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Medical-Surgical Nursing > Module 1 PRELIM > Flashcards

Module 1 PRELIM Flashcards

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1
Q

entire surgical experience

A

perioperative

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2
Q

Begins when decision to proceed with surgery is made and ends when patient is transferred to the operating room (OR) bed

A

preoperative

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3
Q

Begins when patient is on the OR bed and ends when patient is admitted into the postanesthesia care unit (PACU)

A

intraoperative

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4
Q

Begins with the patient’s admission into the PACU until patient regains optimal functioning

A

postoperative

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5
Q

visualization of anatomical area of concern and facilitation of diagnosis

A

diagnostic

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6
Q

aim to cure or solve an anatomical problem; usually involves removal of affected organ or tissue

A

ablative

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7
Q

Aims to relieve pain and reduce symptoms from the condition by correcting a problem

A

palliative

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8
Q

Repair of damaged part of the body for cosmetic purposes

A

reconstructive

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9
Q
  • requires hospitalization
  • long surgery
  • prolonged recovery
  • higher risk for complications
A

major

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10
Q
  • may be done outpatient
  • lower risk for complications
A

minor

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11
Q

requires immediate attention without delay may be life threatening

A

emergent

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12
Q

requires prompt attention within 24 to 30 hours

A

imperative/urgent

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13
Q

needs the surgery and is planned within a few weeks or few months

A

required

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14
Q

should have the surgery, but if unable to, effects will not be catastrophic

A

elective

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15
Q

patient decides whether or not to do the surgery based on personal preference

A

optional

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16
Q

patient’s autonomous decision whether to undergo the surgery. it protects the healthcare providers and patients

A

informed consent

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17
Q

contains all vital information that must be assessed ensuring the safety of the surgical patient

A

preoperative checklist

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18
Q

directly involved in the surgical procedure

A

sterile team

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19
Q

who are the sterile team?

A

surgeon
first assistant
scrub nurse

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20
Q

supports the sterile team; maintains sterile field

A

nonsterile team

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21
Q

who are the nonsterile team?

A

anesthesiologist
circulating nurse
technicians

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22
Q
  • captain of the ship
  • performs the surgical procedure
  • heads the surgical team
A

surgeon

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23
Q

a member of the operating room team whose responsibilities may include handling tissue, providing exposure at the operative field, suturing, and maintaining homeostasis

A

registered nurse first assistant

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24
Q

physician trained to deliver anesthesia and to monitor the patient’s condition during surgery

A

anesthesiologist

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25
Q

registered nurse who coordinates and documents patient care in the operating room

A

circulating nurse

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26
Q

prevents contamination of surgical wounds

A

principle of asepsis

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27
Q

a state of narcosis or severe central nervous system depression produced by pharmacologic agents, analgesia, relaxation, and reflex loss

A

anesthesia

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28
Q

involves the total loss of body sensation and consciousness induced by anesthetic agents administered primarily by inhalation or intravenous injection

A

general anesthesia

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29
Q

what are the 4 stages of general anesthesia?

A

onset/beginning anesthesia
induction/excitement
surgical anesthesia
toxic medullary depression

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30
Q

*Dizziness and feeling of detachment during induction

*Exaggerated sound perception: ringing, buzzing, roaring; low voices and minor sounds seem loud

*Still conscious, but may sense an inability to move extremities easily

*These sensations may cause agitation. Avoid unnecessary noises and motion when anesthesia begins

A

onset/beginning anesthesia

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31
Q

*Patient may struggle, shout, laugh, or cry

*Pupils dilate, but constrict with light exposure

*Pulse rate is rapid

*Respirations may be irregular

*There may be Uncontrolled movements

*Anesthesiologist must be assisted during administration just in case the patient needs to be restrained

A

induction/excitement

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32
Q

*The stage can be maintained for hours in several planes, depending on the depth of anesthesia needed (light (1) to deep (4))

*The patient is unconscious and lies quietly on the table

*Pupils are small but constrict with exposure to light

*Breathing is regular

*Pulse is normal

*Skin is pink or slightly flushed

A

surgical anesthesia

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33
Q

*Occurs when too much anesthesia has been given

*It is not a planned stage of surgical anesthesia

*Shallow respirations

*Pupils are small and nonreactive to light

*Cyanosis develops. Without prompt intervention, may lead to death

*Discontinue anesthetic agent immediately

*Initiate circulatory and respiratory support

*Stimulants may be given. Narcotic antagonists may be given if causative agent was opioids

A

toxic medullary depression

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34
Q

local anesthesia is injected into epidural space that surround the dura mater of the spinal cord

A

epidural anesthesia

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35
Q

what does epidural anesthesia blocks?

A

sensory
motor
autonomic

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36
Q

epidural anesthesia require higher or lower doses?

A

higher

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37
Q

does epidural anesthesia causes LOC?

