Periop care

Question 1

Includes all part of surgery like…

Answer 1

1. maintain strict infection control
2. monitor pt physical and psychological response to surgery
3. maintain pt safety

Question 2

Phase 1

Answer 2

Preop
- prepare pt for surgery including preassessment and signing consents
(NPO, labs, check abnormalities)

Question 3

Phase 2

Answer 3

Intraop
- the surgery time itself while in operating room

Question 4

Phase 3

Answer 4

Postop
- period immediately after surgery

Question 5

Classifications of surgery

Answer 5

1. seriousness
2. urgency
3. purpose
   - can fall into more than 1
   - same procedure is performed for different reasons (urgent vs. emergent

Question 6

Seriousness

Answer 6

Major: reconstruction/ alteration of body parts
- lung resection, coronary artery bypass

Minor: minimal alteration in body parts w/ minimal risk
- tooth extraction, cataract surgery

Question 7

Urgency

Answer 7

Elective: pt choice
- rhinoplasty, breast reduction

Urgent: necessary for pt health
- cholecystectomy, excision of cancerous tumor

Emergency: immediately to save life/ function of body part
- ruptured appendix, internal hemorrhaging

Question 8

Purpose

Answer 8

1. diagnostic: surgical exploration and biopsy to confirm
   - breast mass biopsy
2. ablative: removal of diseased body part
   - amputation, gallbladder removal
3. palliative: relieves/reduces intensity of disease symptoms but does not cure
4. reconstructive: restore function or appearance of malfunctioning tissue
5. procurement: for transplant
   - removal of organs/tissue from donor
6. constructive: restores function due to birth defects
7. cosmetic: improve appearance

Question 9

Risk factors

Answer 9

• smoking
• age
• nutrition
• obesity
• obstructive sleep apnea
• immunosuppression

Question 10

Checklist for effective communication

Answer 10

1. prior to administration of anesthesia
2. prior to skin incision
3. prior to pt leaving OR

Question 11

“time out procedures”

Answer 11

• called by member designated or not
• pt should be awake
• must be standardized at every institution
• confirm right pt, procedure, sight

Question 12

glycemic control and infection prevention

Answer 12

• monitor glucose levels for diabetics and prediabetics
• relationship between wound/tissue infection and glucose levels
• hyperglycemia increase pt risk for adverse effects
• surgery creates stress response altering glucose levels

Question 13

Preop education

Answer 13

• reduce anxiety
• realistic expectation
• collab decision making
• reduce postop complications
• manage/lessen pain
• reduce costs
• lessen depression

Question 14

Notes

Answer 14

• postop n/v affects 30% of pt
• postop urinary retention affects 70% of pt
• VTE: increase longer than 90 mins (never event)
• VTE: increases longer than 60 mins for pelvis and lower limbs, acute surgery, inrta-abdominal conditions