Intro, Periop, Delegation Flashcards
How can a nurse promote safety in nursing practice?
minimize the risk of harm to patients and providers
- follow safety recommendations
- communicate and report any hazards/errors or unsafe conditions
- contribute to improve safety
- reduce workplace violence
How to develop cultural competence? Cultural Awareness.
- understand your cultural background, values, and beliefs, especially as r/t health & healthcare
- examine your own cultural biases towards people whose cultures differ from your own culture
How to develop cultural competence? Cultural Knowledge.
- learn basic information about predominant cultural groups in your area
- assess patients for the presence or absence of cultural traits
- do NOT make assumptions based on cultural background
- read research studies that describe cultural difference
- read ethnic newspaper articles and books
View documentaries about cultural groups
How to develop cultural competence? Cultural Skill.
- be alert for unexpected responses w/ patients, especially as r/t cultural issues
- become aware of cultural differences in predominant ethnic groups
- develop assessment skills to do a competent cultural assessment of any patient
- learn assessment skills for different cultural groups, including cultural beliefs and practices
How to develop cultural competence? Cultural Encounter.
- create opportunities to interact w/ different cultural groups
- attend cultural events
- visit markets and restaurants in ethnic neighborhoods
- explore ethnic neighborhoods, listen to different types of ethnic music, learn games
- visit or volunteer at health fairs in local ethnic neighborhoods
What are some interventions to promote health equity?
- treat all patients equally
- be aware of your own biases
- learn about services that focus on specific cultural/ethnic groups
- inform patients about health care services available for their specific cultural/ethnic group
- recognize health care & cultural practices that are important to cultural & ethnicity
- take part in research focused on improving care for culturally and ethnically diverse populations
- identify stereotypic attitudes toward culture/ethnic groups that may interfere w/ getting appropriate healthcare
- support patients who are fearful about traveling outside their accepted neighborhood for health care services
- advocate for patients to receive health care services that pay attention to English-language limitations and cultural health practices
- learn advocacy & interpersonal strategies from leaders of specific cultural/ethnic groups
- ensure the availability of culturally appropriate patient education resources
What are some health inequalities that patients in the LGBTQ+ community face?
- many stem from stigma and discrimination
22% of LGB and 29% of transgender people live in poverty (compared to 16% cisgender) - rates of substance use (alcohol, tobacco) are 2x as high
- mental health issues such as depression & anxiety are higher
- higher rates of violence & victimization, cancer, and obesity
What is the job of the circulating nurse, nonsterile?
- helps prepare room; ensures equipment is in working order & sterile
- monitors practice of aseptic technique in self & others
- confirms informed consent is present and the patient has no questions
- takes part in surgical time-out
- records intraoperative care; keeps count of sponges, needles, etc.
- gives hand-off report to PACU nurse (SBAR)
What is the job of the scrub nurse, sterile?
- helps prepare the OR
- completes surgical hand antisepsis and gowns and gloves self and other members of the surgical team
- takes part in surgical time-out
- passes instruments to surgeon and assistants
What are some common intraoperative nursing activities?
Maintain safety
- the integrity of the sterile field
- ensure sponge, needle, instrument, and medical device counts are correct
- positions patient to prevent injury
- prevents chemical injury from prepping solutions
Monitors physical status
- monitor & report changes in vital signs
- monitors blood loss and urine output
Monitor Psychological status
- emotional support
- ensure the patient’s right to privacy
- communicates patient emotional status to the healthcare team
How to manage Tongue falling back (Respiratory Complication)?
patient stimulation, head tilt-jaw thrust, artificial airway
How to manage Laryngeal edema (Respiratory Complication)?
O2 therapy, antihistamines, corticosteroids, sedatives, possible intubation
How to manage Retained thick secretions (Respiratory Complication)?
suctioning, deep breathing & coughing, IV hydration, Chest PT
How to manage Aspiration (Respiratory Complication)?
O2 therapy, cardiopulmonary support, antibiotics
How to manage Atelectasis (Respiratory Complication)?
Humidified O2 therapy, deep breathing, Incentive spirometry, early mobilization
How to manage Bronchospasm (Respiratory Complication)?
O2 therapy, bronchodilators
How to manage Pulmonary edema (Respiratory Complication)?
O2 therapy, diuretics, fluid restriction
How to manage Pulmonary embolism (Respiratory Complication)?
O2 therapy, cardiopulmonary support, anticoagulation therapy
How to manage Depressed respiratory drive (Respiratory Complication)?
start capnography, stimulation, reversal of opioids or benzodiazepines, mechanical ventilation
How to manage Pain (Respiratory Complication)?
Opioid analgesic drug therapy, NSAID therapy, complementary and alternative therapies (e.g. music, imagery)
How to prevent infections?
- Scrubbing, Gowning, and Gloving
- surgical hand antisepsis is required of all sterile members
- wet scrubbing: fingers -> distal to proximal
- hold hands away from surgical attire & higher than elbows
- don sterile gown and 2 pairs of sterile gloves
Basic Aseptic Technique - maintaining a sterile field
- all material that enter the sterile field must be sterile
- if a sterile item comes in contact with an unsterile item, it is contaminated
- contaminated items are removed at once from the sterile field
- if the entire field is contaminated it should be set up again with all new material
What is an appropriate delegation to a licensed practical nurse (LPN)?
LPNs/LVNs can handle stable patients w/ predictable outcomes
- Stable patients 24 hours post-op
- Routine wound care
- Routine medications (NO high alert meds, blood products, plasma)
- Collect specimens
- Blood glucose readings
- Suctioning
- Set up basic equipment
- Sterile procedures
- Cannot do an initial assessment, initial teaching, or discharge teaching (they can do follow-up assessments and reinforce teaching)
What is appropriate delegation to unlicensed assistive personnel (UAP)?
- ADLs (stable patients ONLY)
- Vital signs
- Can do VS 30 mins after blood infusion has started (if patient has not had a rection)
- Urine collection
- Input & Output
- Daily weight
- Repositioning/turning
- Gather equipment
