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nursing theraputics > Perioperative > Flashcards

Perioperative Flashcards

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0
Q

Intraoperative

A

In OR

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1
Q

Preoperative

A

Scheduled then transferred OR

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2
Q

Postoperative

A

PACU, ACU, ICU through follow up provider visit

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3
Q

Categories for surgical procedures

A 
Diagnostic/exploratory
Curative 
Ablative
Reconstructive 
Palliative (reduce pain or symptoms)
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4
Q

General classifications

A

Major

Minor

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5
Q

Preoperative care

A 
Client history 
 Medical history
 Medications
 Allergies 
 Tobacco/ETOH/other use
 Psychosocial/economic factors
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6
Q

Physical assessment

A 
General 
Head and neck
Integument
Chest and lungs
Cardiovascular 
GI
GU
Neuro and mobility
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7
Q

Diagnostic tests

A 
UA
Chest x-Ray
CBC
Blood type and cross match
Electrolyte 
Fasting blood glucose 
BUN and creatine 
ALT, AST, LDH, bilirubin
Serum albumin and total protein
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8
Q

Informed consent

A 
Nature and purpose
Expected outcomes
Risks and benefits 
Alternatives to procedure
Effect of not having procedure
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9
Q

Developmental considerations

A 
Infancy 
Toddler
Preschoolers
School age
Adolescent- body issues, privacy
Adults-anxiety
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10
Q

Physical preparation

A

Anesthesia assessment
Skin prep
GI prep

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11
Q

Day of surgery

A 
Consent
Baseline VS
Teeth
Dress
Void
Nail polish
Jewelry
Hearing aids
Glasses/contacts
Medications
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12
Q

Intraoperative care

A

Surgical asepsis
Surgical scrub
Sterile field

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13
Q

Anesthesia

A 
Moderate sedation (conscious sedation) 
  IV narcotics and anti-anxiety agents

Regional anesthesia
Local, nerve blocker, epidural, spinal anesthesia

General anesthesia

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14
Q

Anesthetic agents

A

Inhalation

IV

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15
Q

Stages of anesthesia

A

Stage 1- introduction
Stage 2- excitement
Stage 3- appropriate for procedure
Stage 4- don’t want to go here

16
Q

Environmental hazards

A

Equipment
Latex allergy
Exposure to blood and body fluids

17
Q

Nursing roles

A 
Scrub nurse
Circulating nurse
Admin IV infusion and medication 
Positioning
Grounding 
Monitor
18
Q

The universal protocol joint commission

A
  1. Conduct pre-procedure verification process
  2. Mark the procedure site
  3. “Time out”
19
Q

Potential complications

A 
N/V 
Respiratory 
Hypothermia
Malignant hyperthermia 
Paresthesia and impaired skin integrity 
Excessive fluid and blood loss
20
Q

Immediate post-op care

A

Receive report
Assess effects of anesthetic agents and surgical procedures
Monitor vital functions
Provide comfort and pain relief

21
Q

Assessment in PACU

A 
Maintain patent airway (priority)
Maintain cardiovascular stability 
Assess for hypotension or shock
Assess for hemorrhage 
Assess for hypotension and dysthymias
Relieve pain and anxiety 
Assess neuro status 
Body temp 
Integument
22
Q

Discharge criteria from PACU

A

VS
Gag reflex
Arousable

23
Q

Discharge criteria from ambulatory surgical unit

A 
A&O
No respiratory distress
Cough, swallow, walk
No vomiting
Voided
Pain
Bleeding
Driver
24
Q

Post-op care on nursing unit

A 
Report
Assessment 
  Respiratory
  VS and circulation 
  Surgical site and drainage 
  Pain
  I&O
  Voiding
25
Q

Post-op problems (respiratory)

A

Pneumonia
Atelectasis
Pulmonary embolism

26
Q

Post-op problems (circulatory)

A 
Hemorrhage 
Hypovolemic shock
Thrombophlebitis 
Thrombus 
Embolus
27
Q

Post-op problems (urinary)

A

Urinary retention

Urinary tract infection

28
Q

Post-op problems (gastrointestinal)

A

N/V
Constipation
Tympanites
Ileus

29
Q

Post-op problems (wound)

A

Infection
Dehiscence
Evisceration

30
Q

Surgical site infection

A 
Up to 5% of operation develop SSI
30% require readmission
Occurs within 30days of surgery or 1year of o
Implant
Source of pathogen for most-skin flora
31
Q

Risk factors

A 
Uncontrolled DM
Smoking
Long term steroid use
Malnutrition 
Morbid obesity
Existing infection 
Hypothermia and hypoxia 
Lack of adequate skin prep
Length of operation 
Improper asepsis

nursing theraputics (2 decks)

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