Perio-operative nursing

Question 1

Why is it important to explain procedures or possible effects of medications prior to commencement or adminsitration?

Answer 1

Informs a patient and therefore are usually more willing to cooperate as it can reduce stress and promote relaxation

Question 2

In the PACU when are artificial airways removed?

Answer 2

• When coughing, swallowing and gag reflexes return

- When the patient is awake and can maintain their own airway

Question 3

Different ways to assess pain in adults?

Answer 3

Numerical rating scale

PQRST mnemonic

Question 4

Why are non-adherent dressings used in the post-op period?

Answer 4

Promotes absorption and minimises wound adherence to the dressing by dry exdudate

Question 5

Why are wound drains used?

Answer 5

To remove excess fluid from around surgical site in order to reduce:

• The tension placed on the wound by accumulated fluid
• The medium for microbial growth –> reducing infection
• Discomfort and pain

Question 6

Average time sutures remain insitu in a post-op wound?

Answer 6

5-10 days (can be left in up to 14 days)

Question 7

Where is the ileum and what is an illeostomy?

Answer 7

The ileum is the last section of the small intestine. An illeostomy involves making an incision in the abdomen and bringing the ileum through the incision to form a stoma

Question 8

AMPLE is involved in the pre-op assessment. What does it stand for?

Answer 8

A: allergies
M: medications 
P: pre-existing conditions
L: last ate and drank (have they fasted) 
E: event history

Question 9

What is involved in Pre-op education?

Answer 9

• Day of surgery routine and preparations required
• What to expect post-operatively
• Pain management
• Deep breathing and coughing exercises
• Discharge planning

Question 10

How should a patient be positioned after surgery?

Answer 10

• In the semi-fowlers position: on a 30 degree angle

- Elevate legs to promote circulation and reduce swelling

Question 11

What is involved in discarge planning?

Answer 11

• Return to work
• Ambulation tasks
• Type of pain relief
• Wound care education
• Follow up appointments

Question 12

What are 2 legal precautions prior to administering medication?

Answer 12

Check the allergies on medication chart to ensure no adverse reactions will occur

Obtain valid consent prior to giving medications or treatment

Question 13

What is involved upon return to ward?

Answer 13

• Conduct a primary survey, obtain vital signs.
• Provide analgesia as required
• Undertake post op orders
• Post-op wash
• Reinforce pre-op education and tasks

Question 14

What are potential complications during surgery?

Answer 14

• Hypoxia; due to airway mismanagement and deprivation of O2
• Hyoptension; due to agents used in anaesthetic
• Hypothermia: due to long time exposed
• Hypovalemia; due to excessive bleeding
• Anaphylactic reaction; agents used and medications given