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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
what are examples of minor risk surgery
breast biopsy or cataract surgery
26
what is a major risk in surgery
higher risk to life and reconstruction/alteration to body
27
what are examples of major risk surgery
mastectomy and bowel resection
28
what are factors that affect degree of risk
general health, meds, cognition, nutrition, family history, previous surgery
29
what is malignant hyperthermia
hereditary, severe muscle contractions and rapid increase to body temp, life-threatening
30
what does malignant hyperthermia occur with
inhaled anesthetics or neuromuscular blocking agents
31
how do you treat malignant hyperthermia
IV dantrolene
32
what is moderate sedation
conscious, amnesia, analgesia, IV pain meds & sedative, pt may speak and respond to commands
33
what does amnesia do
can't remember surgery
34
what does analgesia do
don't feel surgery
35
what is general anesthesia
drug induced coma: CNS depression, loss of consciousness and sensation, skeletal muscle relaxation, inhaled gases and IV drugs,
36
what does general anesthesia require
requires intubation and ventilator
37
what are the risks of general anesthesia
circulation depression, MH, respiratory depression
38
what is regional anesthesia
stops nerve impulse transmission, no intubation or loss of consciousness, area becomes numb
39
what are examples of regional anesthesia
epidurals and local/topical anesthesia
40
what are the safety concerns of surgery
wrong pt, procedure, site, and retention of foreign body
41
how does unsafe surgery occur
lack of communication, teamwork, pt involvement, staff education, and ineffective leadership
42
what happens during airway obstruction
tongue falls back on pharynx, laryngospasm, bronchospasm, or aspiration of gastric contents
43
how to treat airway obstruction
jaw-thrust/chin lift, remove obstruction (suction), meds, reintubation, manual resuscitation
44
what is hemorrhage
uncontrollable bleeding in pt
45
what causes hemorrhage
weak suture, stress on site, meds, dislodged clot
46
what are the S+S of hemorrhage
anxiety, cold, clammy, weak/thready rapid pulse, hypotension, rapid +deep respirations, decreased UO
47
what can you do for hemorrhages
outline or reinforce dressings
48
what is shock
circulatory system fails to maintain perfusion to vital organs
49
what happens if shock is untreated
cell + organ death
50
what is hypovolemic shock
most common, decrease in blood volume b/c of hemorrhage or dehydration
51
what is the goal for treatment of shock
improve + maintain tissue perfusion, correct the cause
52
how to correct the cause of shock
airway (ABC), VS, O2, supine elevated legs, labs, body temp, administer blood, IV fluids, meds
53
what is thrombophlebitis (VTE)
inflammation of vein b/c of thrombus
54
what causes thrombophlebitis
trauma, decrease blood flow, immobility, varicose vein
55
S+S of thrombophlebitis
cramping, pain, redness, swelling in extremity
56
what is the diagnostic procedure for thrombophlebitis
venous doppler ultrasound
57
what is the nursing care for thrombophlebitis
PREVENTION: anti embolism stockings, SCD, leg exercise and ambulation
58
what treatment is used for thrombophlebitis
anticoagulants, analgesics, elevate, measure, monitor clotting lab values
59
what is a pulmonary embolism
blood clot detaches and lodges in pulmonary artery, can travel to brain or heart
60
what are contributing factors of PE
venous stasis
61
S+S of pulmonary embolism
anxiety, chest pain, dyspnea, cough, cyanosis, leg pain +swelling, dysrhythmias, tachypnea + tachycardia, hypotension
62
what are nursing care for PE
PREVENTION
63
what is the treatment used for PE
stabilize respiratory and cardiovascular systems, anticoagulants, administer O2, elevate HOB, bedrest, close monitor
64
what is pneumonia
inflammation of lungs b/c of infection or foreign material
65
what are the causes of pneumonia
aspiration, excessive pulmonary secretions, immobility, failure to deep cough, depressed cough reflex
66
what are S+S of pneumonia
dyspnea, cough (productive or non productive), chest pain, fever, chills
67
what is the nursing care for pneumonia
PREVENTION
68
what is the treatment for pneumonia
promote lung expansion and prevent spread
69
how to treat pneumonia
incentive spirometer, nebulizer, antibiotics, expectorants (muscinex), antipyretics, analgesics, semi/high- Fowlers, O2
70
what its atelectasis
collapse of all/part of lung because of pressure on outside or blockage of air passages
71
what happens during atelectasis
pulmonary secretions are retained: poor gas exchange
72
what are the S+S of atelectasis
cough, dyspnea, diminished breath sounds, crackles anxiety, chest pains, cyanosis
73
what is the treatment for atelectasis
lung expansion and improves oxygenation
74
how to treat atelectasis
O2, analgesics, sit upright, TCDB Q2, ambulate
75
what are contributing factors to wound complications
smoking, meds, pre-existing medical problems, infection, defective sutures, allergic reactions, obesity, coughing, sneezing, vomiting
76
what are spinal/epidural complications
hypotension, bradycardia, nausea, vomiting, headache, urinary retention
77
what is spinal/subdural hematoma
sharp pain radiating from back of leg, notify anesthesia for clot evacuation

Nursing Essential: NAT (11 decks)

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