioning to prevent injury
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7
Q

intra-operative nursing interventions cont.

A
  • *monitor for malignant hyperthermia**
  • genetic (autosomal)
  • jaw muscle rigidity
  • ventricular dysrhythmia
  • tachypnea
  • cyanosis
  • unstable BP
  • increase in body temp
  • LIFE THREATENING
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8
Q 
general anesthesia (steps 4)
-will come back through the stages
A
  • beginning
  • excitement
  • surgical phase
  • medullary depression
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9
Q

stage 1 of general anesthesia

A

1) beginning

just got meds, just going under

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10
Q

stage 2 of general anesthesia

A

2) excitement

- talk, shout, cry, laugh

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11
Q

stage 3 of general anesthesia

A

3) surgical phase
- light / deep anesthesia
* WHERE THEY START INCISION*

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12
Q

stage 4 of general anesthesia

A

4) medullary depression

- BAD!!

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13
Q

what is the last sense to leave & the first to come back

A

HEARING

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14
Q

2 general anesthesia types

A

1) intravenous

2) inhalation

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15
Q

6 types of regional anesthesia

A

1) spinal
2) epidural
3) caudal
4) topical
5) local infiltration
6) block

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16
Q

spinal anesthesia

A

pushed into nervous system

ex/ suberacnoid space, abdominal

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17
Q

epidural anesthesia

A

for lower extremity surgeries

ex/ ankle, knee

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18
Q

caudal anesthesia

A

below umbilicus

ex/ lower limb, skin graph

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19
Q

topical anesthesia

A

for biopsy

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20
Q

local infiltration anesthesia

A

litocain, root canal

21
Q

block anesthesias

A

hit nerve bundle

ex/ breast biopsy, lymph node biopsy

22
Q

uses for regional anesthesia

A
  • surgery below diaphragm
  • surgery on extremity
  • surface biopsies
23
Q

conscious of moderate sedation

A
  • moderately sedated
  • drowsy but can still follow directions; respond purposefully to verbal stimuli
  • no intibation; can maintain airway

ex/ colonoscopy, breast biopsy

24
Q

____ is the responsibility of everyone in the OR suite

A

asepsis

sutures & staples

25
Q

immediate assessment post-op on RESPIRATORY

A
  • check airway & monitor respiratory rate/depth
  • auscultate breath sounds
  • observe symmetrical chest expansion
26
Q

immediate assesmnt post-op on CARDIAC

A

-BP & HR and rhythmn atleast every 15 min

27
Q

immediate assessmnt post-op on NEUROLOGIC

A
  • check pupil response

- monitor muscle strength

28
Q

immediate assesmnt post-op on DRESSINGS

A
  • monitor for drainage

- observe for hemorrhage or hematoma formations

29
Q

immediate assessment post-op on PAIN

A
  • assess for both subjective & objective manifestation of pain
  • administer analgesics prn
30
Q

immediate assessmnt for renal fx post-op

A

-monitor urinary output (atleast 30ml/hr)

31
Q

post-op nursing

A
  • type of anesthesia
  • medications & dosages
  • amount of blood loss
  • intubated
  • complications
32
Q

post-op complications:
RESPIRATORY
(develop within first 48hrs)

A
  • atelectasis (collapse of alveoli)
  • pneumonia (lung infection: crackles)
  • pulmonary embolism (blood clot in lung)
33
Q

post-op intervention for respiratory

A

1) cough & deep breathing q 2 hrs
2) hydration (2,000ml/day)
3) check for respiratory depression
- rate & depth -> symmetry
4) sputum: yellow/green = infection
5) incentive spirometer BREATH IN
6) early ambulation

34
Q

Heparin/lovanox given post-op to prevent what?

A

blood clots

35
Q

Post-op complications:

Circulatory

A
  • hemorrhage (early postop prob, call surgeon ASAP)
  • thromophlebetis
  • DVT
36
Q

post-op interventions:

Circulatory

A
  • leg exercises hourly
  • early ambulation
  • TEDs and SCDs (esp at night)
  • hydration
  • low-dose Heparin (lovenox) air lock
  • promote proper positioning
  • adequate fluid intake
37
Q

post-op complications:

metabolic & urinary

A
  • dehydration (skin turgor, mucous membranes)
  • fluid overload
  • difficulty voiding (void every 8 hours)
38
Q

post-op interventions:

nutrition & hydration

A

-IV fluids (fluid volume deficit)
-progressive dietary intake DAT:
clear liquid, full liquid, soft diet

39
Q

post-op interventions:

metabolic & elimination

A
  • accurate I & O
  • asses serum electrolytes (K so <3 beat regular rhythm)
  • catheterize if unable to void
  • give fluids as soon as client tolerates
40
Q

post-op complications:

elimination

A
  • nausea
  • vomiting
  • paralytic ileus (motility doesn’t fx normally d/t anesthesia) -> generally no bowel mvmnt
  • abdominal distention (w/ air, common in laproscopic surgeries)
41
Q

nursing interventions:

gastrointestinal

A
  • obtain order for antiemetic
  • bowel rest
  • NPO
  • N/G tube in stomach
42
Q

normal bowel progression

A
  • gradual progression w/ diet
  • promote ambulation & exercise
  • maintain fluids
  • foods client likes
  • administer fiber, stool softeners, suppositories as ordered
  • clear -> full -> soft diet*
43
Q

wound care complications

A
  • infection (3-6 days post-op)
  • dehiscence (wound splits open)
  • evisceration (organ protrusion)
44
Q

skin and incision interventions post-op

A
  • splinting w/ mvmnt
  • hydration & nutrition
  • abdominal binder
  • prevent infection
45
Q

steps you take when evisceration happens

A

1) semi-fowler’s position
2) notify doctor
3) cover intestine w/ sterile normal saline moist dressing
4) monitor vitals
5) prepare for surgery

46
Q

mobility & self-care interventions

A
  • early ambulation w/ assistance
  • assist with care but encourage SELF CARE
  • comfort & rest -> nonpharmacologic interventions along w/ pain meds
47
Q

comfort measures post-op

A
  • narcotics (#1)
  • PCA pump (set amount of dose/hour)
  • back rubs
  • imagery (bella ruth: close eyes, guided imagery)
  • distraction
48
Q

psychological post-op complications

A
  • maintain/enhance self-concept
  • provide privacy
  • maintain clients hygiene
  • empty drainage devices
  • client to discuss feelings
  • family support
49
Q

home and community care post-o

A
  • activity restrictions
  • incision care
  • dietary instructions
  • when to call doctor
  • post-op meds

Interventions Test 2 (5 decks)

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