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Old Tests > Nursing W&H 12, ATI 88 > Flashcards

Nursing W&H 12, ATI 88 Flashcards

1
Q

define surgery

A

use of instruments during an operation to treat injuries, disease, and deformities

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2
Q

surgical procedure are named according to:

A

1-involved body organ part or location

2-the suffix that describes what is done during the procedure

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3
Q

-ectomy

A

removal by cutting

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4
Q

-orrhaphy

A

suture of or repair

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5
Q

-oscopy

A

looking into

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6
Q

-ostomy

A

formation of a permanent artificial opening

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7
Q

-otomy

A

incision or cutting into

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8
Q

-plasty

A

formation or repair

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9
Q

purpose of aesthetic surgery

A

requested by pt. for improvement (breast augmentation)

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10
Q

purpose of diagnostic surgery

A

to obtain tissue samples, make an incision, or use a scope to make a diagnosis

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11
Q

purpose of preventative surgery

A

removal of tissue before it causes a problem

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12
Q

purpose of curative surgery

A

removal of diseased or abnormal tissue

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13
Q

purpose of palliative surgery

A

alleviation of symptoms when disease cannot be cured

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14
Q

main priorities for care in the PACU

A
  • maintain airway
  • ventilation
  • monitor circulatory status
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15
Q

postoperative client outcomes

A
  • vital signs will return to baseline levels
  • client will perform post-op exercises
  • client will be free from injury
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16
Q

risk factors for post-op complications

A
  • immobility (pressure ulcer, thrombophlebitis)
  • anemia (blood loss, healing factors)
  • hypovolemia (tissue perfusion)
  • respiratory disease (respiratory compromise)
  • immune disorder (risk for infection, delayed healing)
  • diabetes (delayed wound healing)
  • malnutrition
  • obesity (wound healing, dehiscence, evisceration)
  • age (respiratory, cardiovascular, and renal changes with age)
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17
Q

signs that pt. is ready to be transfered out of PACU

A
  • stable vital signs
  • no evidence of bleeding
  • return of reflexes (gag, cough, swallow)
  • wound draining is to a minimum
  • urine output at least 30 mL/hr
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18
Q

post-op diagnostic procedure and purpose of each

A
  • CBC=infection, immune status
  • Hgb and Hct=fluid status, anemia
  • Electrolyte levels=electrolyte balance
  • serum creatinine=renal status
  • ABGs=oxygenation status
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19
Q

post-op positioning of pillows

A
  • Under feet to promote venous return

- NOT UNDER KNEES (this will decrease venous return

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20
Q

risk factors for dehiscence or evisceration

A

obesity
coughing
moving without splinting
diabetes mellitus

21
Q

A client who had a hysterectomy resumed a regular diet earlier in the day. Now the client is reporting nausea and has vomited once. Which action should the nurse take?

A

monitor for bowel sounds

22
Q

A nurse is caring for a pt. who had abdominal surgery 7 days ago. The nurse observes serosanguineous drainage from the incision site. Which actions should the nurse take at this time

A

report findings to the charge nurse
reinforce coughing, but avoid forceful coughing
splint the incision upon movement
place pt in supine position with hips/knees bent

23
Q

A nurse is caring for a pt. who is post-op gastric resection. What actions should the nurse take

A
  • Apply pneumatic compression stockings bilaterally
  • administer pain med 30 minutes prior to ambulation
  • encourage the pt to perform leg exercises every 1 to 2 hr
24
Q

what are the phase in the surgical process

A
  • -preoperative=begins with decision for surgery and ends with transfer to the OR
  • -intraoperative=begins with the transfer to OR and ends with admission to PACU
  • -postoperative=begins with admission to PACU and continues until recovery is complete
  • -all together=preoperative
25
Q

what is the primary role as LPN in preoperative phase

A
  • assist in data collection
  • reinforce explanations and instructions
  • provide emotional and psychological support
26
Q

what is the physicians role in preoperative phase

A
  • obtain a medical history
  • perform a physical exam
  • orders diagnostic tests
27
Q

when preparing a pt. for surgery, the goal is:

