Perioperative

Question 1

3 phases

Answer 1

pre
intra
post

Question 2

pre phase

Answer 2

time pt decides to have surgery to OR table

Question 3

intra phase

Answer 3

OR to PACU

Question 4

PACU

Answer 4

post anesthesia care unit

Question 5

post phase

Answer 5

PACU to complete recovery

Question 6

3 types of urgencies

Answer 6

elective
urgent
emergency

Question 7

elective

Answer 7

scheduled, not urgent

Question 8

urgent

Answer 8

perform soon

Question 9

emergency

Answer 9

perform STAT

Question 10

ambulatory surgery

Answer 10

reduces length of stay
cuts costs
reduces pt stress
*stay home night before and come in for same day surgery

Question 11

risks: minor or major
what contributes

Answer 11

surgery length
under longer=greater risk

Question 12

6 purposes

Answer 12

diagnostic
curative
ablative
palliative
reconstructive
transplantation

Question 13

diagnostic

Answer 13

to diagnose

Question 14

ablative

Answer 14

removal of organ

Question 15

palliative

Answer 15

reduce intensity

Question 16

reconstructive

Answer 16

restore function

Question 17

transplantation

Answer 17

organs

Question 18

a biopsy is

Answer 18

diagnostic

Question 19

a hip replacement is

Answer 19

reconstructive

Question 20

debridement of injury is

Answer 20

palliative

Question 21

an appendectomy is

Answer 21

ablative

Question 22

main priority for preop

Answer 22

screening
teaching

Question 23

what is screening

Answer 23

identify risks so they don’t occur in OR

Question 24

risk factors to assess during screening

Answer 24

allergies
lab results
abnorm results
signed consent

Question 25

teaching is performed when

Answer 25

pre op phase

Question 26

teaching is reinforced when

Answer 26

post op phase

Question 27

preop meds/skin preps

Answer 27

sedatives anticholinergics histamine receptor antihistamines narc analgesics antibiotics hygiene and skin prep

Question 28

what do we teach

Answer 28

pain management coughing and deep breathing incentive spirometer meds

Question 29

what do coughing and deep breathing do

Answer 29

prevent pneumonia and atelectasis *anesthetics decrease ciliary movements- causes secretions to sit and lead to resp problems

Question 30

teach patient with midline abdominal surgery to

Answer 30

splint

Question 31

what meds to discontinue before surgery

Answer 31

blood thinners

Question 32

what meds do you continue

Answer 32

blood pressure beta blockers

Question 33

what do chest xrays tell us

Answer 33

infection heart failure lung info

Question 34

what does an EKG tell us

Answer 34

arrthymias

Question 35

what does a CBC tell us

Answer 35

WBC HCT HB *infection, anemia, platelets

Question 36

electrolytes tested

Answer 36

NA K CA CL

Question 37

what does K tell us about

Answer 37

heart

Question 38

what does NA tell us about

Answer 38

dehydration

Question 39

what does atelectasis turn into

Answer 39

pneumonia

Question 40

what do we need to know about illicit drug use

Answer 40

what type last use *to avoid withdrawals

Question 41

what is an advanced directive

Answer 41

legal document for pt specific instructions post op

Question 42

AND

Answer 42

allow natural death

Question 43

what risks do we want to minimize

Answer 43

aspiration intraoperative positioning injuries imbalanced body temp

Question 44

when are antibiotics hung

Answer 44

1 hour prior to first cut

Question 45

clear liquids up to ___ hours before surgery

Answer 45

2

Question 46

light breakfast ___ hours before surgery

Answer 46

6

Question 47

heavier meal allowed ___ hours before surgery

Answer 47

8

Question 48

main goal intraop

Answer 48

safety and monitoring

Question 49

how to prevent aspiration

Answer 49

fluids positioning

Question 50

bleeding/shock vital signs

Answer 50

increase HR decrease BP

Question 51

what does hypothermia lead to

Answer 51

decreased blood flow= less O2 to site= less nutrients

Question 52

what does general anesthesia affect

Answer 52

LOC analgesia relaxation loss of all reflexes

Question 53

what does regional anesthesia affect

Answer 53

analgesia loss of reflexes below site

Question 54

what does conscious anesthesia affect

Answer 54

analgesia amnesia

Question 55

what do topical/local anesthesia affect

Answer 55

analgesia

Question 56

example of regional

Answer 56

spinal block epidural

Question 57

which anesthesia has the greatest risk

Answer 57

general

Question 58

malignant hyperthermia

Answer 58

autosomal dominant trait *reaction to general anesthesia and neuromuscular blocking agents

Question 59

reactions from malignant hyperthermia

Answer 59

increased HR and RR leads to: hyperthermia dysrhythmias respiratory/metabolic acidosis

Question 60

malignant hyperthermia treatment

Answer 60

dantrolene

Question 61

main priority in PACU

Answer 61

assessment prevention of complications

Question 62

how long is normal stay in PACU

Answer 62

1 hour

Question 63

what reflexes do we need to see

Answer 63

cough and gag *protect airway

Question 64

nursing interventions for hemorrhage and shock

Answer 64

monitor BP and HR monitor I&O assess dressings and drainage monitor hgb and hct

Question 65

lung complications

Answer 65

thrombophlebitis pulmonary embolus

Question 66

what is a saddle embolism

Answer 66

goes into both pulmonary arteries and veins