PeriOP Lecture

Question 1

Informed Consent is comprised of 3 major things, what are they?

Answer 1

1. Adequate Disclosure
2. Pt must CLEARLY UNDERSTAND (Language, Education Barrier ETC.)
3. Consent must be given voluntarily
   * a pt can refuse surgery at anytime, and we must respect that

Question 2

What does Adequate Disclosure mean/ comprised of ? (6)

Answer 2

1. Risk of the procedure/ recovery of the procedure/ weeks out etc.
2. Outcomes/ Expectations for the procedure/Exploratory/Pallative
3. Diagnosis: whats wrong with me?
4. Risks of not having the procedure,” what will happen to me if i decide not to have it “ what are the other options
5. Purpose
6. Chances of success with the procedure

Question 3

MEDICAL EMERGENCY MAY OVERRIDE THE NEED TO OBTAIN CONSTENT BUT ONLY WHEN?

Answer 3

Next of Kin then if not available to get into contact HCP can contiue without this consent

Question 4

Pt. Must be NPO before procedures why?

Answer 4

There is a risk of Nausea, Vomiting and Aspiration

Question 5

What is the Universal Protocol or Surgical Time out?

Answer 5

Procedure
Allergies
Surgical Site
Pre-op (antibiotics, medication)
Extremity has to be marked pre-op
Nothing will start until the surgical time- out has been done

Question 6

PACU Nursing Interventions?

Answer 6

Frequent vital signs monitoring

Continuous ECG monitoring

Adequate fluid replacement

Assess surgical site for bleeding

Question 7

Phase I PACU Discharge Criteria: 6

Answer 7

1. Patient awake /Vital signs at baseline or stable
2. No excess bleeding or drainage
3. No respiratory depression/O2 Sat >90%
4. Pain controlled or acceptable
5. Minimal nausea and vomiting
6. Report given

Question 8

Phase II/III PACU discharge criteria: 5

Answer 8

1. All PACU discharge criteria met (Phase I)
   2.No IV opioid drugs for last 30 minutes
2. Voided
3. Able to ambulate if not contraindicated
4. Responsible adult present/written discharge instructions given and understanding confirmed

Question 9

Once you receive the patient from PACU, what are your initial steps?

Answer 9

1. Move pt to bed without injury or loss of lines
2. apply 02 if needed, stabilize IV, Foley
3. Introduce self, position pt to comfort
4. quick asses, LOC, Reassure/orient and Identify pt
5. get VS and attach tele

Question 10

Post Procedure Vital Signs
how often? and when are you clear to go back to routine VS monitoring?

Answer 10

• Every 15 min x 4
• Every 30 min x 4
• Every hour x 1
• Every 4 hours for the remainder of the 24 hours. If your patient is stable at the end of the 24 hour period, begin routine vital signs (every 4 hours).
  NOTE: Initial vital signs must be taken by licensed nurse accepting the patient and entered into the computer.