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Nursing 1 > Mod 8 > Flashcards

Mod 8 Flashcards

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1
Q

preoperative care takes place from…

A

the time clients are scheduled for surgery until care is transferred to the operating suite.

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2
Q

preoperative care includes thorough data collection of the clients..

A

physical, emotional, and psychosocial status prior to surgery

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3
Q

surgery may be performed for?

A

restorative, curative, palliative, or cosmetic purpose

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4
Q

whose responsibility is it to obtain consent after discussing procedure risks and benefits?

A

Responsibility of the provider. The nurse IS NOT TO obtain the consent for the provider IN ANY circumstance

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5
Q

can the nurse provide new information or additional information not previously given by the provider

A

no. They can claify and info that remains unclear after the explanation but nothing new that has not been covered by the provider first.

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6
Q

palliative surgery

A

to relieve pain or complications Ex; to remove a metastatic rumor from the abdomen that is causing considerable pain

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7
Q

curative surgery

A

alleviates (cures) a problem as when a gallbladder that is full of stones causing blockage or pain is removed

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8
Q

who is at risk of higher complications of surgery and why

A

the infant and the elder because of either immature body systems or a decline in function of various body systems.

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9
Q

light amplification by the stimulated emission of radiation

A

laser surgery

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10
Q

what surgery is common and is often combined with microscopic, endoscopic, and robotic enhanced procedures.

A

laser surgery

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11
Q

allows the use of endoscopes with high-resolution video cameras passed through a very small incision for an ever increasing variety of surgical procedures.

A

fiberoptic surgery

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12
Q

this surgery is operated from a nearby comp, views magnified three dimensional images of surgical field on screen, magnification up to 12 times that of normal. remote controlled instruments are inserted through small incisions.

A

robotic surgery

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13
Q

what are some advantages of robotic surgery

A

has rock-steady hands, providing precision that is beyond human dexterity. Only small incisions are needed, the pt has less pain postoperatively and requires less time to heal. less scaring and fewer infections

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14
Q

what decreases complications?

A

a normal fluid and electrolyte balance

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15
Q

how long should pts avoid smoking before surgery

A

24 hours before surgery or 3 to 4 weeks before

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16
Q

what is the benefits of not smoking before surgery

A

increases the action of the lungs defense mechanisms and makes more hemoglobin available to carry oxygen during surgery and improves wound healing

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17
Q

what may cause nutritional deficiencies and bleeding problems

A

long term alcohol use

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18
Q

PAT

A

preadmission testing

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19
Q

what is included in the PAT interview

A

health history, identification of risk factors, pt and family teaching, discharge planning, and necessary referrals to social work, support groups, and educational programs. Ask about previous problems with anesthesia or malignant hyperthermia

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20
Q

how much water can the pt take with their medications the morning of surgery when they are to be NPO

A

1 ounce

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21
Q

atelectasis

A

collapse of the lung caused by hop ventilation or mucous obstruction preventing some alveoli from opening and being fully ventilated

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22
Q

what helps prevent atelectasis

A

deep breathing, by expanding and ventilating the lungs.

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23
Q

arterial blood gases

A

obtain baseline levels and detect pH and oxygenation abnormalities

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24
Q

bleeding time

A

detect prolonged bleeding problem

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25
Q

blood urea nitrogen (BUN) or creatine

A

detect kidney problem

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26
Q

complete blood cell count (CBC)

A

detect anemia, infection, clotting problem

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27
Q

electrolytes

A

detect potassium, sodium, chloride imbalances

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28
Q

fasting blood glucose

A

detect abnormalities, monitor diabetes control

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29
Q

partial thromboplastin time

A

detect clotting problem

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30
Q

international normalized ratio (INR)

A

detect clotting problem, monitor warfarin therapy

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31
Q

type and cross match

A

identify blood type to match blood for possible transfusion

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32
Q

urinalysis

A

detect infection, abnormalities.

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33
Q

what are the main priorities of care postoperatively?

A

maintaining airway, latency and ventilation and monitoring circulatory status

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34
Q

most surgeons postpone surgery if the pts ? is to low

A

hemoglobin level

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35
Q

the dictated report must be in the record…

A

before the pt goes to surgery

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36
Q

stasis

A

stoppage of flow

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37
Q

thrombophlebitis

A

blood clot causing inflammation of a vessel

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38
Q

how long should deep breathing and coughing be performed after general anesthesia

A

every 2 hours for 72 hours

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39
Q

most preoperative medications are given ? in the surgical holding area

A

intravenously

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40
Q

what are the two purposes of a consent

A

1) protects the patient from unauthorized procedures
2) protects the physician, anesthesiologist, hospital, and hospital employees from claims of performance of unauthorized procedures.