A

no

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38
Q

advantage of epidural anesthesia

A

absence of headaches

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39
Q

disadvantage of epidural anesthesia

A

challenging to inject in epidural space instead of subarachnoid space

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40
Q

what could happen if there is an accidental puncture of dura which high spinal anesthesia?

A

severe hypotension
respiratory depression
arrest

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41
Q

treatment for accidental puncture of dura?

A

airway support
IV fluid
vasopressors

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42
Q

local anesthesia is introduced into subarachnoid space usually between L4 and L5

A

spinal anesthesia

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43
Q

where does spinal anesthesia produced?

A

lower extremities
perineum
lower abdomen

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44
Q

WOF in spinal anesthesia

A

hypotension
N/V
headache

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45
Q

WOF spinal headaches

A

respiratory paralysis
neurological complications
ruptured nucleus pulposus

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46
Q

critical areas of assessment during postoperative phase

A

neurological status
respiratory status
cardiac status

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47
Q

WOF postoperative phase

A

airway obstruction
hypoventilation

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48
Q

partial or complete separation of skin edges and suture line; increased wound drainage

A

dehiscence

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49
Q
  • internal organs outpouching or protrusion
  • increased serosanguinous fluid drainage
  • emergency condition
A

evisceration

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50
Q

procedures that use specialized instruments inserted into the body either through natural orifices or through small incisions

A

minimally invasive surgery

51
Q

surgery that does not require an overnight hospital stay

A

ambulatory surgery

52
Q

A series of diagnostic tests done before surgery to establish the patient’s health status and identify any potential problems that may occur during surgery

A

preadmission testing

53
Q

appropriate cover when an older patient is moved to and from the OR but never replaces asking patients if they feel sufficiently warm and attending to their needs

A

lightweight cotton blanket

54
Q

specialty that provides treatment for obesity

A

bariatric surgery

55
Q

unplanned and occur with little time for preparation of the patient or the perioperative team

A

emergency surgery

56
Q

the patient concentrates on a pleasant experience or restful scene

A

guided imagery

57
Q

the patient thinks of an enjoyable story or recites a favorite poem or song

A

distraction

58
Q

the patient recites optimistic thoughts (I know all will go well)

A

optimistic self-recitation

59
Q

The patient listens to soothing music (an easy-to-administer, inexpensive, noninvasive intervention)

A

music therapy

60
Q

the patient inhales aromatic oils to trigger emotional and physical relaxation responses through the olfactory system and brain

A

aromatherapy

61
Q

The practitioner places hands over the patient to (theoretically) transfer energy to promote healing and relaxation

A

reiki

62
Q

the substance, such as a chemical or gas, used to induce anesthesia

A

anesthetic agent

63
Q

advanced practice registered nurse who delivers anesthesia care under the direction of an anesthesiologist

A

certified registered nurse anesthetic

64
Q

a thin endoscope inserted through a small incision into a cavity or joint using fiber-optic technology to project live images of structures onto a video monitor; other small incisions allow additional instruments to be inserted to facilitate laparoscopic surgery

A

laparoscope

65
Q

a rare life-threatening condition triggered by exposure to most anesthetic agents inducing a drastic and uncontrolled increase in skeletal muscle oxidative metabolism that can overwhelm the body’s capacity to supply oxygen, remove carbon dioxide, and regulate body temperature, eventually leading to circulatory collapse and death if untreated; often inherited as an autosomal dominant disorder

A

malignant hyperthermia

66
Q

previously referred to as conscious sedation, involves the use of sedation to depress the level of consciousness without altering the patient’s ability to maintain a patent airway and to respond to physical stimuli and verbal commands

A

moderate sedation

67
Q

monitored sedation given by an anesthesiologist or certified registered nurse anesthetist (CRNA)

A

monitored anesthesia care

68
Q

the intentional practice of using a combination of nonopioid pharmaceuticals and regional anesthesia techniques

A

multimodal anesthesia

69
Q

area in the operating room where scrub attire and surgical masks are required; includes operating room and sterile core areas

A

restricted zone

70
Q

registered nurse, licensed practical nurse, or surgical technologist who scrubs and dons sterile surgical attire, prepares instruments and supplies, and hands instruments to the surgeon during the procedure

A

scrub role

71
Q

area in the operating room where scrub attire is required; may include areas where surgical instruments are processed

A

semirestricted zone

72
Q

measures taken to prevent the spread of pathogens from the environment to the patient by eliminating all micro-organisms in that environment

A

sterile technique

73
Q

absence of microorganisms in the surgical environment to reduce the risk of infection

A

surgical asepsis

74
Q

area in the OR that interfaces with the other departments including the pt reception area and holding areas

A

unrestricted zone

75
Q

A tool used to assess the dangers of fires for each surgical case

A

fire risk assessment tool

76
Q

a bacterium is the most common type of particle on dispered skin cells

A

staphylococcus aureus

77
Q

designated spaces established for sharps to be put down and picked up

A

neutral zone or safe zone

78
Q

what are the most reliable guides to the patient’s condition when given anesthetics?

