LEC 1: Perioperative Nursing Care Flashcards
What are risk factors for surgery?
- Age
- Nutrition
- Obesity
- Immunocompetence
- Fluid and electrolyte imbalances
How is age a risk factor for surgery?
- The young are most at risk because their system is not fully developed
- The old are at risk because they have a slow functioning of body system
How is nutrition a risk factor for surgery?
Malnourished individuals have trouble healing
How is obesity a risk factor for surgery
May have underlying diseases
What are preoperative assessments that a nurse should do?
Check:
- Vital signs Weight and height Mobility (ADLs); usual level of functioning
- Pain scale Blood glucose levels
- Skin assessment
Ask patient about:
- Medications Allergies
- Any previous surgeries
- Smoking/ alcohol/ drugs
- Support system for after surgery
What are pre and post op teaching the nurse can teach patients?
- DB & C (deep breathing and coughing)/ Incentive spirometry
- Mobilization Pain management (PCA and epidural)
- Anti-embolic stockings (AES)
- Pneumatic compression stockings (PCS)
- Leg exercises
What are common lab and diagnostic tests that are done pre or post surgery?
- Complete blood counts (CBC)
- Serum electrolytes
- Blood group and screen
- Blood urea nitrogen (BUN) and creatinine
- Serum albumin
- Urinanlysis International normalized ratio (INR) and activated partial thromboplastin time (APTT)
- Chest X-ray
- Electrocardiogram (ECG)
- Alanine aminotransferase(ALT), aspartate aminotransferase (AST), and bilirubin
What does a complete blood counts (CBC) lab and diagnostic test tell us?
Peripheral venous sample of blood measures RBCs, WBCs, HgB, and Hct
Why is a complete blood counts (CBC) diagnostic test done for surgery?
May reveal infection, low blood volume, and potential for oxygenation problems
What does serum electrolytes lab and diagnostic test tell us?
- Peripheral venous sample of blood reveals significant fluid and electrolyte imbalances preoperatively
- Attention is given to Na, K, and Cl levels
- IV fluid replacement may be indicated preoperatively
What does serum creatine lab and diagnostic test tell us?
- Ability of kidneys to excrete creatinine, a by-product of muscle metabolism, indicates renal function
- Elevated level can indicate renal failure
What does INR, APTT, and platelet counts lab and diagnostic test tell us?
- Reveal clotting ability of blood
- Reveals patients at risk for bleeding tendencies and thrombus formation
What does blood urea nitrogen (BUN) lab and diagnostic test tell us?
Ability of kidneys to excrete urea and nitrogen indicates renal function BUN becomes elevated if patient is dehydrated Preoperative IV fluid replacement may be needed
On the day of a surgery, what do nurses want to check (pre op checklist)?
- Hygiene
- Removal of hair and cosmetics
- Removal of prostheses
- Removal of jewellery and piercings
- Safeguarding valuables
- Bowel and bladder preparation
- Vital signs
- Documentation
- Performing special procedures
- Preoperative medications
- Latex sensitivity/ allergy
- Eliminating wrong site and wrong procedure surgery
What is the primary responsibility of the nurse regarding informed consent?
- Explain what the procedure is
- What are the risks and benefits of the procedure
- Expected outcomes
- Recovery time
- Any other alternative procedures/ treatment
- What the risk are if the surgery is not done
*The person doing the procedure has to give this information
* Our responsibility is to ensure that the patient understands; make sure they are informed