41
Q

the type of anesthesia and the anesthetic agents are ordered by the anesthesia prouder with input from?

A

the pt and the physician

42
Q

what are the two types of anesthesia

A

general and local (regional)

43
Q

this anesthesia causes the pt to lose sensation, consciousness, and reflexes. it acts directly on the nerve impulses along the nerve where it is injected, resulting in the loss of sensation to a region of the body without the loss of consciousness

A

General

44
Q

general anesthesia is commonly given by ?

A

IV or inhalation

45
Q

maintenance of anesthesia is accomplished by using ?

A

inhalation agents

46
Q

rare hereditary muscular disease that can be triggered by some types of general anesthetic agents.

A

malignant hyperthermia

47
Q

what is the most effective med for malignant hyperthermia?

A

Dantrolene sodium (dantrium) - muscle relaxant - must be kept readily available in the OR

48
Q

achieved by injecting the medication into the tissue where the incision is to be made

A

local infiltration

49
Q

done by injecting the local agent along a nerve that carries impulses in the region where anesthesia is desired

A

regional block

50
Q

injection of a local agent into a nerve at a specific point

A

nerve block

51
Q

done by placing a tourniquet on an extremity to remove the blood and then injecting the local agent into the extremity

A

Bier block

52
Q

is a series of injections surrounding the surgical area

A

field block

53
Q

is injection of a local agent into an area around the spinal nerves.

A

spinal or epidural block

54
Q

used mainly for lower extremity and lower abdominal surgery. both motor and sensory function is blocked.

A

spinal and epidural blocks

55
Q

what happens if the block travels too far upward?

A

respiratory depression

56
Q

results from leakage of cerebrospinal fluid (CSF) from the needle puncture hole in the dura that does not close when the needle is withdrawn.

A

Postdural puncture headache(reduces pressure on the spinal cord and brain causing a headache)

57
Q

purposeful minimal sedation that does not cause the complete loss of consciousness. pts still have control of their own airway. Medications such as sedatives, hypnotics and opiods are given to produce this sedation

A

conscious sedation

58
Q

what are priority areas of pt assessment

A

ensuring a patent airway, preventing falls and injury from uncontrolled movements, respiratory status, vital signs including Sao2, level of consciousness and responsiveness, surgical site incision/dressing/drainage tubes, and pain level and pain management

59
Q

begins when the pt is admitted to the PACU or a nursing unit and ends with the pts postoperative evaluation in the physicians office

A

postoperative phase

60
Q

what medication is used to relieve shivering or shaking from anesthesia

A

Demerol (meperidine)

61
Q

what med is used for nausea or vomiting

A

antiemetics

62
Q

includes level of consciousness; orientation to person, place time and event; pupil size and reaction to light; and motor and sensory function

A

neurologic assessment

63
Q

IV analgesics usually have a ? duration than IM analgesics

A

shorter

64
Q

the edges of the wound are approximated with staples or sutures. scaring is minimal

A

first intention healing

65
Q

wound is usually left open and allowed to heal by granulation. scaring is usually extensive with prolonged healing

A

second intention healing

66
Q

an infected wound is left open until there is no evidence of infection and the wound is then surgically closed

A

third intention healing

67
Q

wound problems can include

A

hematoma, infection, dehiscense, and evisceration

68
Q

dehiscence

A

sudden bursting open of a wounds edges which may be preceded by and increase in serosanguineous drainage

69
Q

eviscreation

A

is the viscera spilling out of the abdomen ( feels like something let loose or gave away)

70
Q

what aids in healing dehisced surgical incisions that resist healing?

A

VAC - vacuum assisted closure

71
Q

after abdominal surgery, GI assessment should include?

A

monitoring vital signs, the return of flatus, the return of appetite, first bowel movement, any nausea or vomiting, or signs of ileum, such as distention, bloating, and cramps.

72
Q

after abdominal surgery, peristalsis, bowel sounds and flatus is usually stopped or absent for how many hours?

