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Med Surg - Exam 1 > Peri-Op > Flashcards

Peri-Op Flashcards

1
Q

What is diagnostic surgery? What are 2 examples?

A

Determines origin & cause.

Colonoscopy & laparoscopy

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2
Q

What is curative surgery? What are 2 examples?

A

Resolves the problem by repair or removal.

Appendix or gallbladder

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3
Q

What is restorative surgery? What is an example?

A

Improves functionality.

Knee replacement

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4
Q

What is palliative surgery? What is an example?

A

Relives a symptom but may not be a cure.

Cancer or tumor

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5
Q

Risks related to elderly: what is DECREASED in elderly?

1.
2.
3.

A

Cardiac output
Periphery
Circulation

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6
Q

Risks related to elderly: what is INCREASED in the elderly?

1.
2.
3.
4.
5.
A 
Blood pressure
Skin damage
Infection
Sensory deficits
Deformities
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7
Q

What is MIS (minimally invasive & robotic surgery) preferred for?

1-7

A 
Cholecystectomy (gallbladder)
Joint surgery
Cardiac surgery
Spinal surgery
GYN surgery
Urology surgery 
Splenectomy
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8
Q

What is one advantage to cancer patients using MIS?

A

They will know if they are cancer free 1 month after surgery vs. 2 years of radiation with other measures.

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9
Q

What are the 4 types of anesthesia?

A

General
Regional
Local
Moderate sedation

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10
Q

What is general anesthesia?

A

Reversible loss of consciousness induced by inhibiting neuronal impulses in areas of the CNS.

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11
Q

How can general anesthesia be administered?

A

Inhalation
IV injection
Balanced

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12
Q

What is regional anesthesia?

A

Blocks multiple peripheral nerves in specific to body region.

Field, nerve, spinal and epidural.

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13
Q

What reverses local or regional anesthesia?

A

Lipids

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14
Q

What are the side effects that occur when a local or regional anesthetic gets into the blood stream?

A

Ringing of ears
Metallic taste in mouth
Seizures

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15
Q

What is moderate sedation anesthesia?

A

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.

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16
Q

Who is responsible of maintaining airway in surgery?

A

Circulating nurse assists anesthesia provider.

17
Q

What are common surgical positions?

6 positions

A 
Supine
Lithotomy
Trendelenburg
Lateral
Jackknife
Prone
18
Q

What are interventions to avoid potential injury?

A

Prevent pressure ulcer formation-
Proper body position.
Prevent obstruction of circulation, respiration and nerve conduction.

19
Q

What are the 3 phases of Post-Op?

A

Phase I: intensive, close monitoring
Phase II: less intensive monitoring (usually discharged from here)
Phase III: extended observation

20
Q

What members on the surgical team are STERILE?

A 
Surgeon
Surgical assistants 
Scrub nurse
Surgical technologist 
OR tech
21
Q

What members on the surgical team are NON-STERILE?

A

Anesthesia provider
Circulating RN
Unlicensed assistive personnel
OR director/coordinator/manager

22
Q

What is included in the Pre-Op assessment?

A

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.

23
Q

What are the goals of anesthesia?

A 
Amnesia
Analgesia
Depression of reflexes
Muscle relaxation 
Manipulation of physiological systems and functions.
24
Q

What are high-risk surgery risks?

A

Long procedures
Vascular surgery
Demineralizing bone conditions (malignant metastasis or osteoporosis)
Excessive sustained pressure on the body

25
Q

Who is at high-risk for positioning complications?

A 
Geriatric
Pediatric 
Skinny
Obese
Paralyzed
Diabetic 
Prosthetic/arthritic joints
Edema/circulatory limitations
Infections 
Trauma
26
Q

What are some examples of positioning devices?

A 
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
27
Q

Post-anesthesia care is provided in what settings?

A

Inpatient PACU
Outpatient PACU
ICU
Procedure areas

28
Q

What are the priority assessments during Post-Op?

A

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

29
Q

What does Post-Op handoff include?

A 
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
30
Q

What is malignant hyperthermia (MH)?

A

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)

31
Q

How do you treat malignant hyperthermia (MH)?

A

Administer DANTROLENE and cool the patient.

Med Surg - Exam 1 (4 decks)

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