NU 310 Exam 1 Flashcards
What are the 5 surgical classifications?
- Emergent, 2. Urgent, 3. Required, 4. Elective 5. Optional… (Every Urge Requires Erectile Operation)
What is a nurses responsibilities in the preop process?
Assessment, Teaching (WITH FAMILY), verify diagnostic testing, pt. understanding.
What does a preop nursing assessment encompass?
Nutrition, Dentition, Drugs, Alcohol, Respiratory/smoking habits, Cardiovascular Status, Hepatic, Renal, Endocrine, Immune function, Allergies, Medications, psychosocial, and spiritual factors.
Which preop nursing assessment looks at the ability to be under anesthesia and intubation?
Dentition
Which preop nursing assessment deals with 02 sat, V/S and HTN?
Cardiovascular
Glucose, steroids and thyroid function are all a part of what preop assessment?
Endocrine
What type of medications do people often leave out when asked?
OTC and Herbal
Hydration, electrolyte balances and bowel movements are all a part of what preop assessment?
Nutrition
When should post op teaching begin?
ASAP, during the preop process if able
Nurses do not get but make sure this is done prior to surgery.
Informed consent
I was just shot what class of surgery and time frame will I be placed?
Emergent (ASAP)
How soon should an Urgent surgery be done?
within 24 hrs.
What surgery class allows for 1-2 weeks before the surgery needs to be done?
Required
The choice for setting a surgery date is given to what surgery class?
elective
What is the most common optional surgery?
Cosmetic
What are the 3 most common preop tests?
Urine Analysis, Chest Xray and CBC
What other preop tests may a surgeon ask for?
Urine culture, EKG, ABG, Type and Screen, Pregnancy tests, Drug levels, HbA1c
When should informed consent be taken?
Prior to preop medications.
What should be focused on during post op teaching
Respiratory therapy, mobility (DVT), Pain management, Nutrition, Cognitive measures.
What are some common preop medications given?
Tranquilizers, Sedatives, Analgesics, Anticholinergics, H2 receptor antagonists.
What should a pt NEVER do after pre-op meds are administered?
move out of bed
What is a “Time Out”?
During the intraoperative process the surgical team stops to identify the Right pt, right side, equiptment counts, blood typing and allergy documentation.
What extra risks do Geriatric pt’s have in an OR.
Coexisting conditions, Aging organs, decreased homeostatic mechanisms, response to drugs, OTC meds
Different types of Anesthesia
General, Regional, Moderate Sedation and Local Anesthesia
What Anesthesias can be given IV
General and Moderate
Which anesthesia is given by epidural, spinal or local block
Regional
General Anesthesia can be given how many ways?
2 IV and inhaled
Surgical Complications
Hypothermia, Malignant hyperthermia, DIC, infection, anesthesia awareness, nausea, vomiting, anaphylaxis, hypoxia
What is malignant hyperthermia?
A rare condition that is usually paternal in nature. Altered calcium function leading to tachycardia, high temp and muscle rigidity.
Anesthesia and surgery side effects
Allergic reactions, cardiac dysrhythmias, CNS changes, Trauma, Hypotension and Thrombosis
What is focused on during the Post Op process
Physiologic stability, pain management, preventing complications and education
A PACU nurses responsibilities
Baseline assessment, Airway, Cardio, Surgical site, CNS and IV assessments. VS q15 min and prepare for transfer.
What must a patient show prior to discharge from PACU.
urine output >30mL per hour
Care of a postop pt
Low hematocrit, hemodynamically stable, nutrition, assessments, pain management, self care, discharge planning.
The 5 W’s of post op compications
WInd, Water, Wound, Walking, Wonder-drugs
pneumonia, atelectasis during the first 24-48 hours
wind
UTI after day 3 postop
water
wound infection after day 5
wound
Reducing DVT and PE post op
walking
Anesthesia (post op comp name)
wonder drugs
RAT and BED
Early and late signs of hypoxia RAT (restless, anxiety, tach) BED (bradycardic, extreme restlessness, dyspnea)
Surgeon changes the first
dressing
Nurses should assess dressing for?
bleeding