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Med Surg > Operative Care > Flashcards

Operative Care Flashcards

1
Q

key points from pre op

A

report any out of range H/P, VS or labs to surgeon

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2
Q

surgical care improvement plan

A

measures hospitals must meet (interventions to reduce surgical site infections)

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3
Q

minimally invasive/robotic surgery

A

more expensive and accurate with less blood loss and faster recovery times

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4
Q

robotic surgery is preferred for

A

cholecystectomy, joint, cardiac, splenectomy, spinal

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5
Q

anesthesia

A

induced state of partial/total loss of sensation, occurring with or without loss of consciousness

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6
Q

anesthesia is used

A

to block nerve impulses, supress relfexes, paralysis, muscle relaxation, controlled level of conciousness

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7
Q

general anesthesia

A

reversible loss of consciousness induced by inhibiting neuronal impulses in CNS

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8
Q

inhalation of general anesthesia

A

commonly induces post op N/V

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9
Q

IV injection general anesthesia

A

do not give if you have kidney or liver problem

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10
Q

balanced anesthesia for general anesthesia

A

Combination of IV drugs and inhalation agents

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11
Q

examples of balanced anesthesia

A

Thiopental for induction, nitrous oxide for amnesia, morphine for analgesia, pancuronium for muscle relaxation

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12
Q

adjuncts to general anesthetic agents

A

hypnotics, opioid analgesics, neuromuscular blocking agents

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13
Q

local anestheisa

A

briefly disrupts sensory nerve impulse transmission from a specific body area but pt remains concious

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14
Q

local anesthesia is delivered

A

topically and by local infiltration (lidocaine)

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15
Q

regional anesthesia

A

type of local anesthesia that blocks multiple peripheral nerves in a specific region

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16
Q

example of regional anesthesia

A

field block, nerve block, spinal block, epidural block

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17
Q

conscious sedation

A

IV delivery of sedative, hypnotic, opioid drugs to reduce level of conciousness with patent airway able to respond

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18
Q

examples of conscious sedation

A

Etomidate, diazepam, midazolam, meperidine, fentanyl, alfentanil, and morphine sulfate

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19
Q

preventing injury

A

proper body position, prevent pressure ulcers, prevent obstruction of circulation/resp/nerve conduction

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20
Q

interventions for older adults

A

hold onto aids/glasses, small pillow under head, lift pt, head cap, monitor I/O + blood loss

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21
Q

postoperative phase

A

begins w completion of surgery and transfer to PACU/ICU

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22
Q

phase 1 of post op

A

PACU or ICU till stable

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23
Q

Phase 2 of post op

A

prep for lower level of care

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24
Q

phase 3 for post op

A

at home w no restriction on ADLs

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25
Q

PACU recovery room

A

allows for ongoing eval and stabilization of pt to prevent and treat complications after surgery

26
Q

PACU nurses

A

skilled in care of patients with multiple probs after surgery and helps w discharge

27
Q

assessment phase

A

review pre op assessment, pt hx, identify potential surgical comps

28
Q

respiratory assessment

A

patent airway, adequate gas exchange, o2 delivery device, lungs every 4 hrs, any artificial airways

29
Q

cardiovascular assessment

A

VS compared with baseline, cardiac monitor, peripheral vascular assessment, antiembolism stockings to prevent DVT, prophylactic drugs

30
Q

nurse must report BP changes that are at 25% higher or lower than baseline because it cause

A

blood loss, fluid loss, low BP, shock, pain, hemorrhage

31
Q

neuro assessment

A

LOC, A/O x 4, prevent delirium, motor and sensory assessment with return of SNS

32
Q

fluid electrolyte and acid base balance assessment

A

I/O, hydration status, color, IV fluids, acid bases, NG tube

33
Q

before oral feedings are given

A

check bowel sounds and voiding and that no paralytic ileus is present

34
Q

post op IV fluids provide

A

hydration and electrolytes not nutrients/calories

35
Q

renal assessment

A

return of urination, retention s/s, report if UO under 30 ml/hr

36
Q

GI assessment

A

post op N/V, assess peristalsis return, NG drainage, constipation, bowel sounds

37
Q

constipation may be related to

A

anesthesia, opioid analgesia, decreased movement, decreased oral intake

38
Q

NG tube inserted during surgery to

A

decompress/drain stomach, GI rest/healing, provide entereal feeding, monitor bleeding and prevent obstructions

39
Q

NG tube drainage must be assessed

A

every 8 hours

40
Q

oral feedings

A

allows more needed nutrients and stimulates action of GI tract only if bowel sounds return

41
Q

diets must progress from

A

clear to full liquids, soft to reg diet

42
Q

affect on nutrition

A

nutrient loss great, food intake diminished, protein loss for tissue breakdown/blood loss

43
Q

catabolism after surgery

A

tissue breakdown and loss exceeds tissue buildup

44
Q

negative nitrogen balance

A

poor nitrogen means poor ingestion of protein as it controls protein metabolism

45
Q

skin assessment

A

tissue integrity, drainage color/amount/smell, impaired wound healing

46
Q

dehiscence

A

opening of a wound

47
Q

evisceration

A

organs pop out of wound opening

48
Q

pain assessment

A

pain is expected so it should be continuously monitored

49
Q

drug therapy for pain

A

opioid/non opioid analgesics

50
Q

complimentary therapies to manage pain

A

position, massage, relaxation, music

51
Q

psychosocial assessment

A

anxiety, fear, safety, provide reassurance

52
Q

lab assessment includes

A

electrolytes, CBC, urine/renal tests, serum amylase, blood glucose, urinalysis, ABG

53
Q

“left shift” CBC

A

immature neutrophils released due to lack of mature WBCs to fight infection

54
Q

patient problems

A

decreased gas exchange, infection/delayed healing, pain, decreased peristalsis, post op hemorrhage

55
Q

improving gas exchange interventions

A

O2 sat, sit pt up, O2 therapy, incentive spirometer, cough, deep breathing, ambulation

56
Q

prevent wound infection/delayed healing

A

dressing, drains, antibiotics, manage dehiscence/evisceration

57
Q

promote peristalsis interventions

A

monitor abdomen, adequate hydration, increased mobility, metoclopramide

58
Q

prevent post op bleeding

A

assess underneath patient, drains, recognize warning signs, color, cap refill

59
Q

transition management

A

safety, fam availability, adherence to plan, activity, drug reconcilition, high protein/iron/zinc diet

60
Q

outcomes

A

maintain adequate lung expansion/resp function, good wound healing, pain management, peristalsis return

Med Surg (12 decks)

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