A

to identify an implement actions that reduce surgical risk factors

28
Q

nutrition is important. diet must be high in what to promote healing

A

protein=tissue repair and healing
vitamin C=collagen formation
zinc=tissue growth, skin integrity, and cell mediated immunity

29
Q

what does smoking and alcohol do for pt. getting surgery

A
  • increases the pt’s risk.
  • smoking thickens and increases the amount of lung sections
  • reduces the action of cilia that remove sections
  • decreases wound healing
  • alcohol causes liver damage, creates bleeding problems, fluid volume imbalances, drug metabolism alterations, interacts with medications
30
Q

purpose of deep breathing

A
  • helps prevent the development of atelectasis

- repeat hourly while awake

31
Q

define atelectasis

A

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

32
Q

purpose of incentive spirometry

A
  • increases lung volume
  • alveoli expansion
  • venous return
  • prevents atelectasis
33
Q

preoperative consent

A
  • PHYSICIAN is responsible to obtain consent
  • valid for 30 days after signing
  • can be taken back
34
Q

consent has 2 purposes

A
  • protects the pt from unauthorized procedures
  • protects the physician, anesthesiologist, hospital, hospital employees from claims of performance of unauthorized procedures
35
Q

what 3 elements does a consent involve

A

1–physician must explain about diagnosis, proposed treatment, who will perform it, likely outcome, possible risks, complications, prognosis, answer questions
2–consent must be signed BEFORE analgesics or sedatives are given
3–consent must be voluntarily

36
Q

pts who are unable to give consent are:

A

unconscious
mentally incompetent
minors
received analgesics or drugs that alter CNS

37
Q

preoperative checklist items

A
  • id band placed
  • hospital gown
  • vital signs taken
  • make up, nail polish, artificial nails removed
  • remove hair pins, wigs, jewelry(because of edema)
  • dentures, contact lenses, prostheses removed
  • glasses and hearing aids go with pt if unable to communicate w/o them
  • test results reviewed
  • anti-embolism devices applied
  • pts asked to void BEFORE sedation
38
Q

purpose of anti-anxiety and sedative hypnotics as preoperative med

A

sedation; anxiety reduction

diazepam, valium, ativan

39
Q

purpose of anticholinergics as preoperative med

A

secretion reduction

40
Q

purpose of antiemetic as preoperative med

A

control nausea and vomiting. may be effective into the postoperative period

41
Q

purpose of alkalinizing agent

A

increase gastric pH

42
Q

purpose of antibiotics as preoperative med

A

prevent postop infection

43
Q

purpose of histamine antagonists as preop med

A

reduction of acidic gastric secretions to prevent acid aspiration pneumonitis

44
Q

post op patient hospital room preparation

A 
bed linen should be changed
place disposable pads on bottom sheet
apply life sheet
have extra blankets available
fanfold top cover
obtain extra pillows
have emesis basin ready
have tissues and washcloths in room
have urinal or bedpan available
45
Q

if pt requires body hair removal for surgery, what should you do

A

removed with electric clippers or depilatory. shaving should be avoided. can cause micro-abrasion and colonize microorganism

46
Q

what are the two types of anesthesia

A

general

local

47
Q

general anesthesia

A

pt loses sensation, consciousness, and reflexes

acts directly on the CNS

48
Q

local anesthesia

A

blocks nerve impulses along the never where it is injected. loss of sensation to a region of the body w/o the loss of consciousness

49
Q

malignant hyperthermia

A
  • -rare hereditary muscular disease
  • -triggered by some types of general anesthetic agents
  • -history of anesthetic problems
  • history of heat stroke
  • -metabolism in the muscles is increased
  • -very high fever, rigidity, tachycardia, tachypnea, hypertension, dysrhtmias, hyperkalemia, metabolic respiratory acidosis, cyanosis,
  • -give 100% O2, pt must be cooled with ice and infusions. Dantrolene sodium (Dantrium) must be given. Relaxes muscle. Most effective med for malignant hyperthermia

Old Tests (16 decks)

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