A

24 - 72 hours

73
Q

pt will return to normal bowel elimination patterns and report freedom from gas pains and constipation within how many days

A

3 - 4 days post op

74
Q

what is the primary purpose of most IV fluids?

A

to provide hydration ( most iv solutions do not provide enough nutrients or calories to prevent malnutrition)

75
Q

discharge planning begins during the ? and continues…

A

preadmission testing;

after admission to ensure that the pt is ready for a timely discharge.

76
Q

clinical discharge criteria include?

A

stable vital signs, no bleeding, no nausea or vomiting, and controlled pain that is not severe. Depending on the type of surgery the pt may be required to void before leaving.

77
Q

list in order what is done in the intraoperative phase

A

1) pt transported to holding room where circulating nurse verifies pts ID and that all preoperative orders have been accomplished
2) anesthesiologist or nurse anesthetist start IV if not already in place
3) surgical consent for is checked to eunsure pt is being prepared for correct surgery
4) surgical site is verified and marked BEFORE medications are given
5) PREop meds are administered
6) when OR is ready pt is transferred

78
Q

when is anesthesia begun?

A

as the pt is being draped. further skin preparation is done at this time also

79
Q

warming the pt before an operation can reduce the risk of surgical wound infection by what percent

A

57%

80
Q

vital signs are taken every ? - ? mins in the post anesthesia care unit (PACU)

A

5-15 mins until stable

81
Q

anesthesia recovery period usually takes ? hours

A

2-6 hours

82
Q

what form of scoring system may be used to determine readiness for transfer? activity, respiration, circulation, consciousness, and skin color are each given a score of 1-3. total score of 9-10 usually indicates the pt is ready for transfer.

A

form of the “Aldrete” scoring system.

83
Q

when can the post anesthesia care same day surgery pt be discharged?

A

when vital signs are stable, the pt is allowed to sit up and then is ambulated. “when able to ambulate unassisted, the pt may be discharged if ital signs are stable”

84
Q

how long is the usual recovery time in the same day surgery unit

A

1-4 hours

85
Q

(post-op care)
vital signs and careful assessment are performed every ? mins for the 1st hour, every ? mins for the next 2 hours, every ? mins for the next 4 hours, and then every ? hours until the pt is totally recovered from anesthesia and vital signs have returned to normal

A

15mins;
30mins;
60 mins(hour);
4

86
Q

the pt must be positioned ? or ? to prevent aspiration, if not contraindicated, until fully recover, alert, and with the swallowing reflex intact

A

on the side;

with the head turned to the side

87
Q

why is it important to encourage the pt to drink plenty of fluids even those containing caffeine?

A

the fluids and caffeine raise the vascular pressure at the spinal puncture site and help seal the hole

88
Q

what is the expected amount of drainage postoperatively for :
urine, gastric contents, wound drainage, and T-tube, bile

A

urine = 500-700mL for 1-2 days post-op, then 1500-2500mL thereafter depending of intake
Gastric contents = up to 1500mL/day
Wound drainage = variable with procedure and type of drain
T-tube, bile = up to 500mL

89
Q

atelectasis

A

collapse of alveoli in the lungs

90
Q

what occurs when lack of movement or of position change causes stasis of secretions, which become a breeding ground for bacteria?

A

hyopstatic pneumonia

91
Q

coughing may be contraindicated for pts that have had what kind of surgery?

A

hernia repair, eye, ear, or brain surgery

92
Q

what can be especially helpful to prevent atelectasis and hypoventilation?

A

use of an incentive spirometer

93
Q

report arterial oxygen saturation (Sao2) readings below ? to the physician

A

92%

94
Q

when the procedure involved an extremity or the pelvic area, what pulse do you check for each full assessment?

A

check the distal or peripheral pulse.

95
Q

swelling at the surgical site can…

A

compress vessels and decrease blood flow distal to the area.

96
Q

what can an increase in pulse indicate

A

internal bleeding is occurring, but can also signify incomplete pain control

97
Q

blood pressure falling below normal baseline level may indicate…

A

major bleeding

98
Q

if the urine flow is less than ?mL/kg/hr report it to the charge nurse. If flow is less than ? mL over a 2-hour period, notify the surgeon.

A

5mL/kg/hr;

60mL

99
Q

no potassium additive should be given until the urine flow is at least…? why?

A

5 mL/kg/hr;

Potassium may cause hyperkalemia if kidney function is not adequate.

Nursing 1 (12 decks)

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