Peri-op nursing Flashcards by Ericka Berman

What is an elective surgery?

A surgery with no immediate emergency, so it can be scheduled

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What is an urgent surgery?

A surgery needed soon

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What is an emergency surgery?

A surgery needed immediately

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What is a diagnostic surgery?

For testing; biopsy

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What is an ablative surgery?

Surgery taking care of a diseased part

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What is a palliative surgery?

A surgery to improve the quality of life

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Why is the assessment important in periop nursing?

It’s used to ID patient’s norms to recognize, prevent, and minimize postop complications of surgery

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Why is nutrition a risk factor for surgery?

Need a balanced diet for healing
No eating for ~8 hrs beforehand
Need to have conversation pre-op on post-op diet

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Why is obesity a risk factor for surgery?

Medication needed
Potential increased blood loss
Mobilization
Post-op complications
Breathing
Healing slower

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Why is sleep apnea a risk factor for surgery?

At risk for cardiac disease

Important for knowing if you get intubated

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What is the nursing implication for the CV system during surgery?

Vital signs, fluid balance; leg exercises (for DVT)

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What is the surgery risk for the pulmonary system?

Cough and deep breathe, ambulate

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What is the surgery risk for the renal system?

Baseline urinary output/ response to meds

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What is the surgery risk for the neuro system?

Orient; Inspect for signs of pressure (ulcers)

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What is the surgery risk for the metabolic system?

Monitor labs

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What age tends to have lower urine output?

Elderly pts

Can have a problem with incontinence

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What is the rule for older patients and medication?

Start low, go slow

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What types of medications need to be considered preop?

Anticoagulants
Insulin
NSAIDS
OTC
Supplements/herbs
Rec drugs

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Why might Heparin be given in the hospital?

Anticoagulant with a short half life

What can be used to counteract Coumadin?

Vitamin K

Is insulin given in the hospital even if the pt isn’t eating?

Yes

What diagnostic tests should be done?

CBC, serum electrolytes, coagulation, serum creatinine & BUN

What is autologous blood donation?

Taking blood from the pt preop and giving them back their own blood postop

Which surgeries have the biggest blood loss?

Orthopedic surgeries

When should postop care be taught?

Preop

In which pts is delayed surgical recovery seen?

Diabetic pts

When should intervention be provided for pain?

During discomfort because it's easier to slow the progression

Who gets informed consent?

Physicians. Nurses can witness it

What is included in preop teaching?

Reasons for preop instructions and exercises Time of surgery Postop unit and location of family during surgery and recovery Anticipated postop monitoring and therapies Surgical procedures and postop treatment Postop activity resumption Pt verbalizes pain relief measures Pt expressing feelings Sensations related to surgery and anesthesia Instructions on preop orders Invasive procedures (IV, NG, catheters) Turn, cough & deep breathe/splinting/positioning Lower extremity exercises/DVT prevention Early ambulation Pain management

What is included in the preop check list?

``` Patient’s name band Consents obtained Allergies Vital signs Hygiene/Skin prep Personal belongings IV access; blood availability Marking OR site Bowel/bladder prep (document time) Preop med (safety - complete necessary activities before meds) Transport Family ```

When are prophylactic antibiotics used?

For anaerobic organisms

Are razors used for hair removal?

What is a circulating nurse?

Nurse that evaluates the patient’s ongoing clinical status | Continuously monitor vital signs and intake and output

What is general anesthesia?

Loss of sensation/consciousness | Risks associated

What is regional anesthesia?

Loss of sensation in one area of the body | Nerve block, epidural or spinal

What is local anesthesia?

Loss of sensation at a site | Topical/local infiltration

What is a time out?

Procedure aimed to prevent medical and surgical errors. Conduction of a final verification of the correct pt, procedure, surgical site.

When is a time out done?

As the pt is brought into the OR

What is included in the operative report postop?

Procedure, anesthesia, blood loss, blood products, fluids, drains

What is impt in postop care?

``` Maintaining resp function Preventing circulatory complications Achieving rest and comfort Temp regulation Maintaining neurological function F&E balance Bowl elimination/adequate nutrition Urinary elimination Wound healing Self-concept ```

What surgery puts a pt at the highest risk for DVT?

Pelvic surgeries

What is paralytic ileus?

When a portion of the ileum remains sleeping after surgery | Can be medically or surgically treated

When is risk for hemorrhage greatest?

First 24 hours | Later - DVT

When is a distended abdomen expected?

After laparoscopic surgery

What are risk factors for dehiscence?

Conditions that impair circulation, tissue oxygenation, and wound healing Mechanical stress on the wound

How can we avoid dehiscence?

Stool softeners to prevent straining during defecation and alleviate constipation Antiemetics PRN to prevent straining that can occur with vomiting Abdominal binder - reduce mechanical stress Monitoring blood sugar to maintain tight glycemic control (<140 mg/dL [7.8 mmol/L] fasting glucose, <180 mg/dL [10 mmol/L] random glucose) Splinting