Peri-Op Flashcards
What is diagnostic surgery? What are 2 examples?
Determines origin & cause.
Colonoscopy & laparoscopy
What is curative surgery? What are 2 examples?
Resolves the problem by repair or removal.
Appendix or gallbladder
What is restorative surgery? What is an example?
Improves functionality.
Knee replacement
What is palliative surgery? What is an example?
Relives a symptom but may not be a cure.
Cancer or tumor
Risks related to elderly: what is DECREASED in elderly?
1.
2.
3.
Cardiac output
Periphery
Circulation
Risks related to elderly: what is INCREASED in the elderly?
1. 2. 3. 4. 5.
Blood pressure Skin damage Infection Sensory deficits Deformities
What is MIS (minimally invasive & robotic surgery) preferred for?
1-7
Cholecystectomy (gallbladder) Joint surgery Cardiac surgery Spinal surgery GYN surgery Urology surgery Splenectomy
What is one advantage to cancer patients using MIS?
They will know if they are cancer free 1 month after surgery vs. 2 years of radiation with other measures.
What are the 4 types of anesthesia?
General
Regional
Local
Moderate sedation
What is general anesthesia?
Reversible loss of consciousness induced by inhibiting neuronal impulses in areas of the CNS.
How can general anesthesia be administered?
Inhalation
IV injection
Balanced
What is regional anesthesia?
Blocks multiple peripheral nerves in specific to body region.
Field, nerve, spinal and epidural.
What reverses local or regional anesthesia?
Lipids
What are the side effects that occur when a local or regional anesthetic gets into the blood stream?
Ringing of ears
Metallic taste in mouth
Seizures
What is moderate sedation anesthesia?
IV delivery of a sedative, hypnotic or opioid drug used to reduce the level of consciousness.
Allows patient to maintain airway and can respond to verbal commands.
Short action.
Who is responsible of maintaining airway in surgery?
Circulating nurse assists anesthesia provider.
What are common surgical positions?
6 positions
Supine Lithotomy Trendelenburg Lateral Jackknife Prone
What are interventions to avoid potential injury?
Prevent pressure ulcer formation-
Proper body position.
Prevent obstruction of circulation, respiration and nerve conduction.
What are the 3 phases of Post-Op?
Phase I: intensive, close monitoring
Phase II: less intensive monitoring (usually discharged from here)
Phase III: extended observation
What members on the surgical team are STERILE?
Surgeon Surgical assistants Scrub nurse Surgical technologist OR tech
What members on the surgical team are NON-STERILE?
Anesthesia provider
Circulating RN
Unlicensed assistive personnel
OR director/coordinator/manager
What is included in the Pre-Op assessment?
Patient knowledge of surgery, complications and interventions.
Validate and confirm consent was obtained.
Patient’s level of anxiety to manage pre-op and post-op concerns.
What are the goals of anesthesia?
Amnesia Analgesia Depression of reflexes Muscle relaxation Manipulation of physiological systems and functions.
What are high-risk surgery risks?
Long procedures
Vascular surgery
Demineralizing bone conditions (malignant metastasis or osteoporosis)
Excessive sustained pressure on the body
Who is at high-risk for positioning complications?
Geriatric Pediatric Skinny Obese Paralyzed Diabetic Prosthetic/arthritic joints Edema/circulatory limitations Infections Trauma
What are some examples of positioning devices?
OR bed Headrest Arm boards Arm restraints Padding bony prominences Blankets Pillows Safety straps Sand bags Bean bags Towels and sheets Foam pads Gel-devices
Post-anesthesia care is provided in what settings?
Inpatient PACU
Outpatient PACU
ICU
Procedure areas
What are the priority assessments during Post-Op?
Vital signs
Pain level/comfort level
Neurological function
Temp & color of skin
Condition of dressings & visible incisions
Presence and patency of IV caths & drains
Hydration status & fluid therapy
What does Post-Op handoff include?
2 identifiers Procedure Name & contact info Fluid intake & estimated blood loss Placement of IV & drains Important home meds Meds administered & to be administered Any clinical issues (actual or potential) Plan of care
What is malignant hyperthermia (MH)?
A genetic, hyper-metabolic state that causes sustained muscular contractions (increase in intracellular calcium).
Most common sign is skeletal muscle rigidity, unexplained tachycardia and myoglobinuria (amber to brown urine)
How do you treat malignant hyperthermia (MH)?
Administer DANTROLENE and cool the patient.
