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Nursing Essential: NAT > Periop nursing care > Flashcards

Periop nursing care Flashcards

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1
Q

what is periop nursing

A

before, during, and after surgery

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2
Q

what is the nurses role in stress and anxiety with surgery

A

answer questions, comfort, pain management, meds, CHG bath, SAFETY, education, mobility

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3
Q

what are the phases of surgery

A

preoperative, intraoperative, postoperative

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4
Q

what is preoperative phase

A

decision to have surgery

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5
Q

what is intraoperative phase

A

begins when pt enters OR

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6
Q

what is postoperative phase

A

begins when pt enters recovery room and ends when pt is recovered completely

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7
Q

what is the RN role in preoperative phase

A

health history, VS, head to toe, educate, consent, labs and start IV, gown and skin prep

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8
Q

what is the prep diagnostic test

A

anesthesia risk assessment

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9
Q

what are TJC

A

surgical timeouts

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10
Q

what do TJC do

A

decreases error + increases safety

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11
Q

what is the RN role in intraoperative phase

A

safety, infection prevention, VS, proper positioning, prep surgical site, surgical draping

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12
Q

what is a scrub RN

A

part of sterile field, prep equipment

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13
Q

what is a circulating RN

A

gets needed things, documents cut times, when entered organ, etc., walks around

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14
Q

what is lithotomy positioning used for

A

urethral, vaginal, and rectal

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15
Q

what is jackknife positioning used for

A

rectal and spine

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16
Q

what is the RN role of postoperative phase

A

asses pt: VS and priority assessments, prevent complications, promote healing

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17
Q

what is the criteria for discharge from the PACU

A

aldrete score

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18
Q

what is the aldrete score

A

scoring 0-2 on activity, respirations, consciousness, circulation, and oxygen sat

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19
Q

what are the different purposes for surgery

A

diagnostic, ablatie, constructive, reconstructive, palliative, cosmetic, transplantation

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20
Q

what are the different types of urgency for surgery

A

elective, urgent, emergent

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21
Q

what is elective surgery

A

improves QOL, planned in advance

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22
Q

what is urgent surgery

A

not immediately life threatening, done with 24 hours of diagnosis

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23
Q

what is emergent surgery

A

unanticipated and performed immediately, life threatening

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24
Q

what is a minor risk in surgery

A

alteration is minimal and low risk to life

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25
Q

what are examples of minor risk surgery

A

breast biopsy or cataract surgery

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26
Q

what is a major risk in surgery

A

higher risk to life and reconstruction/alteration to body

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27
Q

what are examples of major risk surgery

A

mastectomy and bowel resection

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28
Q

what are factors that affect degree of risk

A

general health, meds, cognition, nutrition, family history, previous surgery

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29
Q

what is malignant hyperthermia

A

hereditary, severe muscle contractions and rapid increase to body temp, life-threatening

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30
Q

what does malignant hyperthermia occur with

A

inhaled anesthetics or neuromuscular blocking agents

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31
Q

how do you treat malignant hyperthermia

A

IV dantrolene

32
Q

what is moderate sedation

A

conscious, amnesia, analgesia, IV pain meds & sedative, pt may speak and respond to commands

33
Q

what does amnesia do

A

can’t remember surgery

34
Q

what does analgesia do

A

don’t feel surgery

35
Q

what is general anesthesia

A

drug induced coma: CNS depression, loss of consciousness and sensation, skeletal muscle relaxation, inhaled gases and IV drugs,

36
Q

what does general anesthesia require

A

requires intubation and ventilator

37
Q

what are the risks of general anesthesia

A

circulation depression, MH, respiratory depression

38
Q

what is regional anesthesia

A

stops nerve impulse transmission, no intubation or loss of consciousness, area becomes numb

39
Q

what are examples of regional anesthesia

A

epidurals and local/topical anesthesia

40
Q

what are the safety concerns of surgery

A

wrong pt, procedure, site, and retention of foreign body

41
Q

how does unsafe surgery occur

A

lack of communication, teamwork, pt involvement, staff education, and ineffective leadership