A

response of the pupils
blood pressure
respiratory status
cardiac status

79
Q

two types of inhaled anesthetic agents

A

volatile liquid anesthetic agents
gas anesthetic agents

80
Q

it produces anesthesia when the vapors are inhaled

A

volatile liquid anesthetic agents

81
Q

it is given by inhalation and are always combined with oxygen

A

gas anesthetic agents

82
Q

what are the most common gas anesthetic agents

A

nitrous oxide
sevoflurane
desflurane

83
Q

it is injected around nerves

A

regional anesthesia

84
Q

largest fibers and have the thickest myelin sheath

A

motor fibers

85
Q

smallest fibers and have a minimal covering

A

sympathetic fibers

86
Q

intermediate fibers

A

sensory fibers

87
Q

used in conjunction with general or MAC anesthesia, or as a stand-alone method

A

peripheral nerve blocks

88
Q

it produces anesthesia of the arm

A

brachial plexus block

89
Q

it produces anesthesia of the nerves supplying the chest, abdominal wall, and extremities

A

paravertebral anesthesia

90
Q

it produces anesthesia of the perineum and, occasionally, the lower abdomen

A

transsacral (caudal) block

91
Q

injection of a solution containing the anesthetic agent into the tissues at the planned incision site

A

local anesthesia

92
Q

potentially life-threatening event of a anesthesia

A

local anesthetic systemic toxicity

93
Q

it intensifies the effects of LAST

A

hypoxemia
acidosis

94
Q
  • flat on the back
  • used for most abdominal surgeries except for gallbladder or pelvis
A

dorsal recumbent position

95
Q

used for surgery on the lower abdomen and pelvis to obtain good exposure by displacing the intestines into the upper abdomen

A

tredelenburg position

96
Q

used for nearly all perineal, rectal, and vaginal surgical procedures

A

lithotomy position

97
Q

used for renal surgery

A

sims or lateral position

98
Q

method of healing in which wound edges are surgically approximated and integumentary continuity is restored without granulation

A

first-intention healing

99
Q

area designated for care surgical patients immediately after surgery and for patients whose condition warrants close monitoring

A

phase I PACU

100
Q

area designated for care of surgical patients who have been transferred from a phase I PACU because their condition no longer requires the close monitoring provided in a phase I PACU. The patient is prepared for transfer to an inpatient unit or for discharge from the facility

A

phase II PACU

101
Q

area where postoperative patients are monitored as they recover from anesthesia

A

postanesthesia care unit

102
Q

method of healing in which wound edges are not surgically approximated and integumentary continuity is restored by the process known as granulation

A

second-intention healing

103
Q

patients who have experienced prolonged anesthesia usually are unconscious, with all muscles relaxed. This relaxation extends to the muscles of the pharynx. When the patient lies on the back, the lower jaw and the tongue fall backward and the air passages become obstructed.

A

hypopharyngeal obstruction

104
Q

what are the signs and symptoms of LAST?

A

metallic taste
auditory changes
slurred speech
seizures
oral numbness
respiratory arrest
arrythmias

105
Q

what is the initial treatment for LAST?

A

airway management

106
Q

other term for moderate sedation?

A

conscious sedation

107
Q

other term for monitored anesthesia care?

A

monitored sedation

108
Q

what does STOP-bang mean?

A

snoring
tired
observed
pressured
BMI
age
neck
gender

109
Q

STOP-bang is an assessment for what?

A

OSA

110
Q

what does OSA mean?

A

Obstructive Sleep Apnea

111
Q

determinator of nutritional needs

A

BMI
waist circumference

112
Q

the organ important in the biotransformation of anesthetic compounds

A

liver

113
Q

the organ involved in excreting anesthetic medications and their metabolites

A

kidney

114
Q

medication that puts patients at risk for adrenal insuffiency

A

corticosteroids

115
Q

flattening of the dome of the diaphragm during inspiration, with resultant enlargement of the upper abdomen as air rushes in

A

diaphragmatic breathing

116
Q

where is PACU located in relation to the OR suite

A

adjacent

117
Q

when a patient is moved too quickly from one position to another they experience this

A

orthostatic hypotension

118
Q

reduced oxgen in the blood

A

hypoxemia

119
Q

excess carbon dioxide in the blood

A

hypercapnia

120
Q

what is the primary objective in immediate postoperative period?

A

maintain ventilation

121
Q

how much blood loss requires replacement?

A

500 mL

122
Q

what are the types of shock?

A

hypovolemic
cardiogenic
neurogenic
anaphylactic
septic

123
Q

what is the common type of shock in postoperative setting?

A

hypovolemic

124
Q

how can oxygen be given?

A

nasal cannula
facemask
mechnical ventilation

Medical-Surgical Nursing (4 decks)

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