42
Q

what happens during airway obstruction

A

tongue falls back on pharynx, laryngospasm, bronchospasm, or aspiration of gastric contents

43
Q

how to treat airway obstruction

A

jaw-thrust/chin lift, remove obstruction (suction), meds, reintubation, manual resuscitation

44
Q

what is hemorrhage

A

uncontrollable bleeding in pt

45
Q

what causes hemorrhage

A

weak suture, stress on site, meds, dislodged clot

46
Q

what are the S+S of hemorrhage

A

anxiety, cold, clammy, weak/thready rapid pulse, hypotension, rapid +deep respirations, decreased UO

47
Q

what can you do for hemorrhages

A

outline or reinforce dressings

48
Q

what is shock

A

circulatory system fails to maintain perfusion to vital organs

49
Q

what happens if shock is untreated

A

cell + organ death

50
Q

what is hypovolemic shock

A

most common, decrease in blood volume b/c of hemorrhage or dehydration

51
Q

what is the goal for treatment of shock

A

improve + maintain tissue perfusion, correct the cause

52
Q

how to correct the cause of shock

A

airway (ABC), VS, O2, supine elevated legs, labs, body temp, administer blood, IV fluids, meds

53
Q

what is thrombophlebitis (VTE)

A

inflammation of vein b/c of thrombus

54
Q

what causes thrombophlebitis

A

trauma, decrease blood flow, immobility, varicose vein

55
Q

S+S of thrombophlebitis

A

cramping, pain, redness, swelling in extremity

56
Q

what is the diagnostic procedure for thrombophlebitis

A

venous doppler ultrasound

57
Q

what is the nursing care for thrombophlebitis

A

PREVENTION: anti embolism stockings, SCD, leg exercise and ambulation

58
Q

what treatment is used for thrombophlebitis

A

anticoagulants, analgesics, elevate, measure, monitor clotting lab values

59
Q

what is a pulmonary embolism

A

blood clot detaches and lodges in pulmonary artery, can travel to brain or heart

60
Q

what are contributing factors of PE

A

venous stasis

61
Q

S+S of pulmonary embolism

A

anxiety, chest pain, dyspnea, cough, cyanosis, leg pain +swelling, dysrhythmias, tachypnea + tachycardia, hypotension

62
Q

what are nursing care for PE

A

PREVENTION

63
Q

what is the treatment used for PE

A

stabilize respiratory and cardiovascular systems, anticoagulants, administer O2, elevate HOB, bedrest, close monitor

64
Q

what is pneumonia

A

inflammation of lungs b/c of infection or foreign material

65
Q

what are the causes of pneumonia

A

aspiration, excessive pulmonary secretions, immobility, failure to deep cough, depressed cough reflex

66
Q

what are S+S of pneumonia

A

dyspnea, cough (productive or non productive), chest pain, fever, chills

67
Q

what is the nursing care for pneumonia

A

PREVENTION

68
Q

what is the treatment for pneumonia

A

promote lung expansion and prevent spread

69
Q

how to treat pneumonia

A

incentive spirometer, nebulizer, antibiotics, expectorants (muscinex), antipyretics, analgesics, semi/high- Fowlers, O2

70
Q

what its atelectasis

A

collapse of all/part of lung because of pressure on outside or blockage of air passages

71
Q

what happens during atelectasis

A

pulmonary secretions are retained: poor gas exchange

72
Q

what are the S+S of atelectasis

A

cough, dyspnea, diminished breath sounds, crackles anxiety, chest pains, cyanosis

73
Q

what is the treatment for atelectasis

A

lung expansion and improves oxygenation

74
Q

how to treat atelectasis

A

O2, analgesics, sit upright, TCDB Q2, ambulate

75
Q

what are contributing factors to wound complications

A

smoking, meds, pre-existing medical problems, infection, defective sutures, allergic reactions, obesity, coughing, sneezing, vomiting

76
Q

what are spinal/epidural complications

A

hypotension, bradycardia, nausea, vomiting, headache, urinary retention

77
Q

what is spinal/subdural hematoma

A

sharp pain radiating from back of leg, notify anesthesia for clot evacuation

Nursing Essential: NAT (10 decks